NHS MESH Integration

In NHS MESH Integration, Workflow Groups and Workflow IDs are critical identifiers that determine which types of messages can be sent or received by a mailbox. Think of them as the “permissions” for specific message types — for example, a pathology result or a vaccination update. These IDs must be registered to your MESH mailbox in advance, and both the sender and recipient must be assigned the relevant workflows for communication to succeed. 6B assists in selecting, requesting, and registering the correct Workflow IDs to ensure seamless message routing and compliance with NHS protocols.

MESH allows secure transfers of files up to 100GB using a process called message chunking, where large messages are broken into smaller, compressed pieces. This is particularly useful for sending high-volume data like imaging files or national audit submissions. However, not all mailboxes or workflows support chunked messages. At 6B, we assess your compatibility, configure chunking support, and ensure your application handles compression, chunk ordering, and acknowledgement protocols in line with MESH API specifications.

In NHS MESH Integration, a delivery receipt (via the API or client) simply confirms that a message was successfully downloaded. A business acknowledgement (ACK), however, is a separate message generated by the receiving system to confirm that the file was processed and acted upon, not just received. This distinction is important for closed-loop workflows such as vaccinations, referrals, or discharge summaries. 6B ensures your integration correctly handles both types of acknowledgements to support robust end-to-end assurance.

NHS MESH is built with end-to-end encryption, mutual TLS authentication, and time-sensitive HMAC-based authorization headers. Each request is single-use, and messages are automatically deleted after 30 days. At 6B, we implement secure authentication workflows using custom authorization tokens, manage certificate provisioning, and ensure your integration adheres to NHS IG, ISO 27001, and Cyber Essentials standards — all while helping you pass the Supplier Conformance Assessment List (SCAL) efficiently.

The NHS MESH API onboarding process includes several stages: use case validation, mailbox creation, TLS certificate setup, integration testing in the Path to Live environment, and technical conformance assessment. On average, the full process takes 4–8 weeks, depending on readiness. At 6B, we accelerate this timeline by guiding you through each step, from drafting your digital onboarding submission to preparing for witness testing and certificate requests — ensuring a smoother path to production.

Yes, NHS MESH supports non-UK message transfers in specific scenarios, particularly when international partners are involved in UK-based health and care initiatives. However, this use case requires strict validation, appropriate workflow configuration, and adherence to cross-border data governance laws. 6B offers guidance on how to structure your message workflows and apply for cross-border mailbox permissions while maintaining NHS interoperability and data protection standards.

Messages that are not downloaded and acknowledged within five days are flagged for non-delivery. The sender’s mailbox receives an error report, and the message is automatically removed from the recipient’s inbox. After 30 days, the message is deleted from the MESH server entirely. 6B helps build robust polling logic and monitoring alerts into your integration to reduce the risk of missed messages — and we provide fallback procedures for resending or escalating undelivered messages.

While NHS MESH is ideal for secure batch file transfers, APIs like NEMS (National Events Management Service) and GP Connect use publish/subscribe or real-time RESTful methods for clinical events. Each has different strengths — MESH excels at handling large, structured data (e.g., pathology reports or discharge summaries), while NEMS supports real-time event notifications (e.g., patient death, change of address). 6B helps you architect a hybrid interoperability strategy that selects the right NHS interface based on latency, volume, and use case.