Message Exchange for Social Care and Health

Message Exchange for Social Care and Health (MESH) provides the ability to share data directly between health and care organisations and is the nationally recognised mechanism for this method of data sharing.

MESH can be used to:

• transfer large files (up to 50GB) securely from one organisation to another
• send a file to someone's GP, using their NHS number and other details
• send documents, in human-readable formats such as PDFs, or machine-readable structured messages, such as FHIR messages, CSV files or binary files

MESH enables any health and social care organisations, including both frontline and backend services, to send and receive messages.

MESH provides two modes of data transfer:

System to system – MESH can be directly integrated into point-of-care applications, using either a client or an Application Programming Interface (API).

User interface – a web-based service for ad hoc transfers of smaller messages.

MESH is used across the UK and is also available for non-UK cases to transfer data across Health and Care organisations.

MESH provides the ability to share data directly with other organisations and we recommend its use in this context.

You can use MESH to send messages of any type, for many reasons.

Support for direct care

• send and receive vaccination data to NHS and supplier systems
• send machine readable pathology reports securely and reliably to GP Systems
• receive reliable data that ensure patients record are updated correctly

Large data transfers

• send datasets to NHS England
• receive a list of NHS numbers from the national data opt-out programme

For a full list of nationally-defined messages, visit our API catalogue, filtered to show MESH integrations.

MESH enables senders and recipients to exchange messages securely and reliably. 

1. Sender uploads a message to MESH via their outbox.
2. The MESH service holds the message until the recipient is able to retrieve it.
3. The recipient retrieves the message and acknowledges the successful download of it. We recommend polling to retrieve every five minutes.
4. Sender is able to track the delivery status of sent messages.
5. A non-delivery report will be sent to the sender if the recipient doesn't retrieve the message within 5 days.

The service also provides message routing controls and directory services. Messages can be given a Workflow ID, which helps recipients understand the type of message they are receiving. For more information, visit MESH: Workflow Groups and Workflow IDs.

MESH supports 2 delivery-routing configurations - carbon copy (CC) and redirect.

These configurations allow messages to be duplicated or re-routed based on predefined criteria. They are applied automatically by the service when a message meets the configured conditions.

Overview of CC and redirect

CC creates an additional copy of a message and delivers it to another mailbox. The copied message will produce a new message with a different MESH message ID. The original recipient still receives the message.

Redirect replaces the original recipient with a different mailbox. The original recipient does not receive the message.

Both CC and redirect are applied during message delivery. They are configured by the MESH service team.

Difference between duplication (CC) and redirection

CC delivers to the original recipient and to one or more additional recipients.

Redirect delivers only to the replacement recipient. The original recipient does not receive the message.

Examples

CC example (copy for an authorised partner system) - a GP practice receives discharge summaries on a workflow ID. A CC rule on the practice mailbox copies each message to an authorised partner mailbox so both receive the same content automatically.

Redirect example (temporary division) - during a migration, a redirect rule routes results for a workflow to a new mailbox. When the migration completes, the rule is removed.

Configuration

CC and redirect are defined using configuration entries managed by the MESH service team. End users and senders cannot set rules themselves.

CC configuration requirements

The required field is:

• cc_to_mailbox_id (target mailbox)

Plus at least one of:

• cc_if_sender
• cc_if_recipient
• workflow_id

Redirect configuration requirements

Required fields are:

• redirect_to_mailbox_id (replacing mailbox)
• redirect_if_recipient (original intended recipient)

Configuration notes

A GP practice may receive multiple workflow IDs. Where needed, create separate CC rules per workflow.

Some workflows are restricted (such as GP Connect/GP Federation, certain PDS demographic data). These may require programme approval and/or conformance. CC cannot be enabled for restricted workflows unless the receiving organisation has the appropriate approval.

Behaviour

Automatic application:

• when a CC or redirect rule is active and a message matches the configured criteria, MESH applies the rule automatically. Senders are not notified that the CC or redirect has occurred

CC behaviour:

• a carbon copy creates a second copy and delivers it to the specified target mailbox. The original recipient will still receive the message. If more than one CC rule matches, each CC target will receive a copy

Redirect behaviour:

• a redirect only delivers to the mailbox specified in the redirect link. The original recipient will not receive the message

Rule precedence and fallback

Precedence: redirect takes precedence over CC. If a message matches both a redirect and a CC rule, redirect is applied and the CC does not generate an additional copy.

Fallback: if a redirect is later removed while related CC rules remain active, deliveries will fall back to CC behaviour. Requestors should declare any existing CC rules when asking for redirect to avoid unintended outcomes.

This service has been live since 2015. It is an evolution of an earlier service called Data Transfer Service (DTS). In terms of usage:

• there are over 400 different message types in use per month
• there are around 22,000 active mailboxes in a given month
• it handles around 30 to 60 million messages per month

It is a platinum service, meaning it is available and supported 24 hours a day, 365 days a year.

The items considered for the MESH roadmap for 2025 are:

You can access MESH in a number of ways. All options are free to use, but you need to show you have a valid use case to use MESH.

You can also use a combination of these options, which you’ll need to set up each one separately.

MESH is available over the internet and over the Health and Social Care Network (HSCN).

Use the MESH API to integrate MESH into your own software products.

There is a digital onboarding process to access the service. Expect it to take a minimum of 1 month.

Once integrated and onboarded, you can send files up to 50 GB.

The MESH Client is a software package that enables basic integration to MESH without the need for in depth assurance. It is best suited to system-to-system messaging.

You'll need system administrator rights to install and configure the MESH Client. This can take 1 to 3 weeks.

Once installed, ideally on a server, you can drop one file for the payload and another file for details about the message type, including the specific folders they should be sent to within your file system. MESH will automatically check these folders (on a configurable interval) and send the messages. Incoming messages will appear in the folders, to be retrieved when convenient.

Once you’ve set up MESH Client, you can send files up to 50 GB.

MESH UI is a web application that enables the manual sending or receiving of small files, in low volumes. It’s ideal for sending things like datasets to NHS England.

There is no need to install any software. This means it's ideal for health or care workers that are not able to automate or integrate systems. To access MESH UI, workers must be authenticated via Care Identity Service.

Expect it take 2 to 3 weeks to apply and get set up.

Once it’s set up, you can send files up to 50 MB, or 100 MB if you access the website through the Health and Social Care Network.

MESH guidance hub

View our selection of MESH and MOLES technical documentation. These guides will help you install and use your MESH client, manage your advanced settings and identify recipient mailboxes using the endpoint lookup service.