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A landmark IT deal between NHSX, NHS Digital and Microsoft was announced on 15th June that will provide access to digital tools and save hundreds of millions of pounds for the NHS.

The deal will enable all eligible organisations in England to access Microsoft 365 digital tools and potentially save the NHS hundreds of millions of pounds. It will help accelerate the adoption of digital tools across the NHS and further bolster the 2018 cyber security agreement with Microsoft agreed in the wake of the Wannacry ransomware attack.

The crux of this announcement is clearly a positive one: it will enable more people in the NHS to have easier access to Teams and other Microsoft applications. It helps support their ability to communicate internally within the NHS via video calls, using chat and all the other benefits that come with the Microsoft applications. Ultimately, it helps towards NHS Digital’s goals of improving Patient Care and saving tax payer’s money.

However, we’ve spoken to some IT managers in the NHS who have expressed concern around what this might mean in practice for them. Will they lose control over elements of their IT portfolio? Will their hands be tied in terms of procurement choices? So we’re delving into these queries in this article...


Let’s start at the beginning, bearing in mind that we’re all learning about what this practically means for the NHS and therefore our thoughts on this at this stage are based on some assumptions: the NHS is fragmented, with separate and independent procurement processes for connectivity, networks, wireless and security, as well as all the applications that apply across these areas. So does the announcement mean a different, centralised service from Microsoft through NHS Digital for all Trusts?

When you take a moment to look a little more closely at the wording within the announcement, it suggests that this is more likely a commercial play that offers a better deal to the NHS, rather than offering a different service entirely. The announcement states:

It ensures that those NHS organisations that have already made their own arrangements with Microsoft benefit from the deal and the significant cost savings on offer.

What’s more, the timing coincides with a number of NHS organisations in England currently renewing their licences. NHS organisations are not obliged to take the Microsoft products and can choose alternative suppliers should they see fit.

So, we assume that this NHS Digital announcement will potentially place NHS Trusts into 2 different categories:

    1. Those Trusts that are using their own Microsoft licenses and mail platform who will continue to have the flexibility & control to do what they choose - whilst also benefiting from the commercial agreement.

    2. Those Trusts that are using NHS Mail (via NHS Digital) who we assume will go down a shared tenancy route with NHS Digital - and with whom there is a different conversation to be had. As a procurement win for the NHS, the deal will allow those separate NHS organisations to benefit from a Teams layer on top of the existing NHS Digital provisions.

We assume IT managers will no doubt still be able to retain control over their sensitive data, according to GDPR in either case.

Whatever camp an NHS Trust falls into, we believe there is an ongoing hybrid discussion to be had with IT managers in the NHS.

Giving Teams a Voice?

As has often been the case with Technology, we are beginning to see more digital areas merging into one. The provision of and rapid uptake of Teams has meant that Microsoft have branched out into the world of unified communications.

This is exactly what it says on the tin – The process of combining multiple ways of communicating into one place. The idea is that it is seamless, easily manageable and efficient.

Certainty, the chat and video functionality are providing exactly that. But what about the voice element?

Voice is a key element of UC. The ability to make a call directly from your messaging platform really provides deeper efficiencies. So will trusts be able to make external calls using their Teams platforms?

If so, where does their PBX come in?

Certainly, Trusts have invested millions of pounds in legacy resilient phone systems and contact centres over the years and they provide that all important critical infrastructure that the NHS requires for Patient Care.

There are a number of important questions, which all need to be considered upfront.

  • Will NHS Trusts eventually aim to get rid of their PBX altogether and plug their SIP directly into their Teams platform, giving them ‘one platform’ for their suite of UC?
  • Will the ability to integrate their Teams platforms with their legacy PBX estates be a better fit for the NHS?
  • If the answer is ‘yes’ to integration - Will the Microsoft Licences provided for the NHS through the NHS Digital / NHSX agreement give Trusts the ability to integrate with their legacy PBX? (This requires a specific and widely considered expensive bolt on from Microsoft).
  • Will the way that Trusts purchase these licences (through NHS Digital or Direct with Microsoft) affect their ability to do this?

A Hybrid Approach

In the near future, accommodating the use of legacy infrastructure within Trust’s Team’s environments is likely the best way forward for most NHS Trusts, largely because there are a number of areas where Teams alone is not a good fit for NHS organisations when making calls.

The 2222 service is one of them. 2222 is effectively the internal 999 number for a hospital where someone can pick up a phone to request an emergency response to a specific area. It’s difficult to think of a hospital where there isn’t a dedicated set of switchboard operators that operate 24/7 to deal with 2222 calls. In a sector that’s particularly risk averse - and for very good reason - it’s highly unlikely that there will ever be a scenario where the NHS moves fully to the ‘Public Cloud’ as a solution.

Another element to throw into the mix is pagers. These devices are still very much in operation in hospitals. They run separately to any other network with their own antennas and frequency, have long life batteries and can alert a nearby doctor to an emergency quickly. For many, they are cost effective and practical.

There are also various alarms in hospitals to consider. Most Trusts have their alarms feeding into their phone systems - from their blood banks to their fridges and freezers. These tend to be small analogue devices and our assumption is that while many Trusts will be looking to modernise these elements of their estate to IP in the future through the use of IoT devices, it’s most likely to sit in their “nice to have” as opposed to “essential” category.

Finally, there are legacy cabling estates in the mix too. Some Trusts are fortunate to have more modern environments but this is by no means the case across the board. While WiFi is being rolled out across many Trusts, for those with these legacy cabling estates, the concept of WiFi is all very well… where it works… but it simply doesn’t cut it for locations where connectivity literally can be a matter of life and death. How Trusts will move away from the public analogue phones on the walls in every ward to IP in its entirety is an interesting and challenging question - it’s not that the technology isn’t available to do so, but with their requirements being so simple in terms of just needing a phone that has a dial tone, it will be a tough nut to crack. It’s often a case of “if it ain’t broke, don’t fix it...”

Supporting Digital Adoption

The hybrid discussion is one that really can support Trusts on their digital journey - whatever stage of that journey they’re at. What’s key is choosing the right partner; one that can talk through the options with you and help you to understand the cost, licence and support implications, whether considering the support of the legacy voice environment, or the connection into Teams. Unified Communications is all about providing a single user experience and a hybrid approach can be taken, as long at that experience is seamless.

With all that Teams has to offer the NHS, Charterhouse is here to add value to the process. We are excited about the recent announcements and our aim is to ensure that Trusts are getting the most out of the services available to them. While NHS Trusts are using Teams and collaborating internally, we can help them look at integration and other options available to aid digital adoption. This will ensure that the analogue features of an IT estate that are the foundations of service delivery are integrated with this additional technology to maximise the benefit of Teams.

If you'd like to know more, do get in touch. 

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