back to article For fax sake: NHS to be banned from buying archaic copy-flingers

NHS trusts have just 20 days to buy in fax machines – because from January 2019 they will be banned from purchasing the outdated devices. Fax machines are technology non grata in the NHS after a Freedom of Information request by the Royal College of Surgeons revealed some 8,000 still creaking away in hospital trusts across the …

  1. CAPS LOCK Silver badge

    Ban a system that works and is malware free*...

    ...genius...

    * Mostly malware free. Mostly...

    1. Christian Berger Silver badge

      Re: Ban a system that works and is malware free*...

      Well that "mostly" is if you don't have a colour fax. Since colour fax machines are about as common as ice-cream cone unicorns, that's not really a serious concern.

      1. nextenso

        Re: Ban a system that works and is malware free*...

        Maybe this is already covered by one of the 82 responses. I have to interact with solicitors, as would NHS. In the legal world in my experience in & around London, fax is very much alive and kicking - sending paper proof that a contract has a signature on it. Its the only thing I use fax for now - as part of a multifunction printer. I also use Adobe Send & Track, but, I find that is not accepted as proof of signature.

        1. katrinab Silver badge

          Re: Ban a system that works and is malware free*...

          In our office, we moved the photocopier / scanner / printer / fax machine to a different location, and didn't plug it into the phone line. Nobody noticed.

    2. Anonymous Coward
      Anonymous Coward

      Re: Ban a system that works and is malware free*...

      And works, even when everything else* has fallen over....

      (*except for the VoIP PABX)

      I must be of a certain age, as I remember staring at the first fax machine I saw, thinking what an amazing piece of technology it was. And how quickly it suddenly reached critical mass when the royal mail conveniently went on strike for a couple of weeks (c. 1987?)

      Last time I sent a fax? Probably about 1998. It seemed to be around forever, but in retrospect was a rather short lived star.

      1. kain preacher Silver badge

        Re: Ban a system that works and is malware free*...

        Fax machines goes back to the 60's . Just most folks could not afford them

        1. Anonymous Coward
          Anonymous Coward

          Re: Ban a system that works and is malware free*...

          "Fax machines goes back to the 60's "

          Alexander Bain demonstrated the facsimile transmission principle in the mid-19th century.

          Quote from the above Fax History site about an improvement of the technology:

          "With a successful demonstration in front of Napolean in 1860, the Pantelegraph started operation between Paris and Lyon in 1865 and extended to Marseille in 1867. For comparison with telephone, it was not until 1876 that Alexander Graham Bell received his patent for the telephone."

        2. Anonymous Coward
          Anonymous Coward

          Re: Ban a system that works and is malware free*...

          The 1860s in fact

          The first patent for the fax was issued in 1843 - and it's another Great British invention (well, Scottish, so British for now)

        3. Mage Silver badge

          Re: Fax machines goes back to the 60's

          Maybe the 1860s. First demo was in 1851!

          In the 1930s there were adaptors sold in USA. News was "faxed" by radio after voice program close down. Rather more useful than 22 line mechanical TV. RCA & EMI killed off both ideas in 1936 with their jointly developed Electronic TV (USA used slightly more lines than UK 405 and changed to the 525 system a little before Russia tested 625 lines in late 1940s. It was mad ego that UK restarted 405 when 18 months later they could have used 625).

          Certainly Fax was a niche and less popular than telex/telegraph till 1970s.

          China & Japan still keen on fax. Clue, have you tried to do eMail in Chinese or Japanese?

          1. MyffyW Silver badge

            Good Enough

            So there are 8,000 fax machines in the NHS? Let's assume they last about 4 years and cost 200 quid to replace. That's GBP 400,000 that will be saved. Round it up to GBP 1 million to account for consumables and phone bills and it's still three parts of eff-all in NHS terms. Show me the NHS system that can replace everything they do and will "only" cost 1 million a year.

            Basically this "ditch the fax" drive is a conjurers distraction. I suggest you guard your watch and check your change.

            1. Alan Brown Silver badge

              Re: Good Enough

              > Basically this "ditch the fax" drive is a conjurers distraction.

              Nope. Fax is a GDPR nightmare - the number of faxes of confidential data sent to the wrong destination is incredible and there's no audit trail to speak of.

            2. Anonymous Coward
              Anonymous Coward

              Re: Good Enough

              Apart from that pesky thing called email. Which they all have already. And everyone else has.

            3. Jim 59

              Re: Good Enough

              @MyffyW I don't think that cost is the driving factor. Did anybody say it was?

              Efficiency and safety seem to be the question, and pieces of paper can go missing. Referrals for life threatening conditions, for example, should probably not lie around in fax trays.

            4. F0rdPrefect
              Happy

              Re: Good Enough

              "Let's assume they last about 4 years"

              Last one I saw in a hospital was well over 10 years old.

              The older they are the longer they last.

              And the one that another customer kept going, because some of their customers didn't have access to email, was getting on for 20 years old.

              Also, they start from about £60 inc VAT.

        4. Kernel

          Re: Ban a system that works and is malware free*...

          "Fax machines goes back to the 60's . Just most folks could not afford them"

          Actually, the first commercial fax service started between Paris and Lyon in 1865, with the network being extended to Marseille in 1867 - Bell received his telephone patent in 1876, 9 years later.

          The first experimental fax system successfully developed was by Alexander Bain, working on it between 1843 and 1846 - the quality wasn't too great, but by 1867 it had improved and wasn't too much different from the early thermal printing types that we are familiar with.

          In other words, fax was over 100 years old before most of us had even heard of it.

          1. big_D Silver badge

            Re: Ban a system that works and is malware free*...

            @Kernel agreed. And the big newspapers used derivatives for decades to transfer photos (and text?) from all over the world back to HQ for inclusion in the papers.

        5. katrinab Silver badge

          Re: Ban a system that works and is malware free*...

          Alexander Bain invented the electric printing telegraph in 1843

          The scanning phototelegraph was invented by Shelford Bidwell in 1880.

      2. Steve K Silver badge

        Re: Ban a system that works and is malware free*...

        Yes I remember that too - during/after the postal strike suddenly everyone had a fax machine or knew what one was!

      3. big_D Silver badge

        Re: Ban a system that works and is malware free*...

        I worked at an IT company and many customers insited on sending faxes of report layouts they wanted.

        Also, for legal reasons, most sent faxes of signed off orders, because a PDF in an email was not a legally binding document in Germany, whereas a fax is - or rather the PDF needed to be digitally signed with a valid certificate, which is expensive and, for most non-IT people, complicated.

      4. Doctor Syntax Silver badge

        Re: Ban a system that works and is malware free*...

        "And works, even when everything else* has fallen over....

        (*except for the VoIP PABX)"

        Give it it's own exchange line and it doesn't even mind if the PABX falls over.

      5. jelabarre59 Silver badge

        Re: Ban a system that works and is malware free*...

        Last time I sent a fax? Probably about 1998. It seemed to be around forever, but in retrospect was a rather short lived star.

        Actually, last sent a fax 3 or so weeks ago (with a multifunction ink printer, of course). The office for one of my daughter's therapists doesn't have email for the doctors yet. Various medical practices in the US are still like that.

        Going back 30+ years ago, when I worked in film distribution, we'd *loved* for the various film depots to have had fax machines, just so we wouldn't have to read out shipping orders over the phone (that or a telex machine, which we also had). And the first fax machine we had there was one of those electrostatic ones, that would take 4 or 5 minutes to transmit/print a fax. These days it would probably be an emailed PDF of a barcoded shipping label. Then again, perhaps not, Films Inc wasn't quite that swift.

      6. Jim 59

        Re: Ban a system that works and is malware free*...

        A short lived star, but not as short as Telex.

    3. Daniel von Asmuth Bronze badge
      Boffin

      Re: Ban a system that works and is malware free*...

      Some political decisions cost human lives.

    4. Alan Brown Silver badge

      Re: Ban a system that works and is malware free*...

      * Mostly malware free. Mostly...

      Until you have a fax-to-email gateway.

      It's a theoretical hole but it's there.

  2. RedCardinal

    Pity they couldn't pay the same attention to the DWP which refuses to accept documents being emailed to them and insists on them faxed instead....

    1. big_D Silver badge

      As I point out elsehwere, over here faxes are accepted as legally binding documents by courts, emails aren't. I don't know if that is the case in the UK.

      1. Lee D Silver badge

        In the UK both are.

        You just may have to retain the original in order to prove its origin via headers etc.

        (Hint: There's a reason that Exchange has a "legal retention" functionality. If they weren't binding, they wouldn't be able to form evidence of any kind).

        There was a time when fax was accepted and email not, but when I moved house last year, I signed a lease agreement electronically, no problems. I pull my suppliers up on their failures via email records, no problems.

        A country that doesn't have email as a binding contract now (provided, as with any medium, that the content is actually received and stored properly... anyone could fake a fax from any number the same way anyone could fake a fax from any email address) is probably a bit backwards.

        If you'd accept it in court as evidence (and everything from Facebook posts to emails have done that in all kinds of jurisdictions), then it's fine.

        With things like Exchange and the proper retention / audit options, it would also be almost impossible to claim you hadn't received it, too. Hell, a president is just about to be put behind bars and that'll come down to emails at some point, you can guarantee.

        The question of "legal service" by email is slightly different, and that has been resolved (positively) for a long time.

        1. Peter2 Silver badge

          There was a time when fax was accepted and email not, but when I moved house last year, I signed a lease agreement electronically, no problems.

          Yep. You signed the lease electronically. But what about the mortgage offer? They sent that to you in the post for a physical signature and refused digital copies, didn't they?

          Mortgage companies still refuse scans, and require faxes to be used for certain things.

          1. Uberior

            "Mortgage Companies"

            That's a bit wide isn't it? Which mortgage companies? There are hundreds.

            1. Peter2 Silver badge

              And out of the lot, find one that accepts a scanned copy of their mortgage documentation.

              I'll wait. Of course, I know that they are all members of UK Finance, formerly the Council of Mortgage Lenders and have almost exactly the same rules drawn from the lenders handbook.

        2. martinusher Silver badge

          >There was a time when fax was accepted and email not, but when I moved house last year, I signed a lease agreement electronically, no problems. I pull my suppliers up on their failures via email records, no problems.

          Its a bit late when you've just been scammed for a few hundred thousand. Currently email is just not reliable for transactions that involve funds transfer. You can add all the legal retention, electronic signatures and whatever else you come up with but the system is fundamentally flawed and these technological fixes are just Band-Aids. I will only use electronic transactions for low value funds transfer in a controlled environment (that is, if the transaction gets hacked the loss will be minimal to zero).

      2. Peter2 Silver badge

        Yes, that's the case in the UK. There is established case law to say that a faxed acceptance is binding from the moment it's sent and faxed copies of documents (as in facsimile copies) actually have specific legal status. email should be the same, but isn't unless accompanied with a digital signature that meets specific criteria, which can still then be challenged in court so companies still require physical signatures on documents which are then faxed. Don't ask me why scanning a copy and emailing it doesn't have the same status as a fax, blame the bloody politicians who are incapable of writing coherent laws, and the courts for literally interpreting the laws as written.

        I have three bloody fax machines that I can't get shot of because other entities we communicate with still use them. IMO: attacking fax machines for having the temerity for existing is pointless. Attack the legal basis for them existing by writing a short law.

        "documents scanned via a scanner and emailed as an attachment [in TIFF/JPG/PDF format] are recognized as being exact copies of the original, and are hereby considered as facsimile copies in addition to documents sent by a fax machine."

        The fax machine would then be living on borrowed time until completely replaced in workflows.

        1. Jan 0

          > "documents scanned via a scanner and emailed as an attachment [in TIFF/JPG/PDF format] are recognized as being exact copies of the original, and are hereby considered as facsimile copies in addition to documents sent by a fax machine."

          Yes, but that doesn't stop the "original" being an unsigned document with a carefully cut and pasted (literally with scalpel and glue) signature from an entirely different document. That's a technique that works with faxes, scans and even photographs, if you use a widely diffused light source.

          We really should move to secure email.

  3. Ol'Peculier

    Apparently, football clubs all have fax machines that they use for transfer window deadlines.

    And I wonder how many MFP's are still sold with a fax modem build it, never to be used again, with an abandoned, unused port regarded as an object of curiosity for those under a certain age...

    1. Detective Emil

      Quite

      It's difficult to buy/lease/rent an "enterprise class" copier/printer/scanner that does not have an embedded fax. Mind, the things are equally happy to send your scans by (unsecured, in my experience) email.

      1. Sandtitz Silver badge

        Re: Quite

        "Mind, the things are equally happy to send your scans by (unsecured, in my experience) email."

        I haven't seen a new MFP in eons that didn't support TLS encryption in email transport.

        Fax certainly isn't secure, since the low bitrate traffic can be intercepted and replayed on another fax at the telco. Caller ID spoofing is also easy to do.

        Just sayin'...

  4. 2+2=5 Silver badge
    Joke

    The law of unintended consequences...

    Multiple choice on this one:

    1) NHS Minimum PC specs will be changed to require a fax modem?

    2) Lots of stand-alone scanners and printers will be bought as fax machine replacements (but at least the image will be sent by email!)?

    3) Royal Mail will receive a welcome boost in the number of letters sent!?

  5. Arthur the cat Silver badge
    FAIL

    the NHS will be paperless by 2020

    Right. Just like our offices have all been paper free for the last few decades.

    1. Flocke Kroes Silver badge

      Re: the NHS will be paperless by 2020

      The paperless NHS project is amazing. It has been going on for years. When it gets excessively late and over budget it gets cancelled and restarted a year or so later. Total deforestation and the complete destruction of the NHS will not end the stream of paperless NHS projects.

    2. Anonymous Coward
      Anonymous Coward

      Re: the NHS will be paperless by 2020

      In Edmund Tenner's great book 'How things bite back', published in the late 90's or thereabouts, he pointed out that sales of copier/printer paper in the US had increased by 500% in the decade since the 'paperless office' had become the must-have accessory. Probablys till higher now than it was in the 80s.

  6. Hans Neeson-Bumpsadese Silver badge

    For instance, she said, they will require signed directions or prescriptions – something easily achieved "in the real world" by taking a photo on your phone and sending it via SMS.

    Unless your phone is on the O2 network, and somebody at Ericsson forgot to update a certificate.

    Technology can - and will - fail, and it's good to have a backup...especially if the use case relates to someone's health and wellbeing.

  7. Christian Berger Silver badge

    Sending a photo via SMS

    I mean yes, there were standards to send images via SMS... however I doubt there is much use in sending a 32x32 monochrome pictures theese days.

    Of course the sensible thing to do would be to define a standard format for document "facsimiles" which includes a simple high resolution bitmap of the page along with an UTF-8 export of its contents.

    If you ban fax machines, people are going to send office documents through mail... which is _much_ worse security wise.

    1. Steve K Silver badge

      Backups

      Carrier pigeon/Chinese whispers...?

    2. Anonymous Coward
      Anonymous Coward

      "Technology can - and will - fail, and it's good to have a backup... [...]"

      Over three days recently I kept trying to correct a hospital appointment via the phone to their dedicated appointments number. It was system that told you where you were in the queue - usually about number 10. On the third attempt I hung on until I reached position number 1. After a further 15 minutes I gave up - having decided that the queue position only advanced when people tired of waiting.

      The next day I walked to the hospital and the matter was sorted out in about 5 minutes.

      Another NHS department's appointment also needs changing. Their dedicated helpline informs you that they have a new IT system that has slowed down processing. They request you to ring back later for anything but urgent appointments or those within the next three weeks.

      1. Teawain

        Ideal delays?

        I would imagine that bringing in more tech to the NHS will provide another few reasons for 'doing it tomorrow'. I've recently seen Office 365 being inflicted on all staff in an organisation and the fallout was notable amongst those not wanting to be re-trained in various IT skills.

    3. Charles 9 Silver badge

      Re: Sending a photo via SMS

      I don't know about that. In the US there is Certified Mail and Registered Mail, both of which carry assurances of delivery (Registered moreso than Certified). I would think the Royal Mail would have counterparts to this. Plus, at the extreme, there are courier services.

      1. Christian Berger Silver badge

        Re: Sending a photo via SMS

        Sorry, I meant E-Mail.

    4. david 12 Bronze badge

      Re: Sending a photo via SMS

      The technology is called MMS -- Multi-Media Service. It's quite popular in some parts of the world. It was supported on Feature Phones, (that is, not-smart phones) which I think are also still quite popular in some parts of the world, but it's also supported on many first-world networks for use with smartphones

      MMS sends MIME information, so basically it works like HTML: if you phone supports the picture type, you can see it.

  8. Anonymous Coward
    Anonymous Coward

    And, since NHS organisations will be audited ever quarter until they are "fax free", this means it is crucial that every part of the NHS and the organisations it works with becomes digital before the full fax ban. that they will most likely be getting quarterly audits until the heat death of the universe.

    1. Anonymous Coward
      Anonymous Coward

      Fax Auditer

      Where do I apply for the job as Fax Auditer? Sounds like it could be a nice gravy train....

      1. Peter X

        Re: Fax Auditer

        Where do I apply for the job as Fax Auditer?

        You need to apply to the Fax Auditer Auditer.

        Also, (top-tip), when you walk in the door, go to shake hands but then make a shrill screeching noise - they absolutely love that! :D

      2. Anonymous Coward
        Anonymous Coward

        Re: Fax Auditer

        Where can you apply for this job?

        Simple, your local NHS trust ... just send them a fax.

      3. Steve K Silver badge

        Re: Fax Auditer

        They’ll get baud quicker if you do that...

  9. Rupert Fiennes Bronze badge

    Security and but also third party issues

    Fax is "secure", but maintaining it requires a phone line. Which is usually plugged into a printer both on the network, and usually in a trusted network, despite people like me getting grumpy about this. That's the security issue; worrying about someone tapping the phone lines is less of an issue. War dialling isn't the thing it was twenty years ago, but it's something people should be aware of, not least because the fax numbers will be well known.

    That being said, there's plenty of third parties who will rely on fax to send things like PO's and contracts...

    1. the spectacularly refined chap

      Re: Security and but also third party issues

      Fax is "secure", but maintaining it requires a phone line.

      No it's not, there is more to security than interception or man in the middle attacks. The big problem with fax is that there is no method of asserting the recipient is the intended one - the details could be out of date or the number misdialled - you don't know until the notes have gone somewhere they shouldn't have. And yes this is a very real concern, I know from experience GP practices won't keep contact details up to date even with the organisations that pay them. What hope for general directories?

      With NHSMail things are not ideal because the address is assigned to the individual rather the organisation (excepting group mailboxes) but if the address is valid they are still within an NHS care provider somewhere and presumably bound by professional standards of confidentiality, even if they no longer work for the intended organisation.

      1. Mage Silver badge

        Re: Security and but also third party issues

        Also it DOES work over decent VOIP. No real phone line needed.

        I remember about 20 years ago explaining to the local Garda HQ how easy it was to open a cabinet or hatch near the station. Fit a bug charged off the phone line and intercept with a radio connected to a PC fax card in a van a few hundred metres away.

        Echelon simply intercepts faxes at the exchanges.

        Still, for everyday purposes less likely to be intercepted by a random script kiddie than email. Secure email still needs some expertise to set up.

        SMS and photos by MMS is terribly insecure as Mobile operators won't spend the money on more up to date security.

      2. DJO Silver badge

        Re: Security and but also third party issues

        The big problem with fax is that there is no method of asserting the recipient is the intended one

        Wrong.

        An important benefit of faxes is the reception receipt, admittedly these generally ignored by they contain the reception time and the recipients number. In fact this is the reason that faxes are usable for legal documents while other more easily spoofed methods (such as email) are not.

      3. Orv Silver badge

        Re: Security and but also third party issues

        The big problem with fax is that there is no method of asserting the recipient is the intended one - the details could be out of date or the number misdialled - you don't know until the notes have gone somewhere they shouldn't have.

        I used to work at a place that had a block of 16 DID fax lines, all going to a single computer fax system, all numerically sequential. Numbers that weren't currently assigned went to my email. I used to get an amazing number of misdirected medical faxes. From what I could tell a prosthetics lab at a local university hospital had a number similar to one of ours.

        The US medical system is also heavily reliant on fax. The biggest problem I've had with it is faxes often disappear into the aether. Fax compatibility is far from 100%, and I once had to change pharmacies just because their fax machine could not successfully receive faxes from my psychiatrist.

      4. david 12 Bronze badge

        Re: Security and but also third party issues

        "If the address is valid" is no more secure than "if the phone number is valid"

        In any case, the NHS could move to Encrypted / HPIIA compliant / TLS fax if they wanted too -- it's not like it's a new idea that nobody offers.

        1. the spectacularly refined chap

          Re: Security and but also third party issues

          "If the address is valid" is no more secure than "if the phone number is valid"

          If the address is valid you are assured that it is the correct recipient. As I indicated they may have moved to ano0tehr orgnaisation but it is still the same person and they are still within the NHS. With a fax number you have no such guarantees.

  10. Teiwaz Silver badge

    Typical half-assed Gov thinking

    Problem:

    For lack of a more up to date working communication system for authorized orders, the (outdated) Fax is used to carry signatured orders.

    Gov. Solution:

    Ban the Fax machine from being a solution going forward, someone will sort out an alternative and the Health Minister can pat himself on the back, problem solved.

  11. phuzz Silver badge

    Sweapstake

    Ok, who wants to guess what year the NHS will actually get rid of their last fax machine?

    I'm going to pick 2041. Oh, and following the removal of that last fax, it turns out it was the only way to order drugs for a major hospital...

    1. Jemma Silver badge

      Re: Sweapstake

      "For the only hospital left* since the UK was designated a 5th world country".

      *In Luton **

      ** For inbredistanis and non UK residents - Luton is the UK version of Tatooine.. "If there's a bright centre to the universe - you're in the shithole that's furthest from...". Even Daleks & Cybermen leave it well alone - on the basis that:

      A: They can't make it worse than it already is.

      B: The suicidal bsod that results from going too close. The Doc missed a trick - just transmat them to Leagrave - job done.***

      *** Yaz please - she's cute.

      1. Teiwaz Silver badge

        Re: Sweapstake

        ** For inbredistanis and non UK residents - Luton is the UK version of Tatooine.. "If there's a bright centre to the universe - you're in the shithole that's furthest from...". Even Daleks & Cybermen leave it well alone - on the basis that:

        @Jemma: Never been to 'Derry then??? it's like Luton with worse rail connections.

  12. LDS Silver badge

    There are two issues: who runs the datacenters, and the doctors themselves.

    Here we've been using electronic prescriptions for a while. Doctors type the prescription on their PCs, and it's sent to a system pharmacies have access to too.

    But it does work because everyone is issued a "Services National Card" which identifies you - something Britons are always against to. You can have a printed copy with a barcode, though. We didn't have big outages - yet. The system was also created to avoid frauds where people who have special exemptions were used to prescribe a lot of drugs, especially expensive ones. Doctors didn't like it (it allows for easier tracking of drug subscriptions...), and many actually have troubles to use a PC - some complained loudly the spent more time using a keyboard than actually visiting people (in many cases, they deserve a load ROTFL!, giving the level of their visits).

    My doctor is a real disaster, and her software too looks very badly designed. Her backup told me she's using a better one, but also more expensive.

    However, a few years ago an hospital wasn't unable to make my mother's CT scans accessible to the doctor PC - luckily I had the DVDs with me...

    Like many companies, hospital and the whole system fail to understand now IT is their nervous system, not a nice-to-have one. It must be designed, maintained and administered with availability, resiliency and redundancy in mind. While software must address practitioner needs - sure, some doctors must understand they're now living in the XXI century, but software can't get in their way.

    1. arrbee

      Re: There are two issues: who runs the datacenters, and the doctors themselves.

      *shrug* we have that in the UK between GP and pharmacy with no id card required(*). The downside of course is that if your selected pharmacy is closed for any reason then, depending on your prescription, you may be stuffed.

      (*) in the UK most regular prescriptions come via your GP, even if the initial one comes via hospital.

      1. LDS Silver badge

        "if your selected pharmacy is closed for any reason then"

        Here you can go to *any* pharmacy. As soon as the prescription is marked as "done" it can't be used anymore, of course. I usually use three different pharmacies, two nearby home, one nearby work. But sometimes I used others as well. The card is also used to compute tax deductions for drugs and visits.

        You can avoid the card and have a simple prescription, but then you have to pay the full price of drugs, because the health service won't pay for them (wholly or partially).

      2. EnviableOne Bronze badge

        Re: There are two issues: who runs the datacenters, and the doctors themselves.

        Id is very definatley required, we have what is known as the NHS SmartCard (a certificate authentiction) that can onlyh be issued on production of three forms of ID one of which to be Photo, and the people that issue it are more pedantic than the passport office.

        1. Anonymous Coward
          Anonymous Coward

          Re: There are two issues: who runs the datacenters, and the doctors themselves.

          NHS Smart Cards are for staff, shirley ?

          For prescriptions you just tell GP surgery your preferred pharmacy & then you can order prescriptions online, go to pharmacy, ask nice lady for prescription for A, they ask you for A's address as a check, if necessary you pay £9 ( not in Scotland, under/over age, have prepaid card, etc ), and thats it.

  13. Timmy B Silver badge

    Recent Experience....

    I wonder how they are going to replace this?

    I have a relative die last week. Faxes were used between the Doctor and the Coroner and the Registrar in registering the death. All three of them required copies of the death certificate, documentation backing this up and follow-up paperwork. They all exist on totally different software systems and don't have easy and direct email contact. For example there is no way of directly emailing a particular coroner for a particular registrar, but currently if information is requested then the recipient will tend to go and stand by the fax and wait. A horrible situation (Doctor made errors on death certificate) was able to be resolved fairly easily because of the simple, speedy and faithful reproduction system that faxes allow.

    We are just going to end up with emails going back and forth to "the coroners office" or "some Dr surgery somewhere" and people will miss them or the wrong person will pick them up. That is after the scanning software and scanners, etc. is all worked out. Scanners - after all - aren't the most user friendly of hardware when compared to a fax machine.

    1. Colin Bull 1
      Facepalm

      Re: Recent Experience....

      I am amazed to see crap like this on the Register. It will only take someone with IT knowledge to transform this system into something fit for purpose.

      It is not dissimilar to the DVLA system. As soon as my car is MOTed it is on the system. PC plod knows it is MOTed or not. I do not have to walk 5 miles to the post office with a VC5, MOT certificate and f** knows what else to tax it as the system is connected and I can do it online in 2 minutes.

      Get real. The removal of fax machines from NHS should have happened years ago. Emails between trusted partners is a piece of cake. I bet in twenty years time some places will still be paying for line rental for devices removed twenty years earlier because there are no systems in place to check requirements.

      1. Jim Whitaker

        Re: Recent Experience....

        Spot on. Where there are problems with comms to some other partner organisations, get a grip and solve them.

        1. Anonymous Coward
          Anonymous Coward

          Re: Recent Experience....

          Ooh - you've never worked with GPs, have you? Or in the NHS, either, I suspect. Nothing ever trumps the blessed and holy status of the GP, certainly not the fact that the technology s/he is using is dangerously flakey and probably harmful to patients' interests - and the phrase 'get a grip' is career suicide when spoken by a techno to a saintly GP, I can tell you. Hence the AC handle here.

      2. Timmy B Silver badge

        Re: Recent Experience....

        RE: "I am amazed to see crap like this on the Register. It will only take someone with IT knowledge to transform this system into something fit for purpose."

        There are hundreds, if not thousands, of people with IT knowledge trying to tie the NHS together and failing. You really need to get some life experience and see what actually happens in the real world. I used a real world example and this also included departments that aren't even part of the NHS and explained why email would be an issue. I think you need to actually get some life experience and see what happens when government, bureaucracy and just plain incompetence gets in the way of someone with IT knowledge.

  14. chivo243 Silver badge
    Trollface

    Monty Python fax banning sketch

    That's a fax, burn it! No, it's not! Yes it is, burn it...

  15. Anonymous Coward
    Anonymous Coward

    I put in a patient record system for a medical charity

    Not in the UK but we had one of our government supervisory bodies insist that patient information be exchanged via fax rather than email, even encrypted email. Medical secretaries refused to learn how to use our encrypted email anyway, while the other hospitals and some regulatory bodies each had their own version and wouldn't use ours.

  16. big_D Silver badge

    Legal Document?

    For instance, she said, they will require signed directions or prescriptions – something easily achieved "in the real world" by taking a photo on your phone and sending it via SMS.

    I don't know what UK law is, but in Germany, for example, a prescription sent by fax (or anything sent by fax) is a legally recognized document. A document sent as a scan in an email or, worse by insecure SMS (surely MMS?) is not recognized as legal document - therefore the pharmacy could issue drugs based on the fax, but not the SMS/MMS.

    A digitally signed email and a digitally signed PDF attachment would be, as long as the senders certificate is valid.

    Also, emails are very unsecure, unless you invest heavily in training users to create digital signatures and install them in the email client etc. which is still a complicated task for most IT professionals. I've done it a few times, but it isn't something most GPs or receptionists would be able to do, for example.

    1. TonyJ Silver badge

      Re: Legal Document?

      "...I don't know what UK law is, but in Germany, for example, a prescription sent by fax (or anything sent by fax) is a legally recognized documen..."

      I don't know if it's still the case but it certainly used to be, as a fax was considered to be a facsimile of an original that couldn't be altered in-flight or post-delivery.

      Of course, I am sure that there are ways that they could be altered in-flight if you were able to set up some kind of MitM attack, but still.

      And for that matter, I believe that the vetting agencies here in the UK (at least until recently) often had pre-programmed fax numbers that were considered acceptable means of confirming/transferring clearance but that could have been one of those half-truths I picked up along the way.

      Edit: Ah look: https://www.efax.co.uk/blog/why-fax-is-legally-binding

      Of course, eFax have skin in the game, but...

      (And yes..I realise fax = facsimile) :)

  17. iron Silver badge

    "prescriptions – something easily achieved "in the real world" by taking a photo on your phone and sending it via SMS."

    Dear Ms Stokes-Lampard, DON'T FUCKING DO THIS! You have no idea of privacy and have just shared the medical details of a patient (a prescription) with your mobile company, their mobile company and possibly others in transit. Please report yourself to the ICO for breaching GDPR and the GMC for breaking your oath.

    1. Anonymous Coward
      Anonymous Coward

      Yes, my wife works as a Church Administrator and she's received guidance recently that she should not use her phone to take pictures of people to use in things like church magazines (even of Church members taking part in Chuirch activities) unless she

      1) disables cloud-sync of photos,

      2) takes the photo

      3) transfers it to a PC

      4) deletes photo from phone

      5) only then can cloud-sync be re-enabled on the phone

      as allowing a photo to be automatically uploaded to any Apple/Google/whatever cloud could breach GPDR etc

      1. LDS Silver badge

        "to take pictures of people to use in things like church magazines"

        Religious beliefs is one of the sensitive data under GDPR - they have special protection, and require special permission to be stored and processed.

        https://ec.europa.eu/info/law/law-topic/data-protection/reform/rights-citizens/how-my-personal-data-protected/how-data-my-religious-beliefs-sexual-orientation-health-political-views-protected_en

        Attending a church might not mean "you have made your sensitive data manifestly public" - or maybe you're even there for different reasons. I'd be anyway very careful to publish any photo in such a magazine of people who didn't give consent explicitly, even if it could fall under the exception usually the press has about public events.

      2. Nifty

        "she should not use her phone to take pictures of people to use in things like church magazines"

        (Not GDPR compliant because of cliud storage, etc)

        Or use one of the many camera apps that store only on your phone unless you take a specific action to store them in your photo library and thence to cloud.

        1. DuncanLarge Bronze badge

          "Or use one of the many camera apps that store only on your phone "

          Or just use a compact digital camera. There are plenty around new or even secondhand. I got a nice 4MP Casio for £2 from a charity shop. It would work just fine for taking photos for a little magazine.

          New ones of course have all sort of bells and whistles not to mention higher resolutions.

  18. big_D Silver badge

    The first rule...

    The first rule of implementing an IT system is to have a backup if the IT system goes down. How do you send that document, if the email or electronic messaging system is offline for a few hours?

    Not really an issue in some sectors, but in the health sector, it can be literally a life or death issue.

    Having a paper based / manual backup was always priority number one on implementing a new system, when I was working as an analyst. But it seems good practices are being thrown out the window in the face of Cloud and DevOps...

    1. Anonymous Coward
      Anonymous Coward

      Re: The first rule...

      "Not really an issue in some sectors, but in the health sector, it can be literally a life or death issue."

      And, during the WannaCry attack the response from large portions of thr NHS was to unplug themselves from networks. Maybe someone should put in a FOI request to find out whether there was a spike in use of faxes while all computer systems were unplugged!

      1. Doctor Syntax Silver badge

        Re: The first rule...

        "Maybe someone should put in a FOI request to find out whether there was a spike in use of faxes while all computer systems were unplugged!"

        And during the recent NHSMail outage.

        1. Charles 9 Silver badge

          Re: The first rule...

          Wonder what would've happened if the telephone exchanges had gone dead at the same time...

  19. karlkarl

    Not happy

    What are we going to be able to dial "24328" on now?

    3 points to the first human to discover the reference ;)

    1. Anonymous Coward
      Anonymous Coward

      Re: Not happy

      "CHEAT"?

    2. EnviableOne Bronze badge

      Re: Not happy

      Havent played that one for an age, back wwhe computer games were fun, and completley unrealistic

  20. EnviableOne Bronze badge

    Paperless 2020

    the paperless 2020 money pot has already been raided and the cupboard is bare.

    NPfIT had some of it the GDE program had its share, the WannaCry remediation took a load, and the W10 desktop licences took what was left. There is no money for replacing faxes, even to expand the fax to email gateways most trusts have.

  21. Anonymous Coward
    Anonymous Coward

    At least 10 years late

    Faxes should have been dumped with other cruft from the 1990's long ago.

    Official guides in how to use a fax and remain secure are big thick binders and it requires all fax machines to be in locked areas and under supervision AT BOTH ENDS when in use.

    No, faxes are not inherently more secure than email. Fax messages are unencrypted and unencryptable. Even a 50 year old administrator can encrypt an attachment after being shown. (Could take 10 minutes) Medical secretaries can do it in much less time. Nobody needs to be told how twice unless they are being deliberately obtuse. If they are already on NHS.net, prior instruction should be between 10 and 30 seconds.

    THis is a good, and long awaited, thing.

    1. Doctor Syntax Silver badge

      Re: At least 10 years late

      "If they are already on NHS.net, prior instruction should be between 10 and 30 seconds."

      That's assuming NHS net isn't down. What do you do when it is?

    2. DuncanLarge Bronze badge

      Re: At least 10 years late

      "Official guides in how to use a fax and remain secure are big thick binders and it requires all fax machines to be in locked areas and under supervision AT BOTH ENDS when in use."

      That is a lie.

      "No, faxes are not inherently more secure than email."

      Go on then, intercept one in transit.

      "Fax messages are unencrypted and unencryptable."

      That is a lie. The FAX standard has always used encryption and FAX over the internet uses TLS. I suggest you do your research rather than making things up because you want to look like you know something about how technology works.

      "THis is a good, and long awaited, thing."

      Yep, it wont be long till we see the headlines and BBC rolling news items about the GDPR data breaches of private medical information stolen while sitting on a third party server somewhere that was configured to be an SMTP smarthost for the NHS by a worm introduced via some secretaries flash drive her 4 year old son found in the plant pot outside and gave to mummy, and the pandemonium caused by an outage of the email system due to someone forgetting to pay for an SSL certificate.

  22. Mage Silver badge
    Coat

    such as secure email

    Though with a Fax you KNOW it's connecting and printing (unless a sneaky computer based system, I was using the 10 numbers on a basic ISDN, ISDN card in NT4 server and integrated, archived, indexed TIFFs direct to desktop before offices had DSL).

    I hope not outsourcing set up of Secure Email to Capita, or on a Cloud. An organisation that big needs their own co-located servers, their own IT experts, redundancy/distribute systems etc.

    What could go wrong outsourcing it all to MS, Capita, Amazon, Google etc?

    My coat used to have a Nokia Communicator N9200i to test the faxes.

    1. Orv Silver badge

      Re: such as secure email

      Though with a Fax you KNOW it's connecting and printing

      Although not necessarily that anyone will see it, or that the printout is legible, or that you haven't misdialed and sent it to the wrong machine.

  23. Primus Secundus Tertius Silver badge

    Fax software

    "Yes, Mr Auditor guv, this is a computer, honest. Look at these super spreadsheets showing how much money we are saving. Fax, what fax, no fax around here, mate".

    Mr Auditor moves on, operator hits start button to reveal fax icon.

  24. Doctor Syntax Silver badge

    The real problem with fax machines is that you can't install Matt Hancock's app on them. They have to be replaced with something compatible.

  25. Anonymous Coward
    Anonymous Coward

    I suspect....

    Only one ward used a fax when I worked at a hospital and most of the lines have already been disconnected for lack of use........

    Should'nt be too hard to remove and dispose of the old kit........

  26. David1

    Is internet as reliable as legacy 'phone system?

    My experience is that POTS outages are rare, but internet outages are common.

    Does anybody have any (non-anecdotal) data about outages?

    1. Maelstorm Bronze badge
      Facepalm

      Re: Is internet as reliable as legacy 'phone system?

      "My experience is that POTS outages are rare, but internet outages are common.

      Does anybody have any (non-anecdotal) data about outages?"

      I used to work for AT&T in wireline service (aka POTS). The outages causes by hardware failure in telephone switching equipment is rare, and usually only affects a small number of customers (usually people within a block of ports or something like that). The really big outages were caused by drunk drivers taking down a pole or some construction crew with a backhoe ripping a cable out of the ground.

      One memorable event took place in the early 2000's where someone was drilling sideways under US101 here in California, USA in Marin County. They snagged the fiber optic cable with the auger and took down a whole bunch of things. The highway patrol closed the freeway so repair crews could jackhammer the pavement to get at the cable to fix it.

  27. Maelstorm Bronze badge
    Devil

    The last time that I checked...

    The last time that I checked, you cannot hack a fax machine and a filing cabinet remotely.

    Medical records? "Secure" email? Single point of failure?

    What can possibly go wrong?

  28. Frumious Bandersnatch Silver badge

    I have a cunning plan

    All I can say is that it's a good time to invest in the telegram service ...

  29. Dave Foster

    The government has claimed the NHS will be paperless by 2020

    So there will be no bulky files of patient notes?

    No patient notes at the bottom of the bed?

    No post it notes on the wall?

  30. clyde666

    still alive and kicking

    I've got a Brother MFC-J5330DW new, sitting boxed beside me, ready to take out and install on Thursday afternoon.

    Client wants this one because it includes fax. Seemingly they still get "a few" faxed drawings from time to time.

    And no, it's not the NHS, not even a government office of any sort, it's a real live small business operating in the real world of small business to small business.

    Anyway, no real price difference between that and a non-fax printer/scanner.

  31. Anonymous Coward
    Anonymous Coward

    Accenture reportedly botched a data centre upgrade

    Accenture botched something?!

    ...

    oh, "reportedly", I see, fake news then :D

  32. Jim Whitaker
    Flame

    Data breaches

    I had a job in the NHS as Interim Governance Manager. I was surprised at the ubiquitous fax machines. I then became aware of the number of serious data breaches which they were implicated in.

    Send full details of child injuries following abuse? OK course, I will fax them now to the flower shop round the corner. No wait, I will send them to the solicitors for the other party.

    Yes as a GP surgery I'm happy for dozens of sheets of health information to be spewed out over the floor overnight for the local cleaning firm to tidy up before surgery staff arrive.

    And those flimsy sheets coming out of the fax by the window - well we recovered most of them from the car park.

    I'm not saying that autocomplete does not cause issues with email but the ability to install controls is so much better with email.

    1. MrMerrymaker

      Re: Data breaches

      Seems like you ended up auditing human error more than anything else.

      It's a shame really. Not because I have some kind of mad hard on for the fax - no, because as ex NHS IT they gave me a fax machine for the purposes of accepting signed training forms for new users of the patient records system.

      Every time I mooted some more up to date method of this, it was met with horror and ignorance and fear.

      Still. I don't know if there was some more arcane NHS regulation about it. Capturing the user's signature was a very significant concept. Methinks a zero-fax overhaul would go way, way outside the mere realm of IT.

  33. DuncanLarge Bronze badge

    Total facepalm, now face is bruised.

    "Email is much more secure and miles more effective than fax machines"

    I'm hoping that you will implement secure email correctly? It can be done just fine as long as you know what you are doing AND TRAIN YOUR USERS to use email in a way that they have never used it before.

    Seems like punching a phone number (or even using a speed dial) and dropping a bit of paper into a sheet feeder of a fax machine is quite a lot simpler. Perhaps there are devices that work like fax machines but email securely instead? I swear I have seen them. I swear that modern FAX machines also can email so there must be secure emailing FAX machines about.

    "they will require signed directions or prescriptions – something easily achieved "in the real world" by taking a photo on your phone and sending it via SMS."

    SMS, are you f*cking serious? You want people to send their prescription requests and signatures via SMS? SMS has been cracked for ages now. It is no more secure against a kid with a raspberry pi, 1TB of HDD space and a software defined radio as a postcard is against a postman. SMS is great for sending that message from the side of a cliff when you are on holiday with only a low strength 2G signal. Its great for sending a message to tell your hubby to get 2 loaves of bread. But for sending a very personal and private communication that if intercepted can be used to help commit ID theft, where have you been?

    How come nobody seems to know that just because its easy, or "high tech" or "modern" does not mean its safer? You want to replace an old system with a new one? Ok well do some proper research and prove that every element of the new system can directly replace or improve upon the old. This includes, as in the case of fax machines, understanding how someone today would go about intercepting such messages or tampering with them. I would argue that due to the shift towards using IP networks that most "hackers" these days are ill equipped to intercept faxes and much more likely to succeed with emails.

    https://www.youtube.com/watch?v=H3HFOlYba-4

    1. ibmalone Silver badge

      Re: Total facepalm, now face is bruised.

      "they will require signed directions or prescriptions – something easily achieved "in the real world" by taking a photo on your phone and sending it via SMS."

      SMS, are you f*cking serious? You want people to send their prescription requests and signatures via SMS? SMS has been cracked for ages now.

      This is the issue. Yes, fax is outdated, yes it is not really secure (though falling to tomorrow's wannacry equivalent is maybe less likely), yes it should be replaced by better systems. But the people driving this then go and say things like, "You can just send it by SMS." What a wonderful idea (let us just stop and consider for a moment, beyond security considerations, what that means for records keeping). And then remember why the name "Matt Hancock" is familiar... https://www.theregister.co.uk/2018/02/01/matt_hancock_app_privacy_bug_ed_vaizey/ from the world of off-the-shelf, not evaluated for purpose, "this is the hip new thing, we'd better get in on it! #necessaryhashtags" ideas. Still, at least the word blockchain hasn't appeared. Yet.

  34. devTrail

    It will be painful

    Forbidding the purchase of new fax machines seems a decent move, dumping what they have in place seems a really dumb move.

    Many among the older people are still not used to modern technology and even if encrypted emails might appear safer many people will be easily tricked into using the email in the most unsafe manner. Probably some government officials spotted a way to make some money from a forced turnaround, but a gradual phase out would have prevented a lot of the problems that will pop-out in the next two years.

    I can foresee not only the problems but also how they will be easily dismissed as teething problems, nobody will dare to talk about corruption.

    1. Uberior

      Re: It will be painful

      They said that about old people using fax machines in the 1980s.

      1. devTrail

        Re: It will be painful

        They already have the machines and probably even tons of paper. What's the point of throwing away everything? Keeping it as a backup wouldn't be so expensive.

        "They said that about old people using fax machines in the 1980s."

        When there are 60 millions of people around there are a lot of different minds and mindsets, forcefully closing a communication channel instead of letting it die down slowly will surely create problems for someone.

  35. Uberior

    There were tantrums when the Trust I worked for switched off their fax machines.

    We gave a full 12 months warning, that was repeated every month, until the day the plugs were pulled.

    Lot's of "what are we going to do?"

    The answer was always easy. Migrate over to an email solution or bike the documents to us. Two organisations threatened to sue us for the cost of couriering the documentation, one claiming that it was "illegal" not to have a fax machine. They didn't, and it isn't.

    1. DuncanLarge Bronze badge

      Re: There were tantrums when the Trust I worked for switched off their fax machines.

      @ Uberior

      Right. This is an interesting one.

      So, you kill off a simple, easy to use fax machine at that trust. Ignoring the issues with how email is woefully inadequate for replacing the functions of fax, you let them "bike" the stuff to its destination?

      Is that progress? Are we to return to riding horses instead of driving cars? Perhaps we should also scrap cruise liners and instead go cruising around the world on rafts. I know, lets get rid of those smelly and dangerous gas powered ovens and make everyone use coal. Progress, rose tinted progress.

      My god man. What were you thinking? Biking private details. I really hope that they were on some medium that was not generally accessible to the public, such as LTO tape (I dont think many members of the public have access to LTO drives) and encrypted using public key cryptography before being handed to a spotty kid on a bike.

      Why didnt you use something like a securicor van? You know, those vans that can guarentee security and have vans designed to make access to the stuff inside difficult. However even with this there is an issue with moving backwards from using a fax machine to using a van that rolls on the public road on inflated balloons called tires. That is those inflated balloons can leak catastrophically resulting in non-delivery of the contents.

      Failure modes for old tech that uses inflated balloons on tarmac:

      1. Robbery. Van = more secure, bike = good luck.

      2. Balloon leaks. Van = time taken to replace balloon, aka the tire. Bike = rider walks or tries to repair tire and continue. Result = potential significant delay.

      3. Dishonesty. Van = driver steals documents and sells them to whoever wants them. Bike = the same.

      4. Accidents. Van = Multiple issues such as the van hitting the rider of the bike, the driver has a heart attack or is taken ill, the van collides with a car or other object and so on. Bike: The rider is hit by the van, the rider comes off the bike and goes to hospital.

      5. Industrial/political action / disobedience. Your van driver or biker goes on strike and refuses to deliver till the union says its ok. Or they get held up by rampaging mobs of climate protesters who are blocking the bridges over the river because idiots like you wish to have a van spewing out CO2 to deliver data that could be sent down a phone line.

      Bike?

    2. gerdesj Silver badge
      Gimp

      Re: There were tantrums when the Trust I worked for switched off their fax machines.

      There were half hearted tantrums when the IT company I part own *cough* lost its fax machine when we moved. It slipped and fell into the skip. Then I had to throw a chair onto it to make sure it broke properly.

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