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How to jump into the cloud

Neil Gibbs, Cloud Engagement Lead at NHS Digital, says we need more NHS organisations to migrate to the cloud and explains what help is available.

The benefits of migrating services from on-premise data centres to the cloud are clear. Cloud hosting is cost-effective, allows for greater speed, agility and scalability of services, improves security and creates more opportunities to adopt innovative solutions.

The author Neil Gibbs stands outside

It also transfers the responsibility of installing, operating and maintaining infrastructure equipment to the cloud service provider. Most NHS organisations rely on a small IT team working an 8-hour day to ensure adequate operations cover is in place; large cloud providers such as Amazon and Microsoft have round-the-clock teams dedicated to this activity.

This was particularly evident during last summer’s heat wave when several data centres experienced outages as their cooling systems failed. One hospital trust had to reschedule some appointments and operations as they worked to restore services. In contrast, cloud providers Google and Oracle also experienced similar outages, but they were able to restore services within hours.

Adopting cloud services requires a fundamental shift in the way IT costs are managed.

So, when there are so many benefits to migrating to the cloud, why hasn’t everybody already done it?

My team conducted a ‘cloud maturity survey’ of dozens of NHS trusts last summer and found that 11% of them had most of their applications and servers running in the cloud already.

The obstacles to migration differ between each organisation, but our survey revealed that the three biggest barriers were challenges around the prioritisation of funding, expertise (the capability and technical know-how around cloud operations), and the complexity of cloud and how to navigate through it.


The Cloud Centre of Excellence

We’ve created a Cloud Centre of Excellence at NHS Digital to provide a central self-service and enablement function for the NHS.

We want to help other NHS organisations on their cloud migration journey by developing solutions and resources, promoting best practice and sharing our knowledge across the health and care system. For those in need of further support, we also offer advice sessions with members of our team.

Here are some of the ways we help:

1. Cloud strategy and assessment

While about half of NHS trusts we surveyed had cloud migration incorporated into their wider digital strategy, those with a separate cloud strategy (18% of respondents) were actively migrating their services to the cloud.

We encourage organisations to review the central NHS Cloud Strategy (requires a FutureNHS account to view) and adapt it to their own needs. There are also other strategy guides for the public sector available for use.

For those early on in their cloud migration journey, we have produced guidance to help NHS organisations develop their own capability maturity assessments. that will help to establish a starting point. It evaluates the current state maturity of cloud implementation in an organisation and the desired target state from 2 key perspectives: technical and non-technical capabilities.

This helps to identify where there is a need for new skills in the organisation as well. We have recommended training and resources from our partner organisations that NHS staff can access for free.

2. Migration planning

Next, it’s important to complete a workload migration assessment. This assess IT services and workloads to determine what’s capable of being migrated to the cloud, and how.

More specifically, it:

  • identifies the migration strategies that can be applied
  • quantifies the effort, cost, dependencies and risks to execute migrations
  • informs the overall migration strategy, roadmap and business case

3. Business case and financial operations

Adopting cloud services requires a fundamental shift in the way IT costs are managed. Because cloud services are billed on a pay-as-you-go model, cloud costs are treated as operating costs – as opposed to the traditional capital expense and asset depreciation model. Additionally, the costs are variable and therefore can be difficult to forecast.

So, how can we help organisations make a case for change and secure the buy-in and budget needed?

We offer guidance to organisations who are working through a business value assessment,  which estimates the benefits which could be achieved by migrating existing platforms to the cloud. More specifically, the value assessment summarises the costs, potential savings, and soft benefits in a clear and concise format.

The key output of this service is a financial model for a first stage (top-down) business case for cloud migration. Organisations can then use this information to create their own detailed business case. We provide standard templates and suggested narratives to use as a resource.

4. Other considerations

Before beginning the migration process, there are a few more things organisations must consider: there may be a need for enhanced information governance controls as data and systems are moved out of the ‘walled garden’ of on-premise corporate data centre.

Additionally, there may be a need to review and adapt the financial operating model in organisations when incorporating new cloud functions. We encourage best practice in this area using a Financial Operations (‘FinOps’) model, and provide several services in this area such as cost optimisation reviews and billing reports.

We proactively explore ways to reduce the purchase price of cloud services for the NHS by negotiating bulk purchasing discounts and savings plans with the cloud service providers.   


Cloud migration is a complex process, but following the guidance and using the resources available in the Cloud Centre of Excellence will break down barriers and lay the foundations for change. The work put in reaps so many benefits that the effort is worth it.

For a quick guide on where to begin, start with familiarising yourself with our persona model to find out where your organisation best fits and follow the links to the relevant services and topics.

If you need further support as an NHS organisation planning or migrating to use cloud services, contact us using our feedback form for an introductory 30 minute conversation with a member of the team. We’re always happy to help organisations get started on their journey to the cloud.



Related subjects

The Cloud Centre of Excellence (CCoE) promotes a best practice approach to drive the adoption of Cloud services. It provides a centralised enablement function and supports Cloud service consumers across NHS Digital and the wider NHS.

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Last edited: 18 January 2023 9:25 am