Is the NHS ready for another WannaCry?

Source: NHE March/April 2018

NHE’s Seamus McDonnell on the plans put in place to protect trusts and other NHS organisations from potential future cyber-attacks.

In May 2017, the NHS’s cyber protection plans were thrust into the limelight after a ransomware programme called WannaCry exposed the weaknesses in current systems – but, nearly a year later, there are still no trusts able to pass NHS Digital’s security inspections.

Out of 200 trusts assessed by the organisation in February 2018, not one was up to the standards set by inspectors, prompting fears the system could be unprepared for a similar kind of attack.

The revelation came at a Public Accounts Committee inquiry where NHS Digital’s deputy chief executive, Rob Shaw, told ministers there was still a “considerable amount” of work left to do to reach standards for cyber security.

Shaw explained that the issue was around ‘patching,’ but reassured ministers that the standards set by the country’s national data guardian, Dame Fiona Caldicott, would take time to reach.

“The amount of effort it takes from NHS providers in such a complex estate to reach the ‘Cyber Essentials Plus’ standard that we assess against, as per the recommendation in Caldicott’s report, is quite a high bar,” he added.

“So, some of them have failed purely on patching, which was the vulnerability around WannaCry.”

The WannaCry attack that began on 12 May is thought to have affected 81 trusts across the country, as well as computers at almost 600 GP surgeries. In total there could have been up to 70,000 devices infected, according to the National Audit Office (NAO).

The programme locked users out of their machines and demanded $300 in return for access to the computer’s hard drive, throwing a number of trusts into turmoil and forcing nearly 7,000 appointments to be cancelled across England.

Despite greater preparations, there are still fears that the systems in place may not be able to support the NHS should a major cyber-attack hit trusts again, especially considering the service had already been warned of a potential future incident up to a year before WannaCry occurred.

A report written by the NAO in October last year scolded the Department of Health and Social Care and NHS England for not doing enough to prepare for the threat, arguing that there was no formal mechanism in place to ensure trusts conformed with guidelines and moved away from outdated operating systems like Windows XP.

The criticism, combined with the WannaCry attack itself, has prompted the government to impose much stricter guidelines and assessments on the capability of NHS bodies.

Shaw, who has served as both chief operating officer and interim chief executive since joining NHS Digital in April 2016, said his organisation had inspected 200 trusts since the attack, a significant rise on the approximately 90 trusts assessed before the incident.

“I always take it better to have information, to know where your vulnerabilities are, so that you can do something about it rather than hope that you will be okay when you do get an attack,” he explained. “These vulnerability reports go back to the trusts and their trust boards to be able to work out how they can then do mitigation.

“Some need to do quite a considerable amount of work, but a number of them are already on the journey that will take them towards meeting that requirement.”

The increasing number of assessments must be a positive, and Shaw’s attitude to their improvement seems to show an overall development in the quality of cyber protection – but, with none of these organisations passing their tests, it is not clear whether the system is truly prepared quite yet.


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