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Node4 gets Nuffield Health fighting fit with an Azure migration and lean cloud-first strategy

Node4 gets Nuffield Health fighting fit with an Azure migration and lean cloud-first strategy

Case StudiesCloudHealthcareTop StoriesUnited Kingdom

Nuffield Health migrated its systems to Microsoft Azure after finding that its previous web hosting infrastructure couldn’t cope with the rising demand being placed on it. Dave Ankers, IT Strategy and Delivery Director at Nuffield Health, explains how the charity achieved infrastructure modernisation and improved its peak-time performance and availability with the help of Node4.

Nuffield Health is the UK’s largest healthcare charity. As an organisation with no shareholders, Nuffield Health invests all its income back into its core objective of building a healthier nation. This is achieved through day-to-day services across 31 award-winning hospitals, 113 fitness and well-being clubs, healthcare clinics and over 200 workplace well-being services.

In its broader community role, Nuffield Health offers flagship programmes that help improve the lives of children with cystic fibrosis (CF) through free exercise classes — and supports the world’s largest research project into how exercise can aid prostate cancer recovery. It also partners with schools to provide thousands of pupils with free timetabled programmes to improve their health and well-being.

The challenge

Before engaging Node4, Nuffield Health hosted its website and digital services on a managed physical platform but was looking to modernise the infrastructure, while improving its peak-time performance and availability.

The IT team had started to use Microsoft Azure for some development environments, as well as selected data integrations and exchanges. They could see the advantages of moving nuffieldhealth.com to Azure too. It would cut costs associated with over-provisioning, simplify and speed up website modernisation and enable the creation of new digital services. Microsoft, too, was making a solid case for complete migration. It was a compelling, cost-saving argument that went to the heart of the charity’s operations — and it was getting harder to ignore each time the website faltered or crashed.  

“We’d done the sums and knew that an Azure migration could save us a lot of money, both upfront and in the long term, as well as improve performance. We had attempted to rearchitect services ourselves, but that approach didn’t work for us,” said Dave Ankers, IT Strategy and Delivery Director at Nuffield Health. “Needing to resolve this rapidly, we asked Microsoft if it could assist us. Microsoft came back with just one recommendation — Node4. The rest, as they say, is history.”

The solution

Node4’s first task was to devise an Azure migration strategy. At its core, this was a ‘lift and shift’ move, but Node4 also rearchitected and optimised nuffieldhealth.com so that the IT team could take full advantage of Azure’s services, infrastructure and wider ecosystem.

Each stage of the project focused on keeping operational disruptions to a minimum. First of all, Node4 spent time with Nuffield Health’s IT team to catalogue the charity’s digital assets and applications — and understand how (or the extent to which) they were integrated. No one wanted to leave a website, asset, or associated application behind — and inadvertently cause a service outage. Then, when everything had been checked and confirmed, Node4 carried out several dry runs ahead of the actual website migration to ensure it would go smoothly.

“I don’t want to sound flippant, but the most positive thing I can say is that no one outside my department — say, for example, a director of one of our hospitals — noticed the switch over,” said Ankers. “The project went smoothly with a first-time, flawless cutover of all digital services in a single overnight maintenance window. Migrating a website like ours with all the interlocking and dependent services is no easy task — and can cause huge operational disruption — but Node4 managed it with ease and minimal fuss.”

The results

Website resilience straight from the cloud

The previous web hosting infrastructure had a finite scaling capability. Even with the large sums spent on hardware over-provisioning, some peak usage periods pushed it beyond breaking point and crashed the site. “Our services are, by their nature, prone to peaks and troughs of demand,” said Ankers. “Our managed hardware infrastructure couldn’t cope with the demands being placed on it – and our budget was not able to stretch to cover the continual over-provisioning that would be required to meet peaks.”

Over-provisioning had been essential because Nuffield Health’s website has very definite and pronounced daily activity spikes. Classically, they’d happened in the early morning when Health Fitness & Wellbeing Centre members logged on to book their classes. But during lockdown, the site saw spikes when the government issued new guidance on gym closures and subsequent re-openings. “If you’ve ever tried to book a gym class and the website crashes, you’ll know how frustrating it can be,” said Ankers. “Difficulty booking classes is likely in the top five things gym-goers most regularly complain about — and a significant factor for members in their decisions to remain with the charity. We simply had to get that fixed.”

By contrast, now that Nuffield Health’s website runs in a Node4-supported Azure environment, resources can be scaled up or down in line with demand — and without needing to allocate IT budget to over-provisioned resources. Today, the website has flexible, scalable cloud-based resources supporting it and helping it power through peak-time demand.

Avoided costs and cost savings

“Node4’s cloud-first deployment strategy meant we avoided a hardware refresh that had the potential to hit the £500,000 mark,” said Ankers. “And we’d have required additional funding too – as the nature of fixed infrastructure services would have required a multi-year, locked-in contract.

“We’ve been able to reduce our storage costs by 50% year-on-year. That’s based on the cost of our previous storage compute vs the cost of the current Azure storage-based compute. To my mind, that means the migration has already paid for itself.

“We’ve also saved around 50% on support bills. Our legacy environment was incredibly complex. It needed highly specialist — and therefore costly — support. Today, Node4 provides us with a single website and infrastructure support contract, which makes life so much easier for us.”

Confidence to launch new services

Today, Nuffield Health’s Azure infrastructure supports class booking and online joining capabilities across its network of Health Fitness & Wellbeing Centres. It also provides the springboard to launch new projects and services — the most recent being Nuffield Health 24/7, a free digital fitness platform for club members. Teachers can also use the website to access a free Schools Wellbeing programme, which makes content available to encourage and support pupil well-being.

“Node4 has a real DevOps approach to the work it has done for us. It really ‘gets’ how a developer wants to work with Azure and do everything to facilitate that. Node4 has set up the infrastructure so that our developers can capitalise on the resources within Azure. This will be an incredible help in enabling us to launch new services further down the line.

“For the first time, it feels like our infrastructure really enables digital delivery, rather than holding it back — and that’s a wonderful feeling!”

We caught up with Dave Ankers, IT Strategy and Delivery Director at Nuffield Health, to gain some further insight into the benefits of the technology transformation.

Can you tell us about your role and the scope of your responsibility?

As IT Strategy and Delivery Director, I have a few accountabilities. Defining and iterating IT strategy and Architecture – covering long-term strategy and contributing to business strategy, as well as leading business, enterprise, data and technology architecture to enable specific business objectives or demands from our customers, members, partners or employees. We also track and manage our response to trends – technological, digital, clinical and operational. However, I’m also responsible for improving and transforming IT and the services we provide to our business – through agile continual improvement and enabling transformational project delivery.

What business challenges were you looking to overcome ahead of the implementation?

We had a fixed capacity model for our online services – this was sized for peak traffic, but given the unpredictability of our peaks, we would often have a situation where the infrastructure could not cope with the demand, leading to significant issues for our customers. On top of these issues, we were also paying for more capacity that we needed the majority of time. Therefore, we needed to move to an architecture that would scale, with a utility-based payment model, where we would pay for what we used.

Why did you decide to work with Node4 as the technology vendor?

We approached Microsoft as our cloud services provider and asked for its advice on the migration. We had been through a few ‘false dawns’ on this objective in the past and wanted assurance that we would deliver the intended benefits successfully, without disruption to service. Microsoft recommended Node4 as a preferred partner in this space.

How transformative has the implementation been for Nuffield Health?

The initial work that we have completed has enabled significant in-year savings and improved performance and the customer experience – i.e. we have delivered the intended benefits and avoided disruption. We are also suffering from a far-reduced number of outages. As part of the implementation, we also agreed an ongoing support model with Node4, where they work in tandem with our partner on the development side. Node4’s ability to work collaboratively in this space is a real advantage.

This transformation also sets us up for the next iteration of our Digital Transformation – providing resilient foundations that we can build upon.

What end-user demands and/or technology trends are driving your overall technology/digital strategy?

There are many. From an end-user perspective – convenience and personalisation are critical, as they are for many businesses. These require us to look for more dynamic ways of delivering services – through cloud computing, DevOps and digital capabilities, such as design thinking and agile delivery.

Efficiency and productivity are also critical. Automation and API-based integration are key here, as well as Artificial Intelligence and Machine Learning. Our business strategy relies on these foundations. As an example, how we integrate with our business-to-business customers has changed in favour of API integration, due to the customer experience benefits this enables. I expect this trend to continue.

Finally – and there are many others I could pick – I see Digital Twins being an important future step for us, particularly in our pursuit of ever-personalised care, focusing on member outcomes and delivering the care they need to achieve their optimum level of health and well-being.

How has cloud technology supported the modernisation of your infrastructure and how important is this moving forward?

It is vital. The nature of our digital world and the drive for convenience and personalisation requires a dynamic and flexible infrastructure. Clearly, the need for governance and cost management is a key consideration. Therefore, cloud-based technologies and the models that come with them are critical to success.

What specific benefits has the solution offered?

The immediate benefits are cost and reliability. We have made significant in-year savings as compared to our previous solution, reducing the cost to serve of the platform. We have also managed to improve reliability significantly. As we come out of the pandemic, our services will be in even higher demand – so this reliability is key. It is an area we will continue to focus on.

How do you plan to continue using technology tools to benefit business operations in the future?

Technology is critical to the operational and strategic success of Nuffield Health. We are refreshing our strategy at the moment, ensuring plans are in place to continue to transform our business with technology as a key enabler.

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