• Salford Royal will be first trust to run core clinical system on Microsoft’s cloud
  • Trust claims this could help spread their digital “blue print” faster across the NHS
  • Suppliers predict a swing towards cloud services in the NHS

One of the country’s leading digital trusts is moving its core clinical system on to Microsoft’s cloud service, as more trusts consider outsourcing IT services.

Salford Royal Foundation Trust will move its electronic patient record completely on to Microsoft’s UK based Azure databases by March.

Digital director Rachel Dunscombe said the trust will be the first in the country to make the full leap to a cloud service with its EPR, which will cut its IT infrastructure costs. The trust runs an EPR from US based supplier Allscripts.

Cloud services are charged like a utility rather a fixed asset with costs rising and falling with demand for access to the clinical system and computing power.

“For some people that is a leap that is going to take a little while. It is a new world,” Ms Dunscombe said.

Several major EPR suppliers to the NHS have told HSJ they also provide “cloud” services – an ill defined term often conflated with “hosting” or “software as a service” – but Salford Royal will be the first hosted on Microsoft’s cloud.

Most IT suppliers told HSJ that Salford Royal’s move is occurring amid a wider shift toward funding IT systems in the NHS as a service that is accessed remotely, rather than run onsite by organisation’s own IT departments.

In theory, cloud services should lower and flatten the cost of deploying a new IT system by reducing the need for upfront capital investment in IT infrastructure, and potentially outsourcing basic IT maintenance.

HSJ understands there is an enthusiasm from some NHS leaders to move toward cloud services as a way to quickly improve cybersecurity in the wake of the WannaCry ransomware attack in May.

However, predictions of a shift to cloud services in the NHS are not new and most trusts still store their patient data and main clinical systems onsite. This is partly the result of years of investment in onsite IT infrastructure, but also because of information governance and access reliability concerns over remote services.

Some suppliers said the flexible pricing and contracts underpinning cloud services did not align with the budgeting processes of most NHS trusts.

One supplier, a competitor of Allscripts, suggested while initially using the cloud was cheap the cost could creep up over time. They said there was a risk it could become the “PFI car park of the future”.

However, in past 12 months the major global cloud suppliers have increased their capacity in the UK. Microsoft opened its first UK based data centres in September 2016 specifically targeting the public sector. This is important for NHS organisations, which are required to store sensitive patient data onshore.

Salford Royal is also one of 16 acute global digital exemplar trusts, which have been mandated by NHS England to provide a “blueprint” for how the rest of the NHS will digitally transform. Last year, it was ranked first in NHS England’s digital maturity index.

Ms Dunscombe said hosting the EPR on the cloud would make it cheaper and quicker for trusts following its digital blueprint to adopt the same system.

Instead of upfront the capital costs of installing a new clinical systems on individual computers and potentially having to buy new hardware, the trust would upload its patient data and subscribe to the clinical system.

Access to the data would remain under the control of the trust, she said.

“The data is still our data, it just happens to be on the cloud,” she added.

Salford Royal has not yet uploaded real patient data to Microsoft Azure but is testing a cloud version of its EPR using a fictional dataset.