PERSPECTIVE APPLIED IT
Monitoring the health of NHS IT
A blow-by-blow account of how NHS Connecting for Health developed a system to monitor the performance of its various outsourced IT services
T
hanks to the ambitious and oft- criticised National Programme for IT (NPfIT), the NHS today relies on a
number of large and complex IT systems operated by outsourced suppliers. Examples include the NHS Spine, a set of national services operated by BT, and Lorenzo, the patient record system that is still mid-way through implementation by CSC. Monitoring the performance and
availability of these systems is essential if NHS staff are to receive the quality of service they require, and it also helps the organisation hold its IT suppliers to account. IT support staff and technical architects in
the various NHS trusts all need visibility into the performance of these systems, but the responsibility for providing that visibility falls to NHS Connecting for Health, the central department charged with ensuring the successful delivery of NPfIT. NHS Connecting for Health’s original
approach was to use ‘synthetic’ transaction monitoring, in which tests are based on simulated user activity, to assess the performance of each system. According to Rob Shaw, a director at the National Integration Centre and Assurance within the NHSTechnology Office, this worked up to a point, but it did not allow it to monitor real-world performance issues that users were suffering at any given time. “Synthetic transaction monitoring
provided a high-level indication that there may be degradation in performance, but it didn’t offer a clear view of who it would affect, and how wide-reaching that impact may be,” he recalls. As a result, that service
32 INFORMATIONAGE APRIL2011
management system was underused. NHS Connecting for Health needed a
new system that could provide near real- time performance monitoring and independent confirmation of the service
hurdle. As originally deployed, the Vantage system was complex, inflexible and highly technical, Shaw reports. This threatened adoption of the system, its ability to scale to meet increased demand in future and
“Having the ability to monitor these systems will continue to benefit any organisation, whether it’s managed locally or centrally”
levels the suppliers said they were delivering, and which could scale to meet future demand. In the end, it selected user experience monitoring software called Vantage from Compuware, which now forms the basis of what is known as the National Monitoring Service.
A SHARED VIEW For the system to work, it was necessary to persuade the external suppliers to install software ‘probes’ in their own data centres. This, Shaw explains, was not easy: “There was a fear that the solution would provide the ammunition for the NHS to consistently challenge suppliers with an unprecedented amount of evidence.” However, the external suppliers were
eventually persuaded, as it would give them access to improved service monitoring functionality and establish a shared view of performance across the NHS. In early 2009, the project hit its next
ultimately the value that NHS Connecting for Health hoped it would deliver. What was needed was a single, shared view of application health and performance across all the relevant NHS systems in near real time. That would mean that when a performance issue arose, it would be possible to identify where the issue had originated – and therefore whose responsibility it was to resolve. At this point, senior stakeholders within the NHS were beginning to question the validity of the project. There had been “high investment in technology with little to show for the efforts and expense thus far”, Shaw recalls. “The project had progressed slowly, and with the transition of a major NHS system imminent, the project team were aware of the need to develop content and features quickly that would support the organisation and NHS users through that transition.” That led the team to adopt Scrum, one of
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