Leeds Teaching Hospitals fully embraces Microsoft’s Azure cloud platform

The Leeds Teaching Hospitals NHS Trust (LTHT), one of the largest acute hospital trusts in the country, has completed the transfer of its electronic health record onto Microsoft’s cloud platform, Azure.

The successful migration has encouraged the NHS Trust to begin putting its data platform into the cloud, too, with the aim of improving both integrated care and resource allocation.

LTHT, which treats around 1.5 million people every year and employs more than 20,000 staff at seven hospitals across five sites, is the largest provider of specialist care in the UK.

It began moving its electronic health record system, called PPM+, onto Microsoft’s Azure cloud platform in early 2022, as part of a wider programme to enhance the technological framework for its operations.

With PPM+ now fully implemented in the cloud, Azure gives the Trust a secure foundation to launch and support other innovations and services.

“In a modern healthcare environment, the patient record is vital,” says Dr Paul Jones, Chief Digital Information Officer at the Trust. “The best way of keeping PPM+ available to clinical staff was by moving to Azure.

“We’re now in the proud position of having a fully cloud-based, properly resilient, totally scalable electronic patient record supporting one of the largest teaching hospitals in the country.”

While many Trusts around the UK have electronic health record systems, PPM+ is notable in its scale and sophistication, which bodes well for other Trusts looking to emulate LTHT’s successful migration as part of the NHS’s continued digital transformation, Dr Jones believes.

The move onto Azure is ultimately enabling more joined-up care across the region, and LTHT is making wider ripples of positive progress, he says.

“PPM+ is already the bedrock of much of the integration in our region and we are looking to be a key part of the wider integration across the ICS [integrated care system] and beyond.

“There’s huge potential for PPM+ to bring benefits to public sector organisations at a range of levels.”

Resilience, scalability, agility

The main aim of moving to Azure was not functionality, but resilience – crucial for such a large Trust, he explains.

PPM+ began life over two decades ago as a small-scale, in-house solution for cancer care teams, and continued to expand and evolve. Continuing to grow it with on-premises data servers was expensive and potentially unreliable. Azure, on the other hand, provided a way for PPM+ to scale safely and more affordably without compromising stability.

“The only real way we could move forward was to put PPM+ into Azure,” he says. “Having that robust, well-managed and reliable infrastructure was key – and knowing we can scale further in the future.”

PPM+ also seems to function better in Azure, he says: “We feel more confident in getting that additional performance.”

Azure’s agility has also helped LTHT to adapt PPM+ when needed. During the Covid 19 pandemic, for example, patients with the disease were quickly identified on Azure-supported electronic whiteboards.

Seamless migration

Most clinical staff are barely aware of the changes to PPM+ – or the migration to Azure – says Dr Jones, and that’s exactly how he likes it. The predicted disruption never materialised.

“The Azure move has been really helpful for letting me sleep at night,” he says. “But the clinicians and frontline staff? I don’t think they’ve noticed, and that’s an absolute result.

“They shouldn’t have to worry about those things. With Microsoft’s help, it all got picked up almost automatically. I thought we’d be talking days of unavailability, so for there to be so little disruption was amazing.”

‘Data-based decisions’

LTHT has also started to put its data platform onto Azure.

“We are not using this at scale yet,” he says. “But the intent is to put our data in the hands of our clinicians and managers, so they can directly make data-based decisions without having to make loads of phone calls.

“That should drive more effective use of resources and improved patient care across the Trust.”

LTHT has 2,000 beds and allocating them efficiently is a constant juggle, he adds.

“It needs more work, but it’s a start.”

‘Working together’

The HomeFirst programme across health and social care in Leeds is seeing a new model of intermediate care services implemented in the city.

Intermediate care is a collective term for a group of services designed to provide short-term help for adults who need continuing support once they have been discharged from hospital, thereby achieving more independent and safe outcomes.

Azure helps the teams involved in the HomeFirst programme function more smoothly, says Dr Jones.

“Nobody wants to be in hospital if they don’t have to,” he says. “Getting our patients home often involves different people from different organisations working together, and what we’ve built in Leeds allows that to happen more seamlessly.”

Joined-up care

The healthcare system in Leeds is a complex picture involving multiple providers, from GPs to social care teams, he explains.

The Leeds Care Record, which sits on top of PPM+, now shares patient information in a read-only format across every healthcare service in the city, even connecting with the wider Yorkshire and Humber record system.

This enables more joined-up care with the potential to improve patient experience and streamline service provision, he says.

“There is huge value in shared records. Leeds is way ahead in that regard.”

Like all NHS trusts, LTHT faces pressure on resources, but with Azure, it has created the strongest possible framework to continue evolving, Dr Jones believes.

“Having both the electronic patient record and our data platform running on a robust, resilient Azure platform puts the trust in a really solid position,” he concludes.

“It’s running really effectively.”