Benefits of Cloud
This guidance is designed to highlight the many benefits cloud services can bring to the NHS or healthcare provider, and how using the cloud can support your digital transformation. It focuses on the beneficial characteristics of cloud, rather than individual outcomes. You should consider these beneficial characteristics when considering your organisation's business drivers and desired outcomes to help you build your case for cloud adoption.
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Cloud technologies are essential to realising our digital ambitions for the NHS. Our cloud-first policy means they are the default choice for all services. Cloud services provide the sector with an opportunity to improve public services that is unparalleled since the mainstream introduction of IT. It is important organisations understand the benefits of using cloud services, and how they can enable digital transformation and help you achieve your digital ambitions.
Reduced time to delivery
Challenge
Delivering new services to your customers takes time. You must establish delivery teams, set out project governance and gather requirements. This is before your teams can design and begin prototyping potential solutions, and procure hardware, software and services. Each stage of the project contributes significantly to the overall time to delivery.
While it is possible to adopt an agile methodology to minimise the 'soft' overheads of a project, the planning and procurement of technology components remain a constant and significant time burden – often, taking four to six weeks.
- Cloud services help to reduce your time to initial delivery (Alpha) from weeks or months, to hours or days – fostering an action mindset that makes it easier to get started. Cloud services support this approach because they allow.
- Self-service and on-demand access: Adopting cloud services can mean procurement timescales are a thing of the past. A well-defined and approved cloud procurement path, supported by effective financial controls, can allow internal delivery teams to self-provision required resources on-demand, rather than waiting weeks for your supply chain to fulfil orders, or for IT to provision infrastructure.
- Proactive prototyping : Your delivery teams can begin prototyping as soon as your initial requirements have been gathered. This enables them to discover technical challenges and test solutions earlier in the design process, without needing to work through the usual procurement process for hardware, software and services.
- Less capacity planning: Building new services using cloud technologies reduces the burden of upfront capacity planning and hardware procurement. The existing model of over-provisioning capacity to ensure service performance is retired and replaced with an approach to build lean and scale based on demand.
- No capital expenditure upfront: The requirement to buy hardware, software and services upfront is removed in most cases. By removing the need to commit to large CapEx purchases upfront, you also simplify your business case and procurement effort allowing delivery teams more flexibly to try multiple solutions before choosing the best fit.
- Low-risk proof-of-concepts: Cloud services reduce risk by enabling your delivery teams to build Proof-of-Concepts (PoC) for new services quickly and with a much smaller budgetary commitment. Once completed, concepts can be torn down immediately to eliminate financial waste.
Skills
To ensure that teams take advantage of the reduction in delivery times there needs to be an understanding that:
- financial management: team financial management/planning needs to change, being able to build solutions in days doesn't benefit the organisation if it still takes months to sign off the team’s budget
- operational management: a clear model for operations, whether running SRE, DevOps or another structure there needs to be a clear understanding of solution ownership and a service lifecycle. If a team other than the one building a service is operating it, they need to understand how it works and need to have control over when it’s accepted into service and
- non-functional requirements: a team will not continue to deliver rapidly if their time becomes consumed with fixing the existing solution building a set of foundations and clear non-functional requirements that mean solutions do not need constant triage gives teams the time to focus more on delivery
Increased organisational agility
Challenge
Government must be able to respond quickly to meet unexpected and sometimes unprecedented challenges on behalf of citizens. New services must be established at short notice in response to national emergencies, or existing services scaled up to meet unprecedented demand.
The challenge is: 'How can government quickly deliver secure, modern digital services that are good value for the public purse?'
- Cloud services increase organisational agility because they: focus on services, not systems: the focus has shifted from on-premises systems to cloud services. As a result, new organisations or government services can be established in dramatically shorter time frames by removing the requirement to provision new IT facilities, hardware, network connectivity, and operational teams (a cloud native organisation)
- reduce organisational overheads: cloud services remove the requirement to build, maintain and operate on-premises systems. In doing so, they also reduce the need to source and build full internal operational teams
- commoditise new capabilities: new cloud features and services can quickly be integrated into new government services, or retrospectively implemented to extend the functionality of existing services
- start small, and build: building new services in the cloud enables your organisation to start small, with low cost proof-of-concept projects that demonstrate the viability of a new service or technology before committing significant effort or public money
- scale rapidly: well-architected cloud services can be scaled quickly to meet any level of demand. Organisations who are responsible for critical citizen services can scale elastically in the face of unprecedented demand with minimal planning or long-term investment
Skills
For organisations to take advantage the following behaviour needs to be adopted:
Reuse - the ability to share learnings and tooling internally so the organisation does everything once and benefits from everyone's learning requires a far more collaborative approach than historically most organisations have encouraged.
Constantly evolving capabilities
The arrival of cloud services into mainstream use is a revolution in business capability, not merely an evolution in IT delivery. The constant innovation that characterises the public cloud landscape is having a profound impact on our ability to develop convenient, secure and integrated public services.
- This is because cloud provides: commoditised services: hyper-scale public Cloud Service Providers (CSPs) offer hundreds of innovative services, designed to be used on-demand, in a plug and play manner, based on a consumption charge model.
- Crowd innovation: CSPs are constantly working with customers around the world to identify and develop new services to meet their needs. Organisations can benefit from this hyper-scale effort by using off-the-shelf cloud services, instead of developing in-house applications, or purchasing static product suites
- Constant improvement: cloud services are constantly updated, with new features and improved functionality being released every day. Development teams can take advantage of these updates with minimal time or cost investment. This is contrary to on-premises software deployments, which usually require large, high-risk upgrades – which incur time and cost.
- Flexibility: well-architected cloud services are easier to develop and maintain, leaving organisations to improve the capabilities of services simply by swapping in new components, without redesigning the service.
Skills
To take advantage of the constantly evolving capabilities teams need the following skills or behaviours:
- the understanding that any solution needs to be “designed for today”, tomorrow the provider will likely release a new feature that will reduce the effort the team needs
- an iterative approach, as new capabilities are released existing solutions need to be reviewed to understand whether there is benefit to adopt them and then the ability to prioritise those changes
Continuous improvement
The use of innovative cloud technologies is critical to the delivery of convenient, secure and integrated public services.
Current development methodologies lean towards the creation of larger, monolithic services with slow-moving and risk-averse development and release cycles.
Operating in this way prevents organisations from delivering service improvements at a pace their customers expect.
- This is because the cloud provides improved approach: cloud adoption forces you to review and improve your behaviours, processes and operating practices when building and delivering services. This disruption requires you to learn new skills, improve your deployment methods and generally re-factor or transform existing services. It opens your organisation to the opportunity to adopt a mindset of continuous innovation and improves the overall quality of your digital estate.
- Constant change: cloud delivery supports small, incremental and continuous improvements to services to help prevent the accumulation of technical debt and results in an ever-improving service based on the latest cloud capabilities. You must build your skills to benefit from this ever-changing landscape fully.
Skills
To take advantage of continuous improvement teams need the following skills and behaviours:
- regular interaction with stakeholders to understand what they want to see from the product and why
- flexibility with road-mapping and prioritisation - the ability to change the priorities of what the team works on based on customer need and an understanding that this need changes based on demand
- the ability to deliver minimum viable product (mvp) - request and record feedback and make incremental changes to the feature/product offering in a short space of time
- ensure releases are made at least on a per-sprint basis
Environmental sustainability
The climate emergency is at the forefront of government policy and public awareness. It is critical the Government leads by example and sets the environmental standard for others to follow.
Cloud services can help you meet your environmental objectives and support the Government’s broader environmental goals.
- The adoption of cloud technologies should be at the heart of this strategy.
- By leveraging the existing – and developing – efforts of the Hyper-scale cloud providers, you can radically reduce the environmental cost of delivering services, while also realising the many other benefits that cloud adoption can bring.
- Major Cloud Service Providers (CSP’s) are driving the industry forward in this area, as they have recently made commitments to being carbon neutral by set dates.
- Cloud services support environmental sustainability.
- Environmentally sustainable services: the hyper-scale cloud service providers aim to achieve carbon neutrality by set dates. To meet their objectives, they are investing significant time, money and effort to reduce the environmental impact of their operations, by progressively transitioning to datacentres powered by 100% renewable energy. By delivering our services from these locations, we can benefit from their investment to reduce the environmental impact of our services.
- Less material waste: it is essential to consider that the manufacture and procurement of IT equipment itself causes a significant environmental impact. The traditional model of running datacentres filled with servers, storage and network equipment is at odds with our environmental strategy. The leading cloud service providers operate extremely efficient datacentres, with custom-built hardware that minimises material waste and maximises workload density, to reduce costs and drive service adoption. Where workloads must remain on-premises, we can reduce our impact by minimising future purchases and consolidating workloads onto hyper-converged solutions (combined compute, storage and network platforms).
Skills
While not specifically a set of skills/behaviours needed to unlock the sustainable elements of public cloud teams need to consider when and how much infrastructure is running to maximise the environmental benefits:
- platform scale up time needs to be understood to ensure that autoscaling can manage demand peaks
- autoscaling groups should be used on any infrastructure the team is running to ensure only required infrastructure is running but also to manage failure in a more graceful manner
- any non-production infrastructure must be stopped when its idle. Ideally this should mean that when it’s needed the team starts it for the specific job and stops it when they’ve finished however this does require a level of maturity and planning to achieve
Evergreen IT
The meaning of the term Evergreen IT depends on the context. It usually refers to 'a technology ecosystem that is continuously changing and evolving, never becoming out-of-date or obsolete'.
An example of this is the latest Windows servicing model, in which the operating system is updated frequently, with many smaller releases, rather than a single more significant version every few years.
One of the most significant challenges our organisations face when providing services is how to effectively and efficiently maintain systems and software to ensure they’re up-to-date, secure and leverage the latest features.
- Adopting cloud services can have a profound impact on how your organisation views its technology and services.
- To realise the benefits of Evergreen IT you should view your services as a set of components that deliver particular functionality, capabilities and data to your customers, rather than as specific systems or technologies. To derive the most significant benefit from this approach, it is also essential to follow a standards-based approach to development and to minimise excessive customisation and reliance on specific product features.
- The underlying components of the service can change (servers, databases, etc.), while the interfaces, data and functionality remain the same.
- Cloud adoption supports Evergreen IT by: reducing the infrastructure burden: migrating to cloud services and away from server-based, on-premises workloads can mitigate your infrastructure burden. The requirement to manage and maintain the underlying infrastructure for services passes to the Cloud Service Provider. The scale of the benefit depends on the cloud service model you choose and how aggressively you migrate workloads
- Providing an Evergreen platform: Software-as-a-Service, Platform-as-a-Service and Serverless offerings provide managed services that your organisation can use to build solutions without assuming ownership of the lifecycle of the underlying platform or its components
- Reducing technical debt: cloud services prevent your organisation from accruing substantial technical debt in the form of legacy services and operating systems. CSPs operate a moving window of supported software, encouraging and eventually requiring customers to move to the latest technologies.
Skills
To take advantage of these benefits teams need to
- understand the shared responsibility model for the services they are using, these vary between services and affect the amount of involvement or planning the team need to make for updates;
- ensure the team understands where the service is in its lifecycle. While cloud providers rarely remove capabilities from existing deployments, they will remove those capabilities from new accounts. The team should move to the latest version of capabilities when they know it’s stable to avoid getting caught with legacy services they can’t easily recreate and
- design services to use Open APIs aligned to standards wherever possible so that you can manage the implementation of your services in a continuous way without exposing the details and impact to the consumers of those services. In addition, support interoperability across services
Disaster recovery
Disaster Recovery (DR) refers to the ability of your systems and services to continue operating, or be recovered, in response to a service-affecting outage or event.
Challenge
Organisations generally view disaster recovery as a burden on operational teams and a cost overhead on service provision.
As it stands, organisations ensure service availability by duplicating services and infrastructure across multiple environments (a hot/cold model). This approach also duplicates service costs.
The challenge is: 'How can we cost-effectively meet service availability requirements without significant investment in infrastructure or facilities?'
- Cloud platforms are based on highly resilient architectures with redundancy incorporated at every level. In most cases, providers operate with an availability SLA of 99.9%, rising to 99.999999999% (eleven nines) for some services.
- This level of availability exceeds the capabilities of most organisations, where cost constraints and geographical limitations hamper their ability to deliver required service levels, even in common failure scenarios, such as datacentre power and cooling failures.
- Using public cloud services introduces several benefits: Stable platform: the redundant and resilient nature of hyper-scale cloud platforms provides immediate improvements in availability for organisations who currently struggle to meet service levels.
- Service-specific availability: using public cloud technologies enables your organisation to set availability requirements at the service level, rather than at an infrastructure level. This gives you more granular control over how particular services should respond in the event of a failure at different levels (host, datacentre, region)
- Minimal maintenance: cloud services – particularly Software- and Platform-as-a-Service models – provide high-availability without the burden associated with managing duplicated infrastructures.
- Reduced costs: cloud service models provide high-availability more cost-effectively by reducing the need for duplicated hosting environments.
Skills
Teams need to understand the following to take advantage of the DR capabilities offered by cloud providers:
- understand the availability requirements of their product.
- understand the services the product is dependent on and their DR solutions.
- be aware of the availability offered by the different cloud services and how to take advantage of them (for example in AWS amazon provide 99.9% availability for instances in a single AZ and 99.99% for instances when used in 2 or more AZ)
Improved security
Challenge
Effective security enables convenient access to public services. Designing services to be secure from the ground up results in a better service for users and protects their data.
The challenge is: 'How do public sector organisations implement and operate effective and proportionate security against a backdrop of skills shortages and challenging budgets?
- Adopting cloud services can help to raise your security baseline and reduce your operational overheads.
- World-class security: the cloud platforms of the hyper-scale Cloud Service Providers feature world-leading security technologies and controls as standard. Your organisation can benefit from this investment to raise your security baseline
- Shared responsibility: platform-level security controls are implemented and maintained by the cloud provider. These controls are sufficient for many services and types of data, which allows you to deliver secure services without investing in, or maintaining, independent security controls
- Secure services, not appliances: cloud-based security services can be integrated with your cloud services without deploying network-based security appliances. You are responsible for configuring the service, but not maintaining it throughout its lifecycle. What's more, the service's capabilities are likely to improve over time, without investment or major architectural changes
- Reduced complexity: cloud services are more architecturally flexible. The cloud acts as the 'control plane', allowing you to implement, secure and operate discrete new services without unnecessarily increasing the complexity of your overall digital estate. Well-architected cloud services allow you to securely and intentionally connect your services. With on-premises systems, the focus is on securely separating them at the network level, which can result in complex network architecture and onerous management overheads
Skills
Public cloud fundamentally changes the approach organisations take to Information technology security. Historically a secure platform would have highly restricted internet access and rely on segregation at a network layer to limit the exposure of internal systems to external threats. Public cloud by its definition is internet connected by default and organisations need to manage security based on this
- the other benefits of cloud come from providing product teams with a level of autonomy. Information security teams need to work with product teams to build secure infrastructure
- build a maturity model and reduce the level of centralisation based on the maturity of teams
- ensure there are dedicated members of the security team able to work in product teams to solve problems together
It is important to remember that you must always be responsible with data and that your services should be secure by design. Cloud services provide world-class security and alleviate the burden of implementing and operating effective security controls, but using the cloud never removes your responsibility to protect data and services.
Further information
A workload assessment is an essential tool to structure and communicate your application transformation roadmap. It allows informed decisions on how each application in the scope of a transformation will eventually touch the cloud.
To provide guidance in your organisations cloud adoption when you have created 6 guides focusing on key areas of your organisations and the NHS Cloud Strategy, principles, policies and guidance is relevant to your role.
Design your service to fit your cloud deployment type.
Support and information to create a cloud exit plan.
Share our Cloud policies to establish a baseline understanding and adopt best practices of cloud and internet first across your organisation.
To help NHS and healthcare organisations get started with understanding how to adopt cloud and what the impact will be on their server, infrastructure, and applications we have provided information on public cloud adoption best practice.
This primer provides an overview of public clouds and focuses on specific areas of importance for public NHS and healthcare organisations.
Last edited: 5 July 2023 4:57 pm