NHS Data Estate Modernisation

Northdoor delivers up to 50% reduction in TCO for NHS Trusts

2nd April 2019Blog

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Digital enablement frees up time and money for front-line services

The National Health Service (NHS) in the UK must make efficiency savings wherever it can – lives literally depend on the organisation’s ability to divert funds from back-office to front-line services. At the same time, the NHS must also deploy new digital tools to meet the changing needs both of its employees and the citizens it serves. Modernising the existing data estate can deliver on both of these requirements, but this is challenging to achieve in a disparate environment that supports mission-critical services.

Recognising the challenge facing NHS Trusts, Northdoor created a targeted framework for modernisation that results in a consolidated, fit-for-purpose data platform on Microsoft SQL Server 2019, with a ready-to-go roadmap for building out into the Azure cloud. In typical cases, the solution cuts the number of SQL Server instances by up to 40 percent and enables an 80 percent reduction in physical servers.


Founded in 1948, the National Health Service (NHS) in the UK provides comprehensive, universal, free-at-point-of-delivery healthcare services to UK residents. As times have changed, the NHS has evolved to remain relevant to the country’s needs; today, one important goal is to re-work the provision of IT services to boost administrative efficiency, reduce costs, and improve patient outcomes.

This is a pressing concern, as the NHS is struggling to balance the wellbeing of a growing population with the rising costs of services, energy and supplies. NHS data estates tend to have grown in a somewhat haphazard way, and are often based on disparate infrastructure that may be unsuited to increasingly demanding and important workloads. With tens of thousands of systems used by more than 1.5 million employees, the sheer size of the organisation makes modernising the data estate a huge challenge – particularly as the specialist skills required may not be available internally.

Recognising that a large number of Trusts (the main subdivisions of the NHS) want to rationalise their data estate and ultimately move to the cloud, Northdoor aimed to create a targeted framework for modernisation. The goal was to build a repeatable solution, composed of consulting services, consolidation methodologies, and pre-defined technology components, that would help NHS Trusts to identify and execute modernisation opportunities.


Northdoor’s data estate modernisation solution for NHS Trusts aims to create a coherent, standardised, fit-for-purpose data platform on Microsoft SQL Server 2019 and to build a clear roadmap for migration to the Azure cloud.

In Trusts where Northdoor has already successfully delivered its solution, the data estate previously included multiple versions of SQL Server, from 2000 to 2008 R2, in both physical and virtual environments. By working with Northdoor to update the underlying software, to consolidate databases, to virtualise wherever possible, and to overhaul backup and disaster recovery arrangements, these Trusts have saved on management, support, and licensing costs, while improving performance and gaining access to important new features. Some Trusts are already building on their modernised platform to take advantage of cloud services on Azure or to deploy Power BI for decision support; in all cases, the Northdoor solution includes a staged roadmap for taking these next steps.

Building on its long experience of working with the NHS, Northdoor’s solution design for Trusts incorporates:

  • A comprehensive environment audit based on rigorous pre-built methodologies
  • Analysis of the SQL Server install base and licensing
  • Identification of SQL Server instances that can be decommissioned
  • Structured project workshops to establish current and future requirements, including desired SQL Server features and functionality
  • Analysis of compliance and security requirements
  • Auditing and measurement of database performance and hardware requirements
  • Fully costed recommendations on the environment and licensing approaches
  • Planning and execution of migration and consolidation exercises
  • (Optionally) fully managed services to operate the new environment.

With four Microsoft Gold competencies focused around data, and a deep understanding of the typical data sets and applications in use at NHS Trusts, Northdoor offers an exceptionally broad set of services. Rather than simply advising on and executing database consolidation and migration, Northdoor helps NHS Trusts to clean up and rearchitect their databases for improved performance, scalability, security and ease of access. This includes the identification of poorly performing and resource-hungry SQL Servers instances, and the optimisation of their queries and reports.

By encouraging Trusts to adapt a core-based licensing model, Northdoor helps them prepare for seamless future migration into the Azure cloud. To ensure appropriate support for mission-critical patient-facing services, Northdoor takes advantage of SQL Server AlwaysOn high availability groups.


By helping NHS Trusts to migrate to a consolidated data estate, Northdoor enables them to reduce TCO by up to 50 percent – freeing up cash for front-line services. In typical cases, the Northdoor solution reduces the number of SQL Server instances by up to 40 percent and enables an 80 percent reduction in physical servers.

Modernisation of the data estate helps drive greater productivity in the workplace by enabling the introduction of newer and more efficient information-management tools. For example, several of Northdoor’s NHS clients have layered Azure-based analytics services onto their modernised SQL Server environments. For one Trust, Northdoor built Power BI dashboards to show real-time performance against patient waiting-list targets, helping hospitals avoid fines.

Northdoor’s structured approach to solution design and its long experience of working with NHS organisations ensure that its data estate modernisation solution is fully repeatable.

See what our customers have to say: 

Dave Jones, Norfolk & Suffolk NHS Foundation Trust, comments:
“Northdoor has helped modernise our SQL Server environment and make valuable cost savings; their experienced and professional team provided very high levels of service.”

Peter Mutton, Royal Borough of Greenwich, says:
“Northdoor helped us understand the existing position of our SQL Server environment and subsequently offered guidance on how best to design a consolidated, migrated and modernised environment, ready for our demanding database and application requirements.”

In another recent case, Northdoor delivered its solution at East Sussex Healthcare NHS Trust, which sought to reduce IT costs and improve application performance. While its longer-term goal is to migrate to Azure, East Sussex wanted to squeeze the full value out of its existing infrastructure. Northdoor updated and then consolidated the SQL Server environment down to just four dedicated host servers.

This modernised environment is more compliant, secure, reliable and efficient, as well as easier to manage – all of which drives ongoing cost savings. Northdoor provides SQL Server as a fully managed service to East Sussex, and is now helping the Trust to rationalise its sprawling data warehousing environment on SQL Server.

Taking advantage of unlimited virtualisation rights via SQL Server Enterprise licensing at the host level will produce a saving of approximately £600,000 over a three-year period at East Sussex. This cost saving, representing a 50% reduction in TCO, is a great example of how Northdoor’s modernisation solution is helping the NHS spend less on IT and more on improving the nation’s health.

Digital Transformation In The Public Sector – East Sussex Healthcare NHS Trust

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“Northdoor helped us understand the existing position of our SQL Server environment and subsequently offered guidance on how best to design a consolidated, migrated and modernised environment, ready for our demanding database and application requirements.” Peter Mutton, Royal Borough of Greenwich

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