CNWL primarily needed a reliable, robust and flexible partner to support a major transition from a legacy server-based system into a more modern private cloud environment. Once the initial infrastructure was in place the team had just six months to migrate all of the Trusts’ data and applications.Solutions Cloud, Cloud Adoption & Migration, Private Cloud Platforms Cloud, VMware
CNWL provides integrated healthcare to a third of London’s population, employing roughly 7,000 staff to provide more than 300 different health services across 150 sites.
Removing technology barriers to become a modern and agile NHS Trust
The Central and North West London NHS Foundation Trust (CNWL) is one of the largest in the country, providing integrated healthcare services to a third of London’s population and many others. Its 7,000-strong team providing expert and critical care, with the Trust overseeing more than 300 different healthcare services across 150 sites.
The majority of its services are provided in the community, treating people in their homes or from nearby clinics. Where community care is not possible, the Trust offers a number of facilities to treat people in hospital or residential environments, as well as providing healthcare in prisons within London and the surrounding areas.
“As NHS Trusts go, we are a large one, which obviously means we have a lot of people relying on us for important and essential care,” said Owen Powell, ICT Director at CNWL. “We offer so many different services, all with their own requirements in terms of technology support. Evolving into a modern, forward-thinking, digital-first organization was a challenge. Our patients are our number one priority, providing the best possible service for them, but to serve them better, we realized that we needed to overhaul our technological systems.”
Making up for lost time
Digital transformation plans had been under way for a while, but had stalled in the last few years, leading to CNWL exploring alternatives as a matter of urgency at the start of 2019. Having previously been with an all-in-one provider, CNWL decided to explore separate contracts and identify the right partners for each of its needs.
Cloud was a central pillar of the Trust’s evolution plans, to support the management of diverse systems and data, as well as to help CNWL embrace new cloud based technologies and capabilities for a more effective, cost efficient and secure environment.
CNWL chose Rackspace Technology® as its partner for the migration because of, among other things, its proven track record of exceptional support, its flexibility in scaling, and its agnostic approach to public cloud solutions. The initial migration included a private cloud deployment in VMware-RPCV: a resilient solution deployed in two data centers, as well as secure managed services. With strict penalties for failing to transition to the new system within a fixed timeline, the round-the-clock support from the global Rackspace Technology team was essential to delivering on time.
“The support we got from Rackspace Technology in that transition period filled us with confidence,” said Powell. “Those projects are never without challenges, but what impressed us most was how maturely and willingly their team would help us to problem solve. Those working relationships we will have moving forward were forged under considerable pressure and their ability to deal with that, especially in how responsive they have been, was very impressive.”
“All the pain has been removed from our usual processes. Now it all works like it should — which, most importantly, allows us to focus on our clinical work and our patients.”
A noticeable difference
Following the successful initial transition by November 2019, CNWL saw immediate improvements to its existing operations.
“The impact on my day-to-day work was instant,” explained Tracy White, Associate Director for Information and Business at CNWL. “I think we had all been worn down by our existing technology and didn’t think to expect any different, and all of a sudden we had systems that could actually do what they were supposed to do — it was an enormous relief! One particular task of mine was generally taking me the best part of a day to complete, so five or six working hours. When we moved to Rackspace Technology, that came down to two hours, just because the system was so much more responsive and could process everything as it should. When something is that immediately obvious and quantifiable, you have the confidence to know you’ve made the right decision.”
“All the pain has been removed from our usual processes,” added Dr Simon Edwards, Divisional Medical Director at CNWL. “We’d all just grown weary of our previous systems and had built into our days the amount of time it took to file notes, for example. Now it all works like it should — which, most importantly, allows us to focus on our clinical work and our patients.”
Underpinning online health services
The positive transformation in working practices supported by the migration was reinforced when the COVID-19 pandemic required the organization to quickly shift to a remote working model.
“To be honest, I don’t think we’d have managed to function if we hadn’t changed to Rackspace Technology so recently,” said Powell. “We’d have found a way, but the newfound confidence we had in our processes definitely helped. Most of what we do is on premises with in-person healthcare so while a few people might work from home throughout the week, we have not generally operated remotely because we’ve never had to. Overnight, we went from about 200 people who work from home to 2,000 remote workers. Many of our clinics closed as staff were redeployed to help elsewhere. By any standards, that is an enormous upheaval, but there was never any issue with scaling to that requirement with Rackspace Technology and our operations were, from a technological standpoint, unaffected by the lockdown, which is remarkable.”
The lockdown has in fact proved useful as a testbed for CNWL to identify how new technological solutions can support it in providing its core services. In particular, certain more personal or sensitive healthcare areas, like sexual health, could see a long term move to online solutions, retaining the discretion many patients desire far more easily than in-person visits.
“Information security is a key part of providing sexual health services, and the move to an online model fully supports this, and is more cost-effective as well,” explained Powell. “The pandemic has allowed us to make great advances in how we interact with these patients, with online tests and prescriptions as well as demos and consults over video calls. There are also transactional type services we provide that don’t need a personal touch and could be automated.
“The big change we’ve seen is that our technology now allows us to lead the way with these changes, thanks to our interfaces and our system’s robustness. We are doing more remotely than we ever thought possible, largely through necessity, but with technology no longer a barrier, we will keep a lot more of this going moving forward.”
The benefits of the Rackspace Technology partnership were felt instantly, with time taken for some routine processes reduced by two-thirds — time that can then be better spent on clinical work. The COVID-19 lockdown provided the most notable test, when CNWL was able to scale — in 48 hours — from 200 people working from home to 2,000 concurrent home users.
Exploring the potential benefits of multicloud
The work Rackspace Technology has done with CNWL has already brought noticeable and quantifiable benefits to the organization, most notably in a clearer and more understandable model for costs, with outgoings and requirements now a lot more predictable. In time, this transparency over costs will help ensure CNWL continues to deliver cost optimization by extracting maximum value from its services and only paying for what it needs.
The next steps for the project are to continue the transition from server-based legacy systems and onto cloud services, as well as exploring the potential to move to a multicloud model by leveraging public cloud. Using Rackspace Technology as a broker for public cloud will present an additional opportunity to reduce costs as CNWL continues to move towards its desired model.
The support of Rackspace Technology will also afford CNWL the cloud native enablement required to then accelerate this multicloud transformation, with cloud native application, data and security all built in a DevOps culture. Data modernization will help CNWL to make predictive, data driven decisions that can ultimately accelerate innovation and leverage modern data analytics to ensure greater efficiency and value.
Alongside this, the ongoing safeguarding of data and systems, as well as upgrades to existing services and applications, is a key focus to ensure the security of the sensitive healthcare information of those that use its services. “The nature of many of the services that we provide means that protecting patient data is of utmost importance,” said Powell. “The support from Rackspace Technology throughout the migration and as our organization quickly transitioned to remote working gave us confidence that we could make these significant changes without compromising on security.”
For CNWL, there are also organizational ambitions to explore further growth opportunities, many of which require the technological agility and expertise now available. External opportunities to provide outsourced services and expertise increasingly rely on technology that can support this and the reliability, speed and robustness enabled by working with Rackspace Technology will be crucial in pursuing these in the future.
An ongoing journey
“In actual terms, we are still at the very beginning of our journey with Rackspace Technology,” said Powell. “Obviously a lot has happened, much of it unforeseeable, and the support we have had has been invaluable. We now know we have a robust, agile and trustworthy partner with us every step of the way and we have enormous confidence in our ongoing project and the benefits we will gain, and most importantly our patients, will feel.”
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