York and Scarborough Foundation Trust : Wi-Fi 6 Implementation Case Study

Between January 2023 and March 2024, NHS England's Future Connectivity wireless trials team collaborated with York and Scarborough Teaching Hospitals NHS Foundation Trust to implement Wi-Fi 6 in their new York A&E department.

Serving around 800,000 people across North Yorkshire, this investment demonstrates the trust's recognition that reliable connectivity is essential for modern healthcare delivery across their geographically dispersed service area.

NHS England provided funding through the wireless trials programme to improve the trust's Wi-Fi connectivity. This case study shows key findings from their implementation reports to share valuable lessons with other NHS organisations. A trial summary accompanies this document.

The trust identified three critical challenges driving the need for Wi-Fi upgrades:

Geographical limitations

As an acute trust located over two primary sites situated roughly 40 miles apart

• patient consultations between sites required three-hour road journeys
• each transfer consumed valuable transport resources, staff time, and created avoidable costs
• the WiFi upgrade enables virtual consultations and remote specialist support
• patients now receive consistent specialist care regardless of location

Unsuitability of the current infrastructure

Pre-deployment wireless infrastructure limitations:

• Inadequate network coverage impeded clinical care and innovation
• Insufficient capacity for essential clinical devices (radiology machines, IoT devices)
• metwork speeds too slow for modern healthcare applications
• unable to support the growing number of connected devices per person (now averaging four per person

Product end of life concerns

Security and reliability risks from outdated equipment:

• Access points across both campuses exceeded end of support date in 2019
• Network controllers at York site also past end of life
• Unsupported equipment creates cybersecurity vulnerabilities
• Lack of manufacturer support results in decreased reliability and increased operational costs

The trial implemented a WiFi-6 network in the new A&E Department with five key objectives:

• deploy a scalable wireless platform meeting current demands while enabling future expansion
• enable clinicians to access clinical applications and technologies throughout the building
• establish a "Wi-Fi first" culture within the new A&E department
• support patient and visitor connectivity needs with capacity for multiple devices per person
• reduce care inequality between sites through advanced digital health services and virtual consultations" (Numbered for better emphasis, slightly reworded for clarity and impact)

As part of their trial, York and Scarborough implemented a Wi-Fi 6 network platform at their new A&E department in York. 

Wi-Fi 6 provides capacity that meets current requirements while offering scalability for future healthcare connectivity demands.

Once the network architecture was determined, York & Scarborough had initially employed a phased migration plan to slowly move all connected devices in the building from one set of LAN controllers (a device that manages many Wi-Fi access points) to another. This migration plan would have minimised downtime and disruption for both clinicians and patients.

The plan involved migrating devices on a ward-by-ward basis to allow for new access points to be installed prior to each ward’s migration.

However, part way into the migration, many of the building’s access points dropped off their network and would not reassociate themselves with their old controller. To respond to this, the trust decided to immediately redirect all the remaining devices to the new controllers – at a much greater pace than the initial plan. This required a large amount of collaboration with the trust’s estates team to ensure that impact to clinical operating procedure was kept at a minimum.

The trust activated business continuity plans during the outage while organising urgent meetings with estates, technical suppliers, and hardware manufacturers. The decisive action to redirect all devices to new controllers proved successful, with the York site deployment completed by August 2023.

The WiFi-6 deployment has transformed connectivity for clinicians and patients. Below we evaluate outcomes against each of the original objectives:

Objective 1: Scalable wireless platform for current and future demand

Signal coverage and capacity:

• each access point now handles 70 devices (up from 30)
• analytics identified heavy usage areas (waiting rooms, nurse stations)
• strategic deployment of higher-specification access points in high-demand areas
• improved user experience despite similar physical coverage area

Network performance:

• upgraded multigig uplinks (2x2.5Gb compared to previous 1Gb)
• Increased capacity reduces congestion and improves response times
• staff report perception of faster network despite similar theoretical speeds
• main limitation now exists at the client device level (2.4/5GHz capabilities)

Figures in the above graphs are approximate.

These simple graphs show live busy periods and comparative averages, but can be broken down into areas and hospital services. This information can then be used to inform staff resourcing, allowing assessment of how best to meet patient capacity demands.

Objective 2: Allow clinicians to access the latest applications and technologies anywhere in the building

One of the most noticeable changes to clinician’s daily lives is the change over from paper-based methods of administration to a digital solution, accessible anywhere in the building.

The reliable network connection supports staff mobility during care administration. This improved connectivity contributed to increasing the patient evaluation rate from 8% to 74%, demonstrating significant operational improvements.

Staff have also provided positive feedback about the new network, reporting it as faster and more reliable compared to the previous system which was often seen as a hindrance to their daily work. This is a noticeable perception change.

Objective 3: Take advantage of the new A&E department build to foster a new “Wi-Fi first” philosophy

Changes to clinical ways of working to accommodate reliable Wi-Fi

As mentioned earlier, there have been many positive changes to Clinician attitudes to their infrastructure, as well as improved quality of life for many, with reduced paperwork and reliable access to applications as a direct result of the deployment.

System allows for IT staff to deal with less tickets and focus on project deployment 

The positive outcomes from their trial have not just been for front line staff – many of their technical staff have also seen the benefits of a better-connected hospital:

Objective 4: Support patient and visitor connectivity needs with capacity for multiple devices per person

Available bandwidth 

As a result of increased availability of reliable signal, the trust identified that their backend uplink that provided free WiFi dedicated to Patients, visitors and staff for personal access was now a limiting factor and as a result is being increased from a 1Gb Uplnik to a 10Gb Bearer (5Gb capacity) to enable a more feature rich experience for all whilst not impacting on the corporate systems.

Greater density of APs

Whilst the trust hasn’t increased their AP count significantly at this stage, the new Access points offering the latest WiFi capabilities have enabled ageing infrastructure to be functional and beneficial to clinicians by enabling a more feature rich, mobile experience, which in turn enables a better outcome for the patient by reducing time to be seen. 

Objective 5: Reduce the care inequality between the York and Scarborough sites

Whilst the program set out to deliver care equality and technical integration between the two new emergency departments, construction delays have meant that the Scarborough site has yet to be completed. Once completed and the trial network deployed, both sites will have the same level of clinical and technological benefits.

The delivery of the new WiFi 6 infrastructure into the York A&E department proved successful so the trust decided to roll the program across all sites and all areas. This work is still underway however many benefits have been realised in both main sites:

• Video interpretation services – This was run as a trial in our A&E department and was instrumental in identifying initial issues in certain “quiet” areas around waiting rooms where services were being conducted. They noted the signal was low and often caused issues with the service. These areas were often in non-standard clinical spaces, such as alcoves between corridors or stairwells. Areas not typically designated for clinical use but used during busy periods.
• Maternity digitisation – due to the digitisation of maternity services, there was a need for increased mobility within the area and so this was a priority area with regards to the rollout of the new infrastructure across the trust.
• Coronary care – to enable mobile patient ECG monitoring. This program has seen the trust prioritise all bedded areas with regards to the project delivery to enable monitoring anywhere and to increase resilience and BC provision.

The trial, and York and Scarborough should be viewed as a representation of the possibilities that Wi-Fi 6 can provide for an organisation and re-emphasises the importance of stable connectivity for clinicians in any area where patients are being treated.

The main recommendation from this deployment is to recognise the importance of early collaboration between an organisation’s IT, healthcare, and facilities teams during a large-scale deployment.

Early collaboration between teams helped resolve potential issues. For example, when contractors needed to follow infection prevention and control procedures during deployment, coordination with the estates team facilitated appropriate access while maintaining safety standards.

The trust recommends involving these teams as early as possible (even before procurement), especially as an estates team can assist greatly with hardware deployment, providing practical advice given their innate knowledge of the sites being upgraded.

The trust also concluded that it is vital to have contingency plans in place to mitigate risks, especially when deploying over such a wide area and with so many devices. During their migration incident, it was the collaboration between these groups that minimised impact and allowed an alternate solution to be explored.

The outage also allowed the trust to use their business continuity plans for connectivity outage. Another recommendation from this deployment is to ensure that the trust’s business continuity plans are kept up to date and tested often, as resilience if key in a deployment of this scale.  

Additionally, they encountered delays of around three and a half months in the supply of wireless equipment and hardware. Whilst frustrating, this was not unique to their deployment, and sadly highlights a broader industry issue that must be considered when planning large scale deployments and selecting suppliers. This can be mitigated somewhat by getting in orders with suppliers as early as possible, and being open to receiving hardware piecemeal as and when they are available.

Finally, the trust has found that continual WI-FI surveying assessment is required to maintain the quality of connectivity in the site. They found many factors can change connectivity quality, for example a kitchen buying and using a microwave affected mobile signal in part of the trust! Keeping up with changes within the organisation will be vital to the continued success of the deployment.

By the end of their deployment, York and Scarborough has a robust network that both creates a better quality of life for clinicians and patients and enables a myriad of possibilities for the trust, all whilst being scalable to future requirements. 

We are excited to continue working with York and Scarborough as they continue to explore the potential of connectivity in healthcare and see how they tackle the future problems that many similar hospitals will face.