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UK National Health Service (NHS) datacentre builds and modernisation projects are continuing apace against the backdrop of the Covid-19 pandemic, as IT leaders need resilient IT infrastructures on which to base their digital transformation plans.
John Thompson, managing director of datacentre infrastructure management specialist Advanced Power Technology (APT), says the future looks rosy for its projects, which are largely focused on refreshing power and cooling or monitoring and management tools, but also include the building of new datacentres. Tenders and contracts continue to progress with a range of NHS trusts.
“When the pandemic started in January 2020, we were expecting to stop work halfway through – but what happened was quite the opposite,” says Thompson. “They said ‘this is our central datacentre – we need you to finish it as soon as possible’. It was very helpful for them to have the infrastructure refreshed, and now they can monitor it, and see any issues.”
The nature of datacentre redevelopment contracts also look to be changing. Organisations are placing more emphasis and openness on finding partners to help them develop their strategies, says Thompson, noting that NHS in-house datacentre teams have in the past often been relatively poorly resourced and informed – suggesting that greater transformation is possible with guidance.
“We are starting another datacentre for a Lincolnshire hospital, and we’ve got another one ahead of that, which may well be a prefabricated one,” he says. “They’ve all got some element of cloud services going on, or hybrid cloud and on-premise.”
Modernisation projects deploying converged infrastructure can lower the total cost of ownership (TCO), releasing resources to boost performance and productivity – including the increasingly data-driven insights that improve and future-proof healthcare delivery. Preconfigured converged infrastructure systems can also be faster to deploy.
NHS datacentre investment levels remain healthy
Ensono, a VMware partner and infrastructure specialist, confirms that continued NHS investment can be enhanced by a software-defined infrastructure, which can typically be about harnessing hybrid IT.
Simon Ratcliffe, principal consultant at Ensono, says that in December 2020, the company was contracted to build a new data platform to support University Hospitals Birmingham NHS Foundation Trust’s quest to improve acute care.
This evidences a new view of fostering incremental improvements in individual NHS projects that enable transformation – through infrastructure modernisation, among other things.
“Every time you used to hear about an NHS project, it was a big systems integrator [SI] being awarded a 15-year, £300m project,” says Ratcliffe. “With Birmingham, you can see the change which, bizarrely, is driven by the infrastructure. We can try a bit, be agile, and iterative.”
Covid-19 seems to be accelerating the push to look at whatever will help build a better healthcare system, which means being able to work with multiple data sources to derive maximum benefits at the end point, he says.
When the NHS can develop better datacentre infrastructure, this can help it to get ahead of need and keep up with future demand, he points out.
Properly curating or triaging all data as it is created and moves through one or more healthcare organisations makes it increasingly possible to exchange useful information between public healthcare bodies and private pharmacies or similar, says Ratcliffe.
“Covid has accelerated a lot of change anyway, in technology in general, and absolutely inside the NHS,” he adds. “I think the mindset has changed. The analogy I might use is that we are getting better at identifying root causes, rather than just seeing the symptoms. Turning data into information helps do that, and you need the infrastructure to do that.”
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Ratcliffe suggests a shift away from a top-down approach across NHS IT, recognising the beneficial modularity that enables individual working parts such as hospitals or trusts to become more nimble – a whole that is greater than the sum of its parts.
He says NHS Digital, the NHS’s digital arm, has partly succeeded in moving away from a more traditional “command and control” approach, shifting emphasis more to the empowerment of clinicians and the individual healthcare bodies for which they work.
“It is amazing what a crisis will do,” says Ratcliffe, pointing to the fast-moving, NHS-driven, coronavirus vaccination roll-out across England. “There weren’t really rules before, but habits that became rules by repetition. I genuinely don’t think we will all suddenly go, ‘oh wow, we’ve got to get back to normal’ either – ‘normal’ doesn’t exist any more.”
The NHS has been able to move forward – for example, in its Covid-19 vaccine roll-out and, to a lesser degree, in contact tracing – in ways that NHS Digital chief Sarah Wilkinson admitted, in an IBM presentation, “no one would have thought possible”.
Ratcliffe says more productive provision might involve slicing resources by disease or by discipline, horizontally or vertically, instead of NHS-wide or even trust-wide.
Providing services, data or facilities in an agile way that can be picked off, say, a grid, can foster new ways of seeing into data and treating people based on more accurate understandings of how individuals might be affected by a specific illness, he says.
It can also be about about breaking down data silos to get a single view of the patient, as Gartner analyst Gregg Pessin has suggested in Computer Weekly.
Ratcliffe notes that the use of myriad providers of solutions, software and hardware, not just of IT but specialist medical and laboratory technology, adds opacity to an already complex web of NHS organisations. But progress is being made in areas such as greater kit interoperability via IP-enablement of medical instrumentation for commonality of connection and adding fog computing and gateway layers.
Ultimately, such moves could precede a drive for full abstraction of the software layer.
Plan for long-term transformation
NHS organisations develop their own digital strategies in line with the official NHS Long Term Plan and guidance on digital transformation. Although some NHS targets, for example on mental health, are being missed because of Covid-19, in other cases, the pandemic has accelerated change.
While not specifying the degree of convergence, infrastructure roadmaps typically include increased virtualisation and initiatives for public-facing digital services, as well as applications that deliver collaborative benefits, including remote and mobile management capabilities.
Louise Fellows, senior director of public sector at Softcat, confirms that the solutions and infrastructure provider is seeing ongoing NHS investment in datacentre-related projects, but warns that making the most of this across a complex NHS remains tricky.
“Right up and down the country, the NHS customers we work with are all at different levels of IT maturity and capability,” she says. “We’ve got to get the structure right from the centre, whether it’s understanding the security guidelines, the policy, or where the funding flows through. They need the ability to be able to get to that baseline.
“In parts of the country, there might still be a datacentre sitting in a corridor somewhere. Then you go to another trust where they are so advanced.”
Many bodies may not be in a position to migrate to a converged infrastructure this year or for some time to come. But over time, digital transformation will happen, and the change will support more use of internet-of-things-enabled artificial intelligence and machine learning, for instance.
Fellows suggests that parts of the NHS may still need to develop enough of a solution provider mentality to move beyond “keeping the lights on”. This makes sense – because advanced convergence strategies typically require an organisation to fully understand what it has already in terms of infrastructure, across the stack, and what can be achieved – especially around legacy applications.
NHS England was contacted for comment on its digital transformation plans, but had not responded at the time of writing.