Interview: Why the UK NHS is Struggling to Move to the Cloud

Despite ploughing more than £50m into the digital transformation of the NHS, evidence suggests only a handful of trusts have adopted the Government’s “cloud first” policy.   NHS Digital spent more than £32m on digital transformation consultancy services, and £23m with cloud, software, and hardware providers between April and December 2017.   But, its bosses must be questioning why, when less than a third of NHS trusts surveyed in January have adopted any level of public cloud. Mistrust soars, according to recent findings from IT management software provider, SolarWinds.   The research questioned more than 200 NHS trusts and revealed that, while respondents were aware of the government’s policy, less than a third have begun the transition.   Of those who have yet to adopt any level of public cloud, 64% cited security concerns, 57% blamed legacy tech, and 52% said budgets were the biggest barriers.   However, for respondents who had adopted some public cloud, budget registered as far more of a barrier (66%), followed by security and legacy technology (59% each).   Eight percent of NHS trusts not using public cloud admitted they were using 10 or more monitoring tools to try and control their environment, compared to just 5% of NHS trusts with public cloud.   In addition, monitoring and managing the public cloud remains an issue, even after adoption, with 49% of trusts with some public cloud struggling to determine suitable workloads for the environment.   Other issues included visibility of cloud performance (47%) and protecting and securing cloud data (45%).   Six percent of NHS trusts still expect to see no return on investment at all from public cloud adoption.   Speaking exclusively to BBH about the findings, SolarWinds’ chief technologist of federal and national government Paul Parker said, “Cloud is this wonderful, ephemeral term that few people know how to put into a solid thought process.   “From the survey results, what we have seen is that the whole “cloud first” initiative has no real momentum and no one particularly driving it along.   “While there are a lot of organizations trying to get off of legacy technology, and push to modernize architecture, they are missing out.”   Improvements to training are vital, he added.   “People tend to believe there’s this tremendous return on investment to moving into the cloud when, in reality, you are shifting the cost from capital to operating expenses. It is not necessarily a cost saving in terms of architecture and people need to recognize that. Rather than owning the infrastructure, with cloud you are leasing it, so it doesn’t change the level of investment much.”   There are savings to be had, though, and they come from converging job roles and improving access to medical records, for example.   Parker said, “With cloud, you do not need a monitoring team for every piece of architecture, so while there are savings to be had, they are more operational. With a cloud infrastructure, everything is ready at the click of a button.”   Moving forward, he says, “It’s that old adage of ‘evolution, not revolution.’ There needs to be technology training, and the NHS needs to have an overarching goal, rather than simply moving to the cloud.   “The first thing trusts need to do is look at their current environment and determine what’s there, what’s critical and what’ non-critical. That will enable them to focus on moving the non-critical things into a cloud environment without jeopardizing anyone’s health or life or affecting security. That will help everyone to better understand the benefits of the cloud and to build trust.   “I would also like to see a top-down approach in terms of policy and direction. The ultimate goal of healthcare services is to make sure people have a better quality of life; and the goal of IT is to make sure they can deliver that. As IT experts, it is our job to try and help them to do that and make IT easier and more affordable.”   Find the full article on Building Better Healthcare.