HTN recently sat down to talk with a team from Rackspace Technology, which delivers hybrid multicloud solutions across platform infrastructure, applications, data, and security. We were joined by Nick Roberts, sovereign services lead (including healthcare, cloud, proposition services and product), and Jason Jones, executive in residence.
To begin, Nick and Jason provided some context on Rackspace Technology’s offering. Nick explained that Rackspace provides secure UK-sovereign compliant healthcare cloud solutions and services designed to underpin and enable NHS organisations to deliver their digital transformation. Within healthcare, Rackspace Technology focuses on the strategy, delivery and on-going management of cloud to support digital transformation. This includes electronic patient record systems and technology platforms utilising cloud infrastructure.
“Rackspace Technology is one of the largest private cloud providers and operates as a top three VMware CSP globally,” Jason said, “and the capability to deliver at scale in this way is what differentiates us in this space. We have the ability to host not just the EPR but all enterprise workloads that connect into the EPR, and an entire business unit focused on artificial intelligence. So no matter where your data is and how you need that data to be leveraged, we have the AI capability to help you achieve your aims.”
The benefits of cloud
The Rackspace team focused on three main areas where leveraging the cloud can provide tangible benefits to the NHS: cost predictability (OpEx); elimination of technical debt; and compliance and security.
Nick drew the conversation to focus on the security that cloud solutions can offer, noting that when it comes to driving additional growth within organisations, “people need to ensure the security and compliance of workloads, whether this is healthcare or any other sector.”
For additional growth to be successful, “you need to be able to integrate between workloads; you need to ultimately see financial benefits; and you need to improve patient outcomes. But all of these things require flexible, agile, affordable and sustainable infrastructure at the back end, and cloud is very well-positioned to offer that.”
Jason raised the point that healthcare providers have more time to focus on the primary business of delivering care when they are able to entrust their technology services to the hands of expert specialising in a specific area. “For cloud providers like Rackspace Technology, it’s what we do day in, day out. That’s what we can focus on. There’s something to be said about having the right team in place who are capable of delivering the right level of capability. This is our bread and butter in the way that caring is the bread and butter of providers and clinicians.”
Cloud considerations for NHS trusts
“I would say availability is the number one consideration that NHS trusts need to reflect on, when they are deciding what solution to go for and thinking about what cloud could offer them,” said Jason. “When you are delivering care, the single most important thing is decision support at the bedside; and that translates to availability.”
When organisations research cloud and cloud capability, he continued, they need to maintain awareness that not all clouds are created equal.
“Rackspace Technology will stand behind and guarantee you five nines of availability – that’s 99.999 percent availability. That is so critical when using an EPR to deliver care, because it translates to around five minutes of unplanned downtime across an entire year. Other clouds may not guarantee that in writing and as a consumer of an EPR, that would concern me. If they are offering 99.9 percent availability, that translates to around 44 minutes a month of unplanned outage. Who wants to put their family member in a surgical bed during one of those slices of time?”
Nick shared a number of other key considerations, starting with the financial side. “It always comes back to affordability,” he said. “It’s common knowledge that unfortunately we are struggling with deficits in NHS organisations and therefore affordability is absolutely a top priority when you are looking for technology to underpin or deliver services.”
Another aspect of finance to take into account, he added, is the need for NHS organisations to ensure that the solution they select allows for individual finance models within each of the trusts. “They are unique, all of them. You need the right mix of CapEx and OpEx to ensure that the trust can buy solutions when they need to, in the way that they wish to purchase them.”
On a related point, Nick raised the consideration of extensibility, which he described as trusts trying to combine together; such as when one trust has an EPR solution in place already and wants another trust to come on board to help better utilise infrastructure and share the associated costs.
“Trusts can end up spending a lot of money on infrastructure that they are not using, and we’ve seen examples of 50 percent wasted cost or more until year five or 10 of a business case,” he reflected. “It can be a significant help to have a scalable, flexible solution in place which includes EPR software solutions that can be bought as and when they are needed.”
Nick also referenced the increasing numbers of bad actors in the digital landscape, meaning that sustainable IT must also be a priority. “NHS organisations need to make sure that they have got all of the security compliance and vulnerability management under control. This is both a challenge and a consideration to take into account. When purchasing an EPR, you need to make sure that whatever solution provider you go for is 100 percent focused on ensuring the security and compliance posture of all systems. There are a lot of stories at the moment about ransomware cyber attacks that can be very difficult for organisations to manage and have a significant impact on outcomes – but at their core, sometimes, there are some fundamental IT-based practices that are simply not being followed.”
On operational efficiency, Nick commented on the need for care providers and suppliers alike to collaborate to work out how the NHS can become more productive.
“We need to deliver more for the same or for less as our population gets older and continues to grow. Unfortunately, our budgets don’t grow at the same pace. So we need to look at operational efficiency over the term of the contract, not just about the day one purchase.”
That led on to the final point raised by Nick: timescales. “I think cloud is what the country needs now, because we are facing all these challenges and it can take years for us to come up with handcrafted solutions from a blank slate. We need to take best of breed solutions, and Epic provides off-the-shelf best practice.”
Supporting the future direction of the NHS
“I think cloud is well-placed to support the future of the NHS and new models of care, and it comes back to the point around the cloud delivery model and cloud as a managed service,” said Jason. “The managed service can deliver the basics of IT, the EPR, the enterprise content management, the systems that the hospital needs to run. Cloud can take those IT-level capabilities and upscale it, so the hospitals get more from it. They can look at how to leverage AI, for example, or tools such as ambient voice technology.
“It stops the view of IT as something that you just patch every Tuesday, or broken infrastructure that frustrates staff and needs replacing, and turns it into something that can really become part of the care delivery system. Cloud helps IT really get involved in the clinical aspect – it means hospitals can take a wider look at improvements that can be made. How can we help the queues flow better in the trust? Are there particular cohorts we need to improve outreach for? When you look at trust-specific organisational needs, cloud can enable higher level capabilities.”
There is an impact on a trust’s workforce too, Jason noted. “Your IT team is no longer thinking about how they can tackle problems relating to that broken infrastructure, they can really become part of the care team. That means they are freed up to identify better ways of caring too.”
Cloud initiatives impact everything a trust does, Jason stated, from back office to front office to care delivery and EPR changes: the entire ecosystem. “It shouldn’t be run by a couple of individuals in IT. Cloud is a trust-level journey, and decisions around cloud should not be isolated to the digital team. It should involve the care delivery team, and it’s crucial that people look at this in the right way. It’s not about ‘getting cloud’ – cloud shouldn’t be the outcome. Buying a specific type of infrastructure shouldn’t be the focus, the focus should be how that infrastructure equips you to change and improve your delivery model at the bedside. So we need to get the whole organisation tuned into that, focused in on the cloud journey, and thinking about the outcomes they can get.”
With regards to the future, Nick referred to Rackspace Technology’s customer Central and North West London NHS Foundation Trust, where ICT director Owen Powell commented: “I know they (Rackspace Technology) will be able to support us wherever we end up.”
Nick stated: “One of the key reasons Owen made that decision is because he didn’t know what was going to be needed next in terms of technical innovation within his organisation. None of us do. We don’t have a solid knowledge of what AI is going to bring, for example; but we do know that hospitals need technology suppliers who can provide that AI specialism when the NHS decides how it wants to use AI. Our customer needed a service provider who could flex and specialise depending on the next steps taken by the NHS. That’s why he chose Rackspace.”
Many thanks to Jason and Nick for joining us and sharing their thoughts. You can find out more about Rackspace Technology and their work with the NHS here.
