Wi-Fi and satellite rapid deployment
Manchester University NHS Foundation Trust is using bespoke satellite connectivity to provide internet access to community hubs.
As part of the 23/24 Wireless Trials intake, NHS England is collaborating with Manchester University NHS Foundation Trust. The goal is to explore bespoke satellite connectivity for providing internet access to community hubs, enabling the formation of pop-up medical sites where traditional fixed line connectivity isn’t available.
The trust operates 10 hospitals in Greater Manchester and is the largest foundation trust in England, employing over 280,000 staff. The trial aims to provide agile connectivity solutions to support clinical service delivery. If successful, it will enable the trust to provide connectivity to remote locations and ensure resilience during unexpected connectivity issues.
Problem statement
Over the last decade, reliable and fast connectivity has become vital for effective care but remains a significant challenge for the NHS. As care focus shifts from hospital to community, there is a clear need for a reliable solution to support both city centre and remote community care sites. Remote and rural residents face unique healthcare challenges, including limited transportation, longer distances to medical facilities and digital connectivity gaps. Currently, the trust relies on laptops with 4G connections to access the internet in remote settings and sites where their own Wi-Fi isn’t available.
This method is often slow and ineffective in low coverage areas, making it difficult to access and update patient records. The problem worsens when multiple users or teams try to connect, impacting clinical service delivery during regular care and proactive health campaigns. The trust needs a solution for rapid hub deployment in emergencies like disasters or illness outbreaks. In urgent situations, staff must quickly and reliably access patient records and secondary services.
Currently, care provision from such sites is severely impacted by the available connection quality. Continued connectivity is required during disruptions to a central trust site's regular connection, such as blackouts or cyber incidents. In these situations, the connectivity challenges are similar to those in remote and rural environments, currently relying on the same 4G backup solution. Therefore, Manchester University’s trial focuses on using satellite connections to support cloud-based applications, providing ad hoc connectivity to nearly any location. This will satisfy multiple use cases for the trust, and provide multiple benefits:
- Improved connectivity for remote sites - Ensures seamless access to patient records, enabling healthcare professionals to deliver higher-quality care in non-traditional settings. Accommodates both long-term and temporary health sites for community care
- Improved clinical service delivery – Reliable, high-speed internet access enables efficient clinical service delivery, positively impacting patient outcomes and easing clinicians' routines
- Business continuity assurance – Ensures uninterrupted services, reducing the risk of disruptions due to connectivity issues
- Cost savings and resource optimisation - Efficient connectivity methods lead to cost savings by optimising clinician and technical resource allocation and reducing operational downtime
- Support for urgent services - Enables the establishment of connected vaccination hubs or other urgent services in areas with little to no connectivity during illness outbreaks
Trial details
The trust aims to use Low Earth Orbit (LEO) satellite connectivity technology as an initial proof of concept for remote site solutions.
Satellite Connectivity
Satellite internet technology allows data transmission and reception via a compact satellite dish, communicating with a satellite above the earth’s surface. The satellite transmits and receives data between the site and a network centre over the internet, ensuring a smooth connection.
1. A new permanent (or semi-permanent) site in a remote location
Here, a new long term health hub is set up - in this example, the only method of connection would be via satellite. This connection would allow for the establishment of a new remote health hub or offer improvements to an already existing permanent site.
The connection utilises the satellite connection to transmit and receive data from one of the trust’s data centres. The data is sent from a device, through the site’s router to the site’s satellite dish, which will communicate with the LEO satellite by using radio waves to transmit data.
Deployment is quick: ship a pre-packaged box of equipment (router and firewall software) and a Starlink dish to the new site to get it up and running. As the site would be intended to stay active for a long time, a fixed business grade satellite would be installed.
2. All use cases include firewalls and an IPsec tunnel to ensure the transfer of sensitive patient information meets NHS England's security standards
Similar to the first user case, but the site is temporary and will be moved or taken down after a short period. This setup allows the trust to respond to rapidly evolving crises or set up short-term rotating clinics in remote areas.
3. Mobile site connectivity – van or ambulance
If the trust requires satellite connectivity on the move, they can use a business mobile dish to maintain a connection where required.
This setup allows a mobile vehicle (such as an ambulance) to provide healthcare in difficult-to-reach areas or ensure connectivity during community care. This use case was not in scope for the trial but represents a possible application of the technology.
4. Remote single user
In this case, a residential satellite link will provide a wide area network (WAN) connection to a user who resides in a remote location and needs connectivity that a physical or cellular line cannot provide.
This use case provides additional flexibility to the trust. If a remote residence needs connectivity (for example a specialist consultant working from home), it can be accommodated similarly to use case 2.
All existing security policies will apply to the remote user, using a secure endpoint client to connect to the trust’s data centres.
By exploring these use cases, MFT is looking to thoroughly test the practical viability of satellite connectivity in a variety of health settings, providing recommendations to the system as the NHS continues to explore this new technology.
Deployment
The initial designs for the technology architecture were revised upon engagement with MFT’s solution and implementation partner, White Spider. Both high-level and low-level designs were approved by both organisations, and the construction of the solutions for the different use cases commenced.
Each use case has had their own deployment and will be covered individually below:
This use case involved a fixed remote site that required secure connectivity to the NHS network via Starlink. It evaluated MFT's ability to rapidly establish connectivity to a remote community location, useful in the event of a primary connectivity failure, such as a disruption of fibre, or where a traditional connection is not feasible, such as when utilising a remote location.
The trust arranged to pilot the solution at Lancaster based Special Education Needs (SEN) School with the involvement of relevant stakeholders, including the school's IT provider and management.
MFT wanted to implement this solution in a school setting to assist the School Nursing team that serves several special needs schools in the Trafford and South Manchester area. Previously, these staff members accessed systems using the school's infrastructure and a "telehealth solution," which proved very unreliable, making it difficult for staff to stay connected to the network.
A baseline staff survey was conducted prior to the installation of the Starlink solution, which confirmed the issues experienced by the staff. The response indicated that connectivity problems were impacting their ability to work effectively and negatively affecting their job morale.
An initial site survey took place, with additional visits required by the Starlink installers to ensure proper installation of the mounting and acceptable cabling routes. This had to be accommodated in the project plan and added delays to the initial planned install date.
Deployment occurred without any further delays or issues, and once implemented the solution's design required no operational changes by staff, as the devices would automatically connect like other MFT locations.
Post deployment, staff at the site can now connect to the MFT network. This deployment streamlined connectivity by allowing their devices to connect to the trust’s Wi-Fi by default and eliminating the need for additional steps to access MFT systems.
The trust is planning to conduct regular visits to the school to ensure that the solution is still working as planned.
Due to a major hardware failure at the trust, MFT had to utilise their satellite connectivity technology in a non-trial event that occurred over one weekend in November 2024.
With both Wi-Fi and wired network connectivity unavailable, the Starlink solution was rapidly deployed to ensure internet and email access was possible, which was required to collaborate with external partners from the Trust's command room.
This command room, situated in the Trust HQ building is an old, listed building with limited mobile signal availability, so the satellite receiver was mounted on the roof. Staff was also able to use the built-in Wi-Fi feature for internet access, calls, and updating WhatsApp groups, thereby effectively managing the outage.
This practical and urgent deployment demonstrates that the solution is able to mitigate the effects of losing primary connectivity and can be deployed rapidly and effectively to allow health sites of continue with regular business functions.
This use case involved a temporary remote site requiring secure connectivity to the MFT network via Starlink. This case evaluates MFT's capability to rapidly establish connectivity at new locations lacking a primary connection, such as a pop-up clinic at a school to support nursing staff with local vaccination efforts.
MFT implemented this solution at the Mount Road Sure Start Centre to enhance the Speech and Language services. This team supports several centres, but the location chosen for deployment has consistently received complaints from staff regarding poor connectivity, with one surveyed staff member adding:
“We require increased time needed to complete admin as we cannot rely on connectivity so whilst we may have planned to work from Mount Road, we then have to travel somewhere else to connect which disrupts plan for the day. Often can’t access resources needed for home visits so we must make do with what available rather than the specific resource needed for that patient which impacts quality of delivery”
Various stakeholders operate from these centres, and previously, staff had to depend on the local Sure Start Wi-Fi for internet access. Once internet access was established, MFT clinical systems were accessed via a secure virtual desktop solution. However, due to poor Wi-Fi connectivity, this process frequently failed, resulting in delayed record-keeping.
The deployment was expected to be an easy process, but delays occurred due to the building design and security considerations of the equipment. This required installer visits and surveys to be completed before the solution could be deployed and added considerable time to the project plan.
Similarly to use case 1, once deployed the solution allowed staff at this site to connect far more effectively to the MFT network, similarly as if they would do at any trust-owned location.
This use case involved evaluating a solution to offer reliable and high bandwidth connectivity for remote lone users in locations with connectivity challenges. This case assesses using Starlink for connectivity paired with an always-on VPN solution to provide access to MFT's network.
The solution was tested and confirmed to be fully operational, achieving connectivity speeds surpassing a traditional fibre connection, sometimes reaching up to 400Mbps. Coupled with MFT’s global protect VPN solution, individuals can access all network resources as if they were in an office or onsite at the hospital from any location.
This use case was expanded to include testing the solution from outside the UK, specifically in Italy, as a key staff member will be working offsite for a period. This ensures that key projects and decisions are not delayed.
The staff member trailing this option used a standard encrypted Trust laptop with a global protect VPN solution, which creates a secure data tunnel and includes multifactor authentication. This ensures that security concerns are addressed when working from outside of the UK.
During the trial, the trust was made aware of the NHS Governance requirements for accessing data from outside the UK and ensured that connectivity via this will comply with them.
Post deployment, the trust has decided to create some simple instructional material for users of this solution, as although it is packaged up and easy to deploy, there are some technical aspects that could cause difficulties for first time users.
Trial results
MFT have demonstrated three different applications of Satellite connectivity in all use cases, baseline connectivity has been established for robust and reliable connections, proving the efficacy of a satellite solution for both long term and temporary access to the internet.
In every installation, connectivity was improved for the two trial sites, the remote user, and even the trust itself, the satellite solution has vastly improved the availability and quality of access to MFT’s systems.
Installations took more time than originally estimated in every installation, there were additional delays caused by additional details and site visits that needed to be planned around. However, even with these delays’ installation was faster that using alternate fixed connectivity methods.
Satellite installations on mobile units can be complex the trust decided to not go ahead with use case 3 (Mobile health unit) due to complications with third party stakeholders and space constraints for equipment installation. Whilst the trust plans to return to this use case in the future, their main advice is to work early with the teams that will be using the mobile unit to plan the deployment thoroughly.
Lessons learned
The trust has provided a series of lessons learned from their deployment, to assist other organisations interested in utilising a similar satellite connectivity deployment at their hospital or trust:
| Activity | Lessons learned |
|---|---|
| Satellite field of view | The satellite needs a clear view of the sky, typically requiring rooftop placement to avoid damage or movement. |
| Outbound connectivity | Outbound connectivity and configuration can be problematic: We used manually configured tunnels back to the data centre instead of SD-WAN, which worked well. |
| Deployment special requirements | Adequate space to site and operate the equipment is required: Our testing indicated that our mobile units were unsuitable due to limited space, so further work is required. |
| Installation activity adaptation | Installation tasks and time allocations were initially a guesstimate in the project plan, it was only once the physical visits and assessment was complete by partners and a true position on tasks and times was definable. These new set of tasks required quick coordination as different parties were required to complete inter dependant tasks. This was not completed effectively which led to otherwise avoidable delays. |
| Installation validation checks | Automation of software deployment was assumed to have been completed, and only when the staff member (use case 3) was in Italy it was discovered that this had not fully deployed. Installation validation checks should have been completed before user went to work from Italy. |
| Offline mode devices | Staff at some of the locations had been using devices not connected to the network (Offline Mode) therefore required to resynched to active directory before they were able to get connectivity working correctly. |
| Deployment activities | The deployment speed depends on several factors that influence the installation timeline, including equipment security, mounting on different surfaces, cable planning, and various assessments required by stakeholders to ensure safe installation. |
| Supplier Management |
A clear definition upfront of the configuration that the satellite technology supplier will be performing is recommended. This would help preventing setbacks and it would also allow for the timely assessment of what activities can transition to be owned by the NHS organisation directly. |
| Activity planning |
Some of the setbacks experienced with deployment activities (for example SD-WAN challenges and other Firewall problems) were unrelated from the Satellite technology. The recommendation is to test connectivity parameters in parallel to the planning of the Satellite technology. |
| Timeline planning | The planning process failed to consider staff leave and holiday closures of certain sites, resulting in delays in equipment deployment due to the need for coordination between installation resources and onsite teams |
Conclusion
When considering these use cases, it becomes clear that the trust is looking to deploy a solution that will allow them to both cover remote areas and respond to emerging events with agility. Additionally, the ease of setting up a similar solution elsewhere means that access to connected healthcare can be easy and affordable for trusts.
If successful, this trial could help inform the NHS of the successes and challenges involved with satellite connectivity, as well as offer a way to overcome many difficulties with remote connectivity. Although the deployment is currently in early stages, we will continue to update this space to cover the trust’s deployment and detail the benefits they will realise.
Contact us
If you are looking into satellite connectivity as a solution to an issue your trust is facing, please get in touch at [email protected] and we will be happy to collaborate and put you in touch with Manchester University NHS Foundation Trust.
Last edited: 26 March 2025 8:58 am