Part of Networks and connectivity standards
Fixed line connectivity standards
Standards you should meet on fixed line connection type, connection speed and resilience.
1.1 NHS organisations should use a full fibre connection for their fixed line connectivity service at all sites
Importance of meeting the standard
A full fibre connection provides the capacity, reliability and performance required to support modern, digitally mature healthcare services. Using an appropriate fixed connectivity service helps NHS organisations:
- meet site‑specific connectivity requirements based on clinical, operational and digital needs
- support the increasing use of wireless connectivity for staff, visiting healthcare professionals, patients and clinical devices
- accommodate growth in bandwidth demand, new technologies and future digital service models
- underpin delivery of high‑availability, resilient and clinically safe digital services
Full fibre services offer long‑term scalability and flexibility. This ensures the network can adapt rapidly to changing demand without requiring major infrastructure changes.
When to meet the standard
- an existing connectivity contract ends
- full fibre becomes available at the site
Where full fibre is not yet available, any new contracts or extensions using alternative technologies must include the ability to migrate to full fibre as soon as it becomes viable and cost‑effective.
How to meet the standard
- assess current and future bandwidth requirements, including headroom for growth
- confirm the availability of full fibre services to the site
- ensure that your connectivity service can be upgraded quickly (typically within days) if additional capacity is required
- implement alternative connectivity options only where full fibre is unavailable or does not represent value for money
- performance is comparable to full fibre for the intended clinical or operational use
- resilience, reliability and latency characteristics meet site needs
- the service can scale with demand
Your organisation should routinely measure utilisation and headroom and have arrangements with suppliers to upgrade capacity without significant lead times.
Technical requirements to meet the standard
- a leased line
- fibre to the premises (FTTP)
- scalability and the ability to increase capacity as needed
- adequate performance for the clinical and operational services delivered
- high resilience and predictable reliability
Note: Copper‑based connectivity services such as ADSL or SoGEA do not meet this standard.
Aligns to the following DSPT principles:
| Principle | How it supports |
|---|---|
| Resilient networks and systems | Full fibre connectivity provides a resilient, high capacity transport layer that reduces dependency on single network paths. It supports planned recovery and continuity approaches by ensuring predictable bandwidth and stability for essential functions. |
| Asset management | Connectivity assets are identified, documented and managed through their lifecycle as part of a structured approach to network asset management. |
1.2 NHS organisations should have a suitable backup connection to ensure resilience and maintain continuity of service at all sites
Importance of meeting the standard
NHS sites rely on internet connectivity to support clinical, operational and administrative services. A loss of connectivity can disrupt access to critical systems, delay care, and increase clinical risk.
A resilient connectivity service:
- mitigates against single points of failure
- underpins safe delivery of digital services, including Electronic Patient Record (EPR) access, clinical applications, and wireless‑dependent workflows
- ensures staff can continue working during faults, maintenance or outages
- provides confidence that connectivity can withstand increasing levels of digital dependency
Building resilience into fixed connectivity is therefore essential for maintaining continuous service availability and supporting digital transformation.
When to meet the standard
- when installing a new primary connection
- after upgrading your existing connectivity
- when current contract terms end, and changes can be made cost‑effectively
- a requirement for greater resilience is identified following standard business continuity or risk reviews
How to meet the standard
- investigate which backup internet services are available to your site
- assess what level of resilience is needed based on business continuity and clinical risk
- ensure backup services use different technologies or suppliers from your primary service where possible
- work with your supplier to ensure that resilience arrangements, such as failover configuration, SLAs and restoration times, are suitable for your operational requirements
- ensure that resilience arrangements are aligned with your organisation’s disaster recovery and business continuity plans
Technical requirements to meet the standard
To meet this standard, connections should be designed with supplier, vendor, technology and (where possible) route diversity to minimise single points of failure. This standard requires a combination of the following resilience measures.
- leased line (vendor 1) + leased line (vendor 2)
- leased line + Fibre to the Premise (FTTP)
- FTTP + low‑Earth‑orbit (LEO) satellite
- FTTP + mobile (4G and 5G)
- multiple routers or router modules
- appropriate routing configuration to ensure seamless switching between connections
- Uninterruptible Power Supply (UPS) protection for network equipment involved in routing and failover
- redundant power supplies where available
Appropriate Service Level Agreements (SLAs), including restoration and fix times aligned with the criticality of clinical services supported.
- clinical risk
- operational complexity
- site type and size
- business continuity needs
Aligns to the following DSPT principles:
| Principle | How it supports |
|---|---|
| Resilient networks and systems |
Redundant connectivity supports continuity and recovery planning by ensuring services can operate during outages. Backup connectivity provides an alternative path for essential services, reducing the impact of primary link failures. |
| Detecting cyber security events | Backup links can be monitored as separate data sources, improving visibility of link health and resilience posture. |
Last edited: 3 August 2026 4:40 pm