C-level briefing: Responsibility for blood and organ transplants means that secure and reliable services are vital.
The NHS is faced with the near insurmountable task of delivering world class healthcare to a growing population while constantly seeking ways to cut how much it is spending.
The demands on the world’s largest employer has resulted in the necessity to seek out new technologies that will enable it to not only do a better job for patients, but become more efficient in the way it does it.
NHS Blood and Transplant (NHSBT) is an organisation that turns over £410m per year, employs around 5,000 people and is responsible for collecting blood in England. It is also responsible for solid organ transplantation and retrieval across the UK, as well as running a diagnostics and therapeutic therapy group and doing things like regenerative medicine and running laboratories.
To give more scale to the operation, the organisation issues around 6,000 units of blood a day and facilitates around 3,500 organ transplants a year.
This is a vital service that plays an integral role in saving thousands of lives.
The importance of the service means that any IT decisions about how it is run must be carefully thought through.
CBR spoke to Ian Trenholm, CEO, NHSBT, and Anthony Evans, digital service manager, NHSBT, about the technology it is using.
Before a move to Microsoft Azure almost two years ago, NHSBT had been using its own in-house service to manage all of its systems, but while they were stable, they struggled to deal with spikes in demand and were un-flexible.
Trenholm said: "The challenge we have is offering a frictionless experience for people both in terms of blood and in organs. People are donating altruistically, there is no financial incentive for people to come and work with us, so we rely completely and utterly on altruistic donations."
This means that NHSBT needs to make sure that it gives users the best possible experience so that people are able to quickly register. Trenholm said that the risk of getting this wrong is that people leave and there is no donation.
While providing the best possible service, it has become necessary to deal with unpredictable spikes in demand for registration.
"One of the challenges we have is that every time there is a news story about blood or organs, there is some sort of reaction from the public.
"So if a celebrity goes on breakfast news and says, ‘I’m very grateful for a blood transfusion’, then people immediately try and go online and book a blood donation appointment. That was causing us very significant problems because our service was just becoming overwhelmed."
This is the kind of demand that can’t be prepared for like Black Friday, Christmas, a bank holiday, and it made a move to the cloud essential.
After evaluating a number of different services, NHSBT ended up moving to Microsoft Azure due to the cost element.
Evans said: "Given what we do, we always want to keep costs to a minimum. We’re part of the NHS family so we don’t want to have unnecessary expenditure but also a lot of our technology is Microsoft as well, we use SQL Server and our technicians were very familiar with other server technology."
Moving to the cloud for an organisation that deals with a lot of sensitive medical data is something that could be met with fear.
Recently The Times revealed that NHS bosses have been told to overhaul their computer technology, staff training, and corporate governance due to a poor record on data security.
This month two NHS trusts were fined £365,000 for leaking information about thousands of NHS staff and hundreds of patients with HIV.
In advance of the Care Quality Commission report into NHS data security, it will come as good news that NHSBT had security as one of its main priorities.
Trenholm said: "I think there is always using any system a concern about data security and some of the data we hold is medical data and is reasonably sensitive but I think we almost have to balance that with ease of access, things like disaster recovery and making sure that we can deliver a good solid service."
After looking at the issue in detail, Trenholm said that there weren’t the security problems that people often talk about with cloud, "It didn’t feel any more of less secure than the normal way in which people use the internet."
NHSBT has architected its systems so that its on-premise estate manages some of the data that is very sensitive, but it has a secure high speed link between its internal database and the digital service that users see.
The impact of the system has meant that users no longer have to wait up to a month to get an online login, instead, there are now cases when a donor has registered in the morning and donated in the afternoon.
Trenholm said that strategically this is very important because if they don’t get people registered quickly then they lose interest and they lose a donor.
"So the ability to deliver a very stable service that operates at pace and is capable of operating even when the service is being hammered, is really important to us," said Trenholm.
Trenholm believes that using Azure has directly impacted the number of donors that the service can sign up and retain. Initially they had expected to register tens of thousands of people but 18 months after deployment NHSBT has reached a million users.
"Because it works so well and seamlessly I think it does mean we’ve been able to attract and retain donors much better than we ever could before," said Trenholm.
Evans said that under its previous system NHSBT has around 24,000 donors that it interacted with online, that number is now over 900,000.
Cloud has then become a massive enabler for the organisation and has also helped to save money. Trenholm estimates that around £1.2m has been saved so far, but it isn’t spending less on the IT budget.
The money saved is being invested into applications and is helping it to move away from spending money on servers and network activity.
Eventually the goal is to move into becoming a genuinely digital organisation that is reliant upon a series of cloud platforms such as a CRM platform and a manufacturing platform.
Trenholm said that cloud has enabled this thinking.