The dire state of cloud-first strategies in NHS Trusts in 2020

Clouds at the top of Snake Pass, Derbyshire

Why Public Cloud?

Who is doing this in Provider Land?

Starting with GDEs is a good move right?

Research Summary Table
  • Alder Hey Children’s Hospital NHS Trust: “Cloud technologies will be reviewed and where appropriate will form part of the overall data centre strategy”
  • Gateshead Health NHS Foundation Trust: “The Trust is assessing the option of utilising cloud based services as part of its options appraisal process for each Informatics programme and project”
  • Milton Keynes University Hospital NHS Foundation Trust: “The Trust has started to invest in cloud based infrastructure and will look to extend this where needed to meet user requirements. This will allow the Trust to make an informed decision as to whether to solutions should be locally or cloud based.”

What about anyone else?

  • Sherwood Forest NHS Trust: Digital Strategy 2020–2025 only mentions cloud in passing “an anticipated move towards a cloud-first strategy”
  • York Teaching Hospitals: Digital Strategy 2017–2022 “appropriate Cloud alternatives will also be reviewed”
  • Barts Health NHS Trust: Article obviously from a Capgemini Press Release “The three-year agreement will see Capgemini work across all five hospitals in the Trust, rolling out end-to-end cloud services across sites in Central and East London”. But a search on the Barts website reveals nothing in terms of a strategy or policy document.

Conclusions and Final Thoughts

  1. The NHS is terrible at sharing, and that makes me sad. If the purpose of the GDE programme is to exemplify good practice and share it with the rest of the NHS then it is failing at the very basic level of Making Things Open [#9 of the NHS Service Manual Principles] and sharing Digital Strategies. Perhaps it is just the way I formulated the Google search or their individual Trust websites that don’t index the content? I’d love for someone to prove me wrong, but even if this is the case, I’d argue that for £300M, the folks running the GDE Programme ought to make it mandatory for each GDE and Fast follower to have a published Digital Strategy. The next step would be for them to have a published statement, updated every 6 months on progress against the Tech Vision¹. [Just so we have our own house in order — the KGH Digital Roadmap and Health Intelligence Strategy are here under “Our Supporting Strategies”.]
  2. The Tech Vision is one of best examples of a sensible policy document we’ve seen in a long time, but it would appear no Trusts are working towards achieving the cloud-related aspects. Why is that? There’s certainly the challenge of moving spend from lumpy capital to annual revenue subscriptions, but it can’t be simply that? Is it about someone needing to go first? That was the point of the GDEs and Fast Followers, so that hasn’t worked. Hasn’t the risk/benefit calculations swung far enough to cloud yet? Perhaps it is simply a case of needing to address years of under-valued and under-funded infrastructure before moving to the cloud is considered?



  • Using the Google search in the format [Full Trust name]+”cloud strategy”. If that yielded no results, then searched in the format [Full Trust name]+”digital strategy”, followed by [Full Trust name]+”digital roadmap”
  • Then did a bit of digging round in any sections on the Trust website that were related to digital strategy.
  • Then a look at the overall Trust strategy. I’m very fond of repeating a phrase I heard a while back (which I think is attributable to Bud Caddell) “There’s no such thing as a Digital Strategy, just a strategy in a Digital World”, so if I could find it, I also opened the Trust strategy and searched for Digital and Cloud.

Husband. Dad to 3 smashing lads. Cub Leader. MAMIL. Group CDIO for Northampton and Kettering Hospitals. Ex NHS Digital. Views own. Always learning.

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Andy Callow

Andy Callow

Husband. Dad to 3 smashing lads. Cub Leader. MAMIL. Group CDIO for Northampton and Kettering Hospitals. Ex NHS Digital. Views own. Always learning.

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