1. Who is the central mail house and who holds the contract?

The NHS Summary Care Record (SCR) central mail house has been procured through the Central Office of Information (COI).
NHS CFH has worked in collaboration with COI to procure a central mail house to support NHS SCR Public Information Programmes (PIPs) on behalf of the NHS. The contract is with the Lateral Group through COI.
The Lateral Group are a multi-channel communications company, based in Nottingham. They have experience of critical and personalised mailings for the NHS and comply with best practice Government standards and the Data Protection Act.

2. Is there a data sharing agreement with the mail house?

Yes there is a data sharing agreement between COI and the Lateral Group.
The mail house is ISO9001and ISO27001 accredited.
The mail house booking system (MarketPower website) is not used for the exchange of patient identifiable data, only for uploading the PIP letter and signature. Security details are provided below:

• SSL encrypted (minimum 256 bit encryption)
• First login change of password
• Account locked on five unsuccessful login attempts
• 60 day password change requirement
• Secure password requirement, minimum eight characters, mixture of Alphanumeric, special characters, capital letters etc.

Secure FTP is used for the transfer of patient demographic data. Security details are provided below:

SSL/SSH 256 bit encryption

• Secure password requirement
• Both commands and data are encrypted prior to transmission
• No traffic is transmitted 'clear‘ over the network.

3. How do I book a mail slot with the central mail house?

A software application (called MarketPower®) has been configured specifically to support the whole process for booking SCR mail slots and preparing for the mail out.
The system will guide users step by step through the process of booking a mail slot and the appropriate guidance and pre-requisite activity along the way.
If you don't already have login details to this system, please contact your NHS CFH Interface Manager for your login details to the mail house website.

• Find out who your NHS CFH Interface Managers is at:
  http://www.connectingforhealth.nhs.uk/systemsandservices/scr/staff/aboutscr/jiteam
• Access the booking system at: http://nhsscr.market-power.co.uk/welcome.aspx?ReturnUrl=%2fDefault.aspx
• View the guidance on using the central mail house and central NHAIS demographic data extraction process at: http://www.connectingforhealth.nhs.uk/systemsandservices/scr/staff/aboutscr/comms/pip
  Please read thoroughly all guidance documents before booking a mail slot.

4. What are the mailing costs?

The MarketPower® system will generate an estimate providing you with a cost which will be specific for your mailing. It is simple and easy to do – logon to the MarketPower website, click ‘generate your estimate or book new mailing' and follow the simple instructions. 

The current patient pack price (August 2011) is between 24.1p – 30.3p* with a £550 set up charge per mailing for the first mailing booked by a PCT. Subsequent mailings will have a reduced set up cost of £350 where the first mailing was booked after 1st November 2010. Please ensure you check the prices listed on MarketPower® for the most up to date prices.

Where a mailing project consists of less than 5000 letters a fixed rate of £600 will be charged for the completion of the project, including set up, production and fulfilment costs, but excluding postage.

If a PCT chooses to use the deceased screening service, the cost of this service is as follows: £2.00 per thousand to perform the matching process against the data base with an additional cost of £0.52 per match. This is to cover the licensing cost of providing PCTs with the name and address details of those that match on the system.
Note: After entering your mail quantities into MarketPower®, the system will prompt you for a Purchase Order (PO) number, which you will need to enter to ensure your PCT accepts the estimated price before the slot is confirmed. This system will not allow you to confirm a mail slot until the PO number is entered. If you need time to get PO signatures/approval, the MarketPower® system can automatically save the mail slot as an unconfirmed booking which can be accessed again once the PO has been approved.

* Please note: At the estimate stage, costs are estimated and may need to adjusted slightly to account for variable data processing costs (see mail house guidance for details) and the cost of deceased screening, if this service is selected. Please note that the lower cost includes the lower rate of postage (mailsort 70) and the higher cost includes the slightly higher rate of postage (unsorted).  The higher postage rate is still significantly discounted from standard 1st and 2nd class postage rates.

5.  What does the estimate generated by the MarketPower® system cover?

The indicative cost provided in the estimate generated by MarketPower will cover the following:

-  All Print, production and mailing costs;
-  Postage costs (NB:  Royal Mail postage rate increase came into effect on 9 May 2011)
-  Optional deceased screening (not including suppression hit rate)
-  Addition of optional HealthSpace leaflet

Any other supplementary costs including, for example, amendments to the letter, additional data files, case conversion, PAF enhancement, and the suppression hit rate, are not included in the original estimate as these costs cannot be predicted at this stage.

Depending on the size of the mailing differing estimates will be received;

A mailing over 20,000 packs will receive two cost scenarios that include:

• An estimate based on the best postage rate being achieved (Mailsort 70 @ 0.19702p per pack). A mailing qualifies for this rate if 90% of addresses and postcodes supplied are accurate and there are in excess of 20,000 records (addresses).
• An estimate for the worst case scenario postage rate (25.9p per pack) will also be supplied so that the PCT can ensure funds are available to cover this should the Mailsort 70 rate not be achieved. This higher rate is still significantly discounted from standard 1st and 2nd class postage rates.

A mailing of less than 20,000 packs will receive one quote for the higher rate postage only. A further estimate can be obtained through Market Power should the PCT feel they may exceed the 20,000 pack threshold.

The final mailing costs will be dependent on final postage costs, data processing costs and any other additional costs incurred as detailed below:

• Suppression hit rate (Permanent) - 52p per match (if you have requested/selected for deceased suppression to be completed this will be charged for each match made)
• Amendment to letter text - £20 per amend
• Supply of additional data files - £20 per file (The mailing project cost includes cost for one data file download and additional data files will be charged extra)
• Case conversion - £2 per 1000 (minimum charge £50)*
• PAF enhancement - £1 per 1000 (minimum charge £50)*

Please see section 3.1 and appendix D in the NHS Mailhouse Guidance for more information.

6. What is contained in the PIP pack?

• Patient Letter
• Free post (business reply)  opt-out form
• SCR patient summary leaflet
• All of the above collated into an outer NHS branded envelope.

As part of the central mail house process, the Materials for PIP packs will be ordered automatically as part of the central mail house process.  PCTs can also choose to include a HealthSpace patient leaflet in their PIP pack. For more information on how to do this, and the associated costs involved, contact your NHS CFH Interface Manager.

7. Where do I get the patient PIP letter template?

The template patient PIP letter is available at:
http://www.connectingforhealth.nhs.uk/systemsandservices/scr/staff/aboutscr/comms/pip

If using the central mail house, the template letter is already built in to the MarketPower® system and PCTs will need to use this functionality, along with the approval functionality on the MarketPower® system. Once a PCT has completed the template, the letter can be saved and downloaded from the MarketPower® site.

After booking a mail slot in MarketPower®, the template patient letter is located in >Manage Existing Mailings>Select PCT and mailing project>Edit Mailing Project>Mailing Requirements>Create Patient Letter
The signature needs to be uploaded separately on MarketPower® at >Manage Existing Mailings>Select PCT and mailing project>Edit Mailing Project>Mailing Requirements
File use the following file naming convention: <SIGNATORYNAME><NHSPCTNAME>
If you are not using the central mail house facility you will have to order your PIP materials separately and ensure a robust process for managing a freepost  opt-out service is in place.
For more information visit: http://www.connectingforhealth.nhs.uk/systemsandservices/scr/staff/aboutscr/comms/pip

8. When will I be able to view the approved patient letter?

A graphical representation of the approved patient letter will be available for viewing on the MarketPower® system on the Mailing Requirements page, approximately five days prior to the mail date. Please note that patient identifiable details will not be shown, however the position of the personalised text will be highlighted.

9. How should a PCT prepare for the central NHAIS demographic data extracts?

If a PCT chooses to use the central NHAIS extract process, they must follow the NHAIS guidance available at:
http://www.connectingforhealth.nhs.uk/systemsandservices/scr/documents/nhaisguide.pdf

It is imperative that a PCT assigns an individual to manage the data extract process. The PCT will need to confirm that the responsible user has appropriate administrator rights/access to install any necessary secure File Transfer Protocal (FTP) software or that local IT support is available as required.

PCTs who have previously used the central process suggest using local NHAIS teams to transfer manipulate and validate data (with appropriate guidance from the PCT and ensuring this responsibility is agreed before the PIP). This approach minimises any security risks by reducing the transfer of data between departments. To ensure this process is successful, engagement and agreement of responsibilities with local NHAIS teams should be completed at the earliest opportunity.

The local team using the secure FTP application (for transferring the data to the central mail house) will also need to ensure the appropriate ports/firewall access is open to enable data transfer. It is advisable to download the secure FTP software and check the appropriate ports/firewall access well before the date that the data is required at the mail house.

10. How do I order my NHAIS extract? Do I need to? How do I find out when my NHAIS extract will happen?

If you have booked a mailing through the central mail house, you will have been asked at the booking stage whether you would like a demographic data extract through the central NHAIS team. If you selected ‘Yes', this extract will automatically be ordered and the details will be emailed to the primary contact (the individual responsible for coordinating the PIP mailing) held on the MarketPower® system for that PCT . The data extract will be scheduled to be sent approximately 20 working days prior to the mail date (to allow five working days for data retrieval and any manipulation/ quality checks by the PCT/local NHAIS teams).
Once the data files have been retrieved, the file name and number of records need to be entered onto the MarketPower® system.

11. What should the file format be if we have less address lines than that in the guidance, e.g. 57 Long Lane, Dewsbury, Wakefield, WK7 8PB?

The central mail house will process your address and automatically realign to avoid any blank lines.

12. How do I use the secure FTP site for transferring demographic data and GP address data to the central mail house?

SHA wide secure FTP sites have been set up for PCTs to transfer their patient demographic data to the central mail house. The SHA wide secure FTP sites are set up as one way sites; they only allow information to be submitted on to the site. PCTs cannot download information from these sites for data security purposes.
PCTs may have their own secure FTP software; alternatively, the secure FTP site can be accessed using Core FTP (free software). Instructions are provided below:

• CoreFTP – How to download: 
  http://www.connectingforhealth.nhs.uk/systemsandservices/scr/documents/ftpdownload.pdf
• CoreFTP Client setup – How to configure:
  http://www.connectingforhealth.nhs.uk/systemsandservices/scr/documents/ftpconfigure.pdf

Note: The PCT will need to confirm that the responsible user has appropriate administrator rights/access to install this software or local IT support is available as required. The local team using the secure FTP application will also need to ensure the appropriate ports/firewall access is open to enable data transfer. It is advisable to download the secure FTP software and check the appropriate ports/firewall access well before the date that the data is needed at the mail house.
You will need to contact your NHS CFH Interface Manager for your login details.

13. What is the process for the mail house destroying the extracted data they receive containing patient names and addresses?

The mail house use DESLock+ Shredder for destroying the data. The DESLock+ Shredder may use one of two methods to shred files. Either writing a cryptographically secure random number stream file over the file; or using the US Department of Defence 5220.22-M standard for sanitising data.

14. How do I select the deceased screening service provide by the central mail house?

If you have booked a mailing through the central mail house, you will have been asked at the booking stage whether you would like the PCTs demographic data to be screened against the deceased register at the central mail house. If you selected ‘Yes', this will automatically happen as part of the mailing and deceased records removed.

15. Which providers are used for the deceased screening service?

The following deceased screening can be applied to the patient demographic data if needed by the PCT.

The demographic data files are compared with the deceased database and any patients who are matched are removed from the final mailing file and will not be sent a PIP pack. Patients are matched using first name, surname, address and gender. The matching is performed approximately nine working days before the mail date.

16. How do I access the list of patients removed from the mailing due to matching against the deceased database?

The list of patients matched against the deceased files (and therefore not mailed) are made available via the PCT specific secure FTP site (see question 17 for more details).
PCTs will need to agree a local process for managing the deceased file lists. Please note that it is not

recommended that the deceased suppression file is used in isolation for any data quality/cleansing activities undertaken by the PCT, although it could be used to initiate a review of data quality in conjunction with further checks.

17. What happens to returned mail packs and how does a PCT know what has been returned?

Any mail that cannot be delivered can be returned to the PO Box number on the back of the outer envelope. This PO Box number returns the PIP packs back to the central mail house.  On arrival at the central mail house, each returned PIP pack is scanned in using encoded 2D barcode which is visible in the window of the outer envelope. The bar code links to a unique identifier for that patient which is only identifiable at the mail house (not by reading the barcode).

Once scanned, the patient's details are added to a list which is generated in the same format as the data originally supplied to the mail house (GP Practice, NHS number etc – as per the central NHAIS guidance).
Each PCT will have login details to a PCT specific secure FTP site from which they will be able to pull a weekly report which will list the details of patients whose PIP packs have been returned to the central mail house.
An initial report will also be available on the same site detailing those patients screened as deceased (if this service was selected) and therefore not mailed. See question 17 for details on the secure FTP sites.

The PCT will need to ensure there is a local process in place to actively manage the returned mail and deceased patient list. It is advisable to agree a process in conjunction with the LMC and GP practices. One option could be for this to be managed by the PCT in the normal way. It should be remembered that the SCR system has been designed so that any patient with an FP69 status set locally will not have a SCR made for them.

18. What is the difference between the two types of secure FTP sites?

SHA wide secure FTP sites
The demographic data and GP address files are sent to the central mail house through the SHA wide secure FTP sites. These only work one way allowing data to be placed on to the secure site, they do not allow data to be transferred, downloaded or removed by another PCT. The central mail house has a sweeper system which quickly removes the data to a secure server for processing the mailing.

PCT specific secure FTP sites
The returned mail reports and deceased lists (if this service is selected) are made available using the PCT specific secure FTP sites (which have been set up in addition to the SHA wide sites for transferring patient demographic data). The reason for having two separate sites is for security reasons. The PCT specific secure FTP sites are one way secure sites; they only allow information to be pulled from the site and are only accessed by an individual who has been approved by the PCT. These individuals are provided with secure login details.
Login details for both sites can be requested through your NHS CFH Interface Manager.

19. What is the process for the mail house destroying the returned mail (physical PIP pack)?

The mail house will ensure that mail containing demographic information is securely shredded and destroyed in line with strictly governed industry standards.

20. What is the process for the mail house destroying the PIP letter signature files they receive?

The same data shredding process is used as for destroying the demographic data (DESLock + Shredder).

21. How does the new free post (business reply)  opt-out process work? Where do the  opt-out forms get returned to?

The envelope containing the form is printed with an encoded 2D bar coded in line with the patient letter to safely identify the patient's GP practice.

The envelope goes back to the central mail house for processing. The central mail house will scan the returned envelopes and securely file them by GP practice. The central mail house will post the envelopes directly to the GP practice for processing at least every fortnight.

Should a package from the mailhouse and/or contents be received in error by a GP practice please contact SCRmailingqueries@lateralgroup.co.uk at your earliest convenience.  Please include your contact details and a brief description of the error and you will be advised of next steps upon receipt of your enquiry. 

It is advised that some contingency is built into plans to allow sufficient time for  opt-out forms to be returned to and processed by GP practices, before records are made.
GP practices about to create records may also wish to contact the mail house to request the return of any remaining  opt-out forms which can then be processed immediately prior to the upload date. Should you wish to request this please email a request to SCRmailingqueries@lateralgroup.co.uk at least seven working days before the return of opt-out forms is needed.

Please note that the opt-out forms are not opened during processing at the central mail house. The  opt-out form remains unopened and the individual opting out will not be identifiable by the central mail house.

The PCT will need to provide the GP addresses to the central mail house in advance of the mailing campaign going to print. This data needs to be submitted to the central mail house along with the patient demographic data 15 working days before the mail date. PCTs will need to use their SHA wide secure FTP site (see question 17) to submit this data (along with the patient demographic data).

View Appendix E of the central mail house guidance (Guidance for the supply of GP address data to support PCT Public Information Programmes when using the central mail house facility) for instructions on obtaining GP addresses and submitting them to the central mail house:
http://www.connectingforhealth.nhs.uk/systemsandservices/scr/documents/mailhouseguide.pdf

PCTs must supply this information on time or the mailing will be delayed and additional costs may be incurred.
The opt-out forms will be addressed to the practice manager. PCTs will need to ensure the practice managers are aware that they will be receiving the opt-out forms.

22. Can I include additional items or extra formatting details in the patient letter?

Please note that any amendments to the basic PIP pack (e.g. additional services such as formatting requirements, additional screening) may impact on timescales and will incur additional cost and will need to be negotiated separately. PCTs will need to contact the project team at SCRmailingqueries@lateralgroup.co.uk copying in the SHA lead and NHS CFH Interface Manager to negotiate any amendments to the standard pack and process.

23. How do I change dates or quantities of an existing mail slot?

Any requests to change quantities or dates must be sent through to:
SCRmailingqueries@lateralgroup.co.uk copying in your SHA lead and your NHS CFH Interface Manager.
Please note that depending on the nature of the change this may cause delays to your mailing, and may incur additional costs.