CASE STUDY

Norfolk Community Health and Care NHS Trust

Revolutionising public health by transforming digital infrastructure

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In the NHS, IT infrastructure is the connective tissue that links large multi-hospital trusts, ensuring thousands of patients receive the highest standard of care possible while consistently delivering efficiencies.

So, if your entire network is underpinned by an outdated technology, how do you transition to a new system without skipping a beat in patient care?

The Norfolk Community Health and Care NHS Trust (NCH&C) is responsible for community-based NHS health and care at more than 70 different service locations across Norfolk, serving a population of more than 900,000.

And so, any disruption to any of their services – across any of the broad range of healthcare and support services they provide – could have potentially life-changing consequences for many thousands of people.

But with our help and support, their digital leadership team took the bold decision to embark on a digital transformation journey to transition to a Cloud based, Software Defined-Wide Area Network (SD-WAN) supported system.

The SD-WAN solution was intended to:

  • Improve network performance
  • Reduce complexity
  • Enable cloud-based services

The desired end goal was a network which delivered fewer serious network incidents, freeing up of clinicians’ time and better care for patients.

“We were already considering what that would look like for us – we decided on Cloud adoption and moving away from data centres. This was quite innovative for the NHS, but had been used before in other sectors. It was a big leap of faith for the Trust to move towards it.”

Paul Walsh, Infrastructure Consultant for Norfolk Community Health and Care NHS Trust

 
 

The challenge

The existing infrastructure, which was underpinned by Multiprotocol Label Switching (MPLS) networking technology, could not meet the needs for a large community health trust.

The MPLS network was regarded as being highly inflexible with poor scalability – and came at a high cost relative to its limited capability.

Worse than that, the whole network was averaging a ‘P1 outage’ between once and twice every week. P1 outages are the most serious type of network outage, which either knocks out traffic to more than 20% of the network, or disables an entire browser type.

Clinicians also reported to the Trust’s digital team that the existing infrastructure did not support them to make innovations and to “do things differently” in pursuit of improved outcomes for their patients.

In their own words, they were in “desperate need” of a digital strategy which could support and connect more than 3,000 members of staff – more than 80% of whom are clinicians working directly with patients, including nurses, doctors, dentists and Allied Health Professionals.

As the first standalone NHS community trust in the UK to achieve an Outstanding rating from the Care Quality Commission (CQC), NCH&C’s digital infrastructure needed to support the very highest standard of care.

A fork in the road

The Trust stood at a fork in the road – with two choices ahead of them.

The lower risk option was to stick with the existing system, despite its flaws, and try to paint over the cracks with upgrades, where possible.

But from the start, they set their sights on the more ambitious option – finding something new altogether.

As part of an options appraisal, all options were thoroughly investigated and presented. If the Trust was to stick with the status quo, it would mean upgrading where possible. But it was still the same network; it would still be centred around a datacentre, with all the issues associated with that model.

The other option on the table was to tear up the orthodoxy of connectivity tech that the Trust had been following up to that point.

The more ambitious pathway

The Trust decided on a programme of Cloud adoption in order to move them away from a model that put data centres at the heart of the operation.

Although this was already the norm in other sectors, it represented a bold, innovative step to take within a large NHS Trust. Consequently, it was a big leap of faith.

The digital team said that the biggest hurdle would be assuring the Trust that the system design and architecture would guarantee success. Partnering with Virgin Media Business went a long way towards gaining the internal buy-in.

“In partnering with Virgin Media Business, we have been completely reassured. They came with a reputation for excellent support and customer service – not to mention the quality and reliability of their connectivity services. And they have not let us down.”

Paul Walsh, Infrastructure Consultant for Norfolk Community Health and Care NHS Trust

 
 

Immediate results

The shift to a Cloud-based SD-WAN system necessitated a full digital transformation across the full NCH&C system and beyond, including a rollout expansion to the Integrated Care System (ICS) and more than 150 GP surgeries.

It meant moving to a multi-Cloud hybrid infrastructure and security system. Existing connectivity systems would need to be repurposed to ensure as smooth a transition as possible.

The Covid-19 pandemic meant that plans to roll out the new system faced a two-year delay, but it began in earnest in April 2022.

“It’s rare when large-scale infrastructure projects deliver exactly what they promise – but with sufficient planning and groundwork, fortunately this was one of those occasions. We transitioned seamlessly with very little disruption to our end users.”

Paul Walsh, Infrastructure Consultant for Norfolk Community Health and Care NHS Trust

 
 

Since then, the new connectivity solution has delivered significant cost savings for NCH&C, as well as a tenfold improvement in the core network, its speed and its resilience.

It also dramatically reduced the occurrence of P1 outages. Previously, the Trust recorded an average of between one and two of these outages per week. Now, NCH&C records one per year.

The SD-WAN system continues to deliver results for clinicians and patients.

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