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The UK Government introduced a cloud-first strategy in 2013 to encourage all public sector organisations (including the NHS) to consider cloud technology first and foremost. This has since been fully embraced and promoted by NHS England. Cloud technology provides the NHS with the opportunity to innovate service delivery and reduce the carbon footprint of its IT estate. The Covid-19 pandemic demonstrated its ability to digitalise rapidly – creating an opportunity to drive further cloud transformation.
NHS England has responsibility for designing, developing and operating national IT and data services that support clinicians, help patients get the best care and use data to improve treatment. It helps to support digital transformation across the NHS, part of which includes supporting the NHS Cloud Strategy and encouraging NHS organisations to adopt cloud services.
“We have key objectives around cloud adoption,” explained Neil Gibbs, NHS England’s Cloud Engagement Service Lead. “At a top level, we need to drive cloud transformation across the NHS. However, we also have to ensure individual NHS organisations can tailor their cloud journeys based on their requirements. We therefore need to establish standards they can work with and foster a community around cloud – empowering people with new digital skills and capabilities.”
How do you achieve those goals in a highly federated organisation of over 220 trusts and integrated care systems? Especially given organisations are at different stages of cloud adoption and maturity?
NHS England’s solution was to establish a Cloud Centre of Excellence (CCoE) to act as the focal point for cloud guidance, assets and guardrails.
“A Cloud Centre of Excellence develops common solutions, promotes best practices and acquires new skills that are spread throughout the enterprise to support successful digital technology adoption and allow teams to become self-sufficient.”
Laying a strong foundation.
“We have skilled teams working across NHS England, but we needed a partner to help us establish the Cloud Centre of Excellence quickly and successfully. We also wanted to incorporate best practices from industries beyond healthcare,” said Neil. “IBM Consulting, with its Nordcloud cloud-native arm, brought deep cloud expertise and experience to support us.”
NHS England and IBM/Nordcloud co-created a CCoE team in October 2021. The aims for the first year were to:
- Develop a cloud strategy
- Define a roadmap of cloud services and related capabilities to make available to NHS organisations, and
- Build and launch the CCoE offering as a baseline of support to digital teams across the NHS
“The NHS cloud transformation programme is ambitious and will be game-changing for how the organisation delivers care,” commented Declan Coombs, Cloud & Technology Adviser at IBM Consulting. “By articulating a clear cloud strategy and defining milestones for the CCoE, we can focus efforts so as to balance quick wins with sustainable value.”
Understanding diverse needs.
To understand how the CCoE could best support the NHS ecosystem, the team needed to understand the current state of cloud transformation across trusts, including their goals and gaps.
“To be successful, the CCoE needed to meet NHS England’s and trusts’ needs. But because trusts operate independently, there wasn’t an overarching view of cloud adoption or digital maturity across the NHS,” explained Markus Kinni, Senior Cloud Adviser at Nordcloud. “We developed an approach to gain this insight while engaging the wider NHS community in the transformation strategy.”
This involved developing and conducting two surveys to assess trusts’ maturity levels. Based on the responses, the team developed five personas from Cloud Novice to Cloud Champion, with a dashboard categorising trusts and giving NHS England maturity-based insight.
“The personas pin down the content and approach needed to help trusts progress from one maturity stage to the next,” said Neil Gibbs. “It’s valuable detail that helps us develop the CCoE to support them in the right way.”
60%+ of NHS trusts engaged with the cloud maturity surveys.
A hub of support.
With this detailed understanding of trust cloud journeys, the team created and launched an in-depth online Cloud Centre of Excellence Service Portal for trusts’ digital teams to access useful services, guidance and policies developed leveraging IBM/Nordcloud’s expertise.
“In just one year, we created an easy-to-navigate hub with detailed and genuinely useful content. It’s helping trusts understand the value of cloud-based transformation and how they can best leverage it in a consistent way, based on their maturity,” said Neil. “We’re now at 7,000 page views of Service Portal content each month – a significant achievement in engaging the NHS community in cloud and providing the practical support they need. As a result, we’ve built stronger relationships with trusts, enabling us to sound out new ideas and better understand their challenges – which is hugely valuable when it comes to launching new services.”
“The Service Portal provides genuinely useful content that helps trusts understand the value of cloud-based transformation and how they can best leverage it in a consistent way, based on their maturity.”
Ready, set, migrate.
Another important element of the partnership’s work involved streamlining the process of assessing applications and workloads for migration to the cloud – a critical early step in the cloud journey.
First, the team created a common framework for assessing workload/application suitability for migration and determining the best migration approach. Having a framework that can be used across the NHS not only boosts efficiency, it also creates opportunities to spot consolidation and optimisation opportunities.
The first use case was assessing the migration of NHS Spine, which supports IT infrastructure for health and social care in England, joining over 23,000 systems in 20,500 organisations. The successful assessment has provided a proof of concept for rolling out the framework to trusts and other NHS England applications.
New platform potential.
A third workstream involved enhancing the cloud platforms supporting the NHS IT estate, which includes a large AWS estate and a growing Microsoft Azure estate.
“Prior to our collaboration with IBM/Nordcloud, we had a glass ceiling with our cloud platforms,” Neil noted. “Their technical design input led to the implementation of new techniques for scaling and managing the platforms. Now, no one’s restricted by ceilings.”
These efforts have consolidated more than 350 cloud accounts into a single platform with best-in-class security, simplified access management and automation. This makes it easier to scale while ensuring robust governance and security.
This centralisation of cloud accounts, security and policies has led to 40% savings on cloud costs and a 35% improvement in cloud security score. “Quite simply, we couldn’t have achieved this without the CCoE foundation and expertise from the partnership with IBM/Nordcloud,” said Neil.
Cloud cost savings
Improvement in cloud security score
Reaping the benefits.
In just one year, the co-creation team has made key progress aligning cloud transformation journeys across the NHS. According to Neil Gibbs, the NHS England and IBM/Nordcloud partnership has built on “pockets of excellence” for scaling out the wider ecosystem, taking “vital, small steps towards the big goals.”
Neil attributed this success to the close collaboration: “We work as one team – and together we’re delivering. Cooperation, upskilling and best-practice sharing are built into the fabric of our partnership. As a result, the resources, frameworks, tools and guardrails are bringing coherence and structure to cloud journeys across the NHS.”
The CCoE’s impact is visible across the growing number of cloud case studies showcasing the value trusts are gaining. “Trusts have leveraged our work for everything from migration assessments to business case development, cost optimisation and governance,” Neil explained.
As the project enters the second year, there’s now a firm and strategic foundation to build on – expanding successes to further progress towards the NHS’ cloud goals.
“Collaborating, upskilling and best-practice sharing are built into the fabric of our partnership. The resources, frameworks, tools and guardrails are bringing coherence and structure to cloud journeys across the NHS.”Neil Gibbs
NHS England Cloud Engagement Service Lead