InfraStruxure At The Heart Of IT Service Delivery For James Paget University Hospitals NHS Foundation Trust

The James Paget University Hospitals NHS Foundation Trust provides medical care for 230,000 inhabitants of Great Yarmouth, Lowestoft and surrounding areas, plus holidaymakers in this popular location. IT plays an increasingly important role in ensuring the wellbeing of the people in its care, so the Trust has recently invested in two new data centres which use APC InfraStruxure architecture to provide efficient, scalable and available services.


With over 500 beds, the James Paget University Hospitals NHS Foundation Trust provides acute care at its main site in Gorleston supported by services at Lowestoft Hospital, the Newberry Clinic and other outreach clinics throughout the locality. It also delivers a range of community services and employs 3,380 members of staff across its healthcare and supporting activities.

The Trust recognises the importance of high levels of service delivery and the need for customer satisfaction in an increasingly competitive market where funding follows patients. Accordingly it introduced its “Improving the Patient Experience” project to bring focus to a range of objectives such as improving the physical comfort of patients; cleanliness and HCAI, privacy and dignity, appointments, access and communications.

Environmental issues are also a priority for the Trust which is fully committed to reducing CO2 emissions in line with the NHS Carbon Reduction Strategy for England. It has been working closely with the Carbon Trust and in February 2010 successfully completed Phase 4 of the NHS Carbon Management Programme to reduce emissions and minimise the environmental impact of activities carried out within all Trust sites.

IT is becoming increasingly critical to the delivery of effective healthcare. So in early 2009, the Trust made a major review of its services and embarked on a “transformational project”, to ensure best practice standards and highest levels of maturity in line with the NHS Infrastructure Maturity Model.

“IT underpins everything that the Trust does,” says Steve Kirk, Infrastructure Operations Manager at James Paget University Hospitals, NHS Foundation Trust. “This might seem like an exaggerated claim, but it’s actually true. IT helps to improve the efficiency of the Trust as well as improving the service we provide to the patients in our care. Today, all investments we make have to provide an additional customer benefit in the form of an improvement in wellbeing.”

The exact nature of the benefits that IT brings can range from speedier access to information, or retrieval of archived clinical records to more efficient clinics and faster dispensing of pharmaceuticals and treatments. “Over the last few years, the perception of the value of IT has changed radically. Today, just as a bank uses IT to deliver services and produce a profit, the Trust uses IT to deliver services and improve patient welfare.”

IT has also helped facilitate a high degree of automation: In the intensive unit, for example, patient’s vital signs such as heart rate and blood pressure are monitored using what is effectively a networked PC. The pharmacy is robot-operated so that prescriptions are picked and placed automatically. Not only does this save time for patients and medical staff, but also it ensures that administration has a more accurate view of stock holding and ordering requirements.

Steve Kirk says, “Medical imaging has become crucial to the diagnosis and treatment of a wide range of conditions. As a teaching hospital, we generate a large number of digital images and therefore a large number of big data files. These all need safe and secure storage. So whether it’s a probe from an endoscopy, an x-ray, an ophthalmic image such as a retina scan or a full body CT scan, the data will sit somewhere on our network infrastructure.”

The physical infrastructure which powers, cools and houses the servers and storage systems at the heart of IT service provision had grown organically over the years, using available spaces rather than dedicated facilities. The limitations of this evolution were highlighted when the need for a new Storage Area Network (SAN) was identified. This threw up a host of issues and a review of physical constraints revealed that not only did the hospital lack the space for the required SAN, it also lacked the skills and process to implement the system.

Because of the way that the network had evolved, the servers which ran the Trust’s email system, administrative functions, clinical applications and admission-critical systems for A & E and Theatres were distributed between four small server closets. Access was a permanent concern as 90% of any hospital consists of public areas, so there had never been more than a key-coded door between the hardware and unwanted intrusion. All of this had also made it very difficult to get a consolidated view of available resources such as space and power for new IT equipment.

Steve Kirk says “To solve the challenge we commissioned a dedicated data centre to be built in a former clinical space. The design and construction was undertaken by NetxiraOne who demonstrated excellent credentials and who already had extensive experience providing communications services to support NHS application. NextiraOne have also managed a large number of major projects in hospitals throughout the UK and our confidence in them was rewarded when they were able to provide the new data centre on time and on budget.”

Known as Nexus One, the new facility is a purpose built server room with two rows of APC NetShelter equipment racks and fully equipped with perimeter air conditioning units, standby power supplies, fire suppressant systems, and its own electrical generator. The project was carried out and the IT load migrated into the new room with no interruption to services. As far as possible, servers were virtualised as the existing facilities were consolidated into Nexus One. The odd, temperamental servers were physically moved into the new facility.

The benefits of having a modern data centre were quickly understood and within 14 months of the launch it was decided that a second data centre should be built to boost the resilience of IT services. Steve Kirk continues, “By having all of our IT in a single room we were also able to see the actual operating cost of powering and cooling IT services for the first time. It was not a pleasant surprise! Having decided we needed a second data centre and not being able to justify it as a cold standby room, it was decided that Nexus Two should be designed as a high efficiency, high density data centre utilising scalable architecture for future growth requirements.”

“Nexus One had been a major step forward compared to our legacy infrastructure, but its design is conventional using a raised floor plenum and perimeter cooling units. We were looking for major efficiency improvements with Nexus Two and decided upon APC InfraStruxureTM with Hot Aisle Containment Solution (HACS). This provides a more energy efficient system using precision cooling to target the IT equipment only – in Nexus One we have to cool the whole room to ensure server inlet temperature requirements are met.”

“The reputation of APC for quality and reliability meant that choosing InfraStruxure for the physical layer of Nexus Two was a no-brainer. It’s built to work as an integrated system, it’s modular and scalable for future growth requirements. And we have a single support contract which covers the whole system including the UPS. So we’re better able to manage maintenance and costs, and we only have one number to call if we need support. We also have metered PDUs installed and will implement APC’s InfraStruxure Manager software to track equipment energy use as occupation of the racks increases.”

Again, NextiraOne won the design and build contract for the data centre. The Trust is implementing a VMWare First policy, meaning that more services will be virtualised and density will start to rise. A major objective was therefore to provide an environment suitable for blade servers. In addition to being ideal for the dynamic load conditions and cooling requirements associated with virtualised environments, precision cooling with hot aisle containments helps maximise outlet air temperatures. This in turn increases the free cooling hours available to the system, reducing the annual cost of mechanical cooling.

The investment in two new and state-of-the-art data centres may prove timely for the Trust. “We have deliberately chosen big and trustworthy brands for these facilities and believe that this may increase their appeal if we are to offer hosted services to other NHS organisations. Funding cutbacks may mean that our colleagues in the NHS may not be able to finance owned facilities like ours. Since NHS establishments are all connected via the N3 network, and since we all have to meet the same regulatory compliance, we believe that the case for hosting services at Nexus One and Two data centres is compelling. Additionally, this means that money spent on hosting will be kept within the NHS as a whole – meaning a larger slice of the overall budget can be utilised for patient care, which is our primary goal.”

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