Comment: How digital enablement can boost frontline health services

In this article, James Cherry, chief technology officer at Northdoor, explains how the NHS data estate can make time and cost savings that will ultimately benefit frontline services

The use of digital solutions is helping to drive efficiencies in the NHS as well as improving patient care

The NHS in the UK must make efficiency savings wherever it can – lives literally depend on the organisation’s ability to divert funds from back-office to frontline services.

At the same time, the NHS must also deploy new digital tools to meet the changing needs, both of its employees, and the citizens it serves.

Modernising the existing data estate can deliver on both of these requirements, but this is challenging to achieve in a disparate environment that supports mission-critical services.

NHS data estates tend to have grown in a somewhat-haphazard way and are often based on disparate infrastructure that may be unsuited to increasingly-demanding and important workloads

Recognising the challenge facing the NHS, trusts must look to IT data providers who specialise in data in order to create a solution that is a coherent, standardised, fit-for-purpose data platform that utilises Microsoft’s SQL Server and Azure cloud services.

In typical cases, this solution cuts the number of SQL Server instances by up to 40% and enables an 80% reduction in physical servers.

By enabling NHS trusts to consolidate and modernise their data estates, IT data providers could help to deliver TCO reductions of up to 50% – taking money from IT and reinvesting it in improving the nation’s health.

The challenge

Founded in 1948, the NHS provides comprehensive, universal, free-at-point-of-delivery healthcare services to UK residents.

As times have changed, the NHS has evolved to remain relevant to the country’s needs. And, today, one important goal is to rework the provision of IT services to boost administrative efficiency, reduce costs, and improve patient outcomes.

This is a pressing concern, as the NHS is struggling to balance the wellbeing of a growing population with the rising costs of services, energy and supplies.

NHS data estates tend to have grown in a somewhat-haphazard way and are often based on disparate infrastructure that may be unsuited to increasingly-demanding and important workloads.

With tens of thousands of systems used by more than 1.5 million employees, the sheer size of the organisation makes modernising the data estate a huge challenge – particularly as the specialist skills required may not be available internally.

By looking to IT data providers, the NHS has the opportunity to create a targeted framework for modernisation and meet the goal of building a repeatable solution, composed of consulting services, consolidation methodologies, and pre-defined technology components, that would help NHS trusts to identify and execute modernisation opportunities

A large number of trusts, the main subdivisions of the NHS, want to rationalise their data estate and ultimately move to the cloud.

By looking to IT data providers, the NHS has the opportunity to create a targeted framework for modernisation and meet the goal of building a repeatable solution, composed of consulting services, consolidation methodologies, and pre-defined technology components, that would help NHS trusts to identify and execute modernisation opportunities.

The solution

In trusts where Microsoft’s SQL server and Azure cloud services has already been successfully delivered, the data estate previously included multiple versions of SQL Server, from 2000 to 2008 R2, in both physical and virtual environments.

By working to update the underlying software, to consolidate databases, to virtualise wherever possible, and to overhaul backup and disaster recovery arrangements, these trusts have saved on management, support, and licensing costs, while improving performance and gaining access to important new features.

Some trusts are already building on their modernised platform to take advantage of cloud services on Azure or to deploy Power BI for decision support. In all cases, the solution should include a staged roadmap for taking these next steps. /

So, what should a forward-thinking IT data solution incorporate for trusts:

  • A comprehensive environment audit based on rigorous pre-built methodologies

  • Analysis of the SQL Server install base and licensing
  • Identification of SQL Server instances that can be decommissioned
  • Structured project workshops to establish current and future requirements, including desired SQL Server features and functionality
  • Analysis of compliance and security requirements
  • Auditing and measurement of database performance and hardware requirements
  • Fully costed recommendations on the environment and licensing approaches
  • Planning and execution of migration and consolidation exercises
  • (Optionally) fully managed services to operate the new environment

    With four Microsoft Gold competencies focused around data, and a deep understanding of the typical data sets and applications in use at NHS trusts, an exceptionally-broad set of services can be offered

Rather than simply advising on, and executing, database consolidation and migration; IT data providers can help NHS trusts to clean up and re-architect their databases for improved performance, scalability, security and ease of access. This includes the identification of poorly-performing and resource-hungry SQL Servers instances, and the optimisation of their queries and reports.

By helping NHS trusts to migrate to a consolidated data estate, this enables them to reduce TCO by up to 50% – freeing up cash for frontline services.

Rather than simply advising on, and executing, database consolidation and migration; IT data providers can help NHS trusts to clean up and re-architect their databases for improved performance, scalability, security and ease of access

In typical cases, an IT data solution reduces the number of SQL Server instances by up to 40% and enables an 80% reduction in physical servers.

Modernisation of the data estate helps drive greater productivity in the workplace by enabling the introduction of newer and more-efficient information-management tools and NHS trusts need to act now in order to utilise this.

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