The healthcare sector is increasingly turning to cloud computing solutions to enhance their IT infrastructure, yet significant challenges remain for organizations like the Princess Alexandra Hospital NHS Trust (PAH) in Essex. A current plan to migrate additional capacity to Nutanix’s cloud-based services has been hindered by fluctuating pricing linked to international tariffs, particularly those imposed by the U.S. government. This ongoing uncertainty has resulted in a cautious approach toward further cloud adoption within the organization.
Past Successes with Nutanix
Previously, the PAH made a successful switch from VMware on legacy EMC VNX storage systems to Nutanix’s hyper-converged infrastructure (HCI), saving approximately £500,000 in the process. This transition not only offered financial relief but also aligned with modern IT practices, helping the hospital improve its operational efficiency. “The advantages were clear,” said Jack Ciezak, the infrastructure manager at PAH. “Our previous system was becoming obsolete, leading to rising maintenance costs and limitations in capability.”
Building on a successful foundation, PAH planned to upgrade its existing 16 Nutanix nodes by establishing two new five-node clusters, with one of them to operate in the cloud using Nutanix’s NC2 services. However, the unpredictability surrounding tariffs and the consequential impact on pricing has stalled the initiative. “Because of the uncertainty with the cloud and skyrocketing costs, we stopped,” Ciezak admitted. “We decided we’re going to do this very slowly, meaning we’re going to wait to see what will happen, and right now, we decided to have it on-premise.”
Navigating NHS Procurement Challenges
One of the contributing factors to this situation is the rigorous NHS procurement process. Any IT initiative must undergo market evaluation, funding requests, and a limited timeframe for finalizing purchases. “That means, if prices fluctuate wildly, things can go wrong,” Ciezak explained. The reliance on specific pricing and deadlines creates a situation where the IT team cannot lock in costs effectively. “When Nutanix quotes, it is based on today’s date and what the dollar is worth. And then we have that for 15 or 30 days, but you cannot get everything done within 30 days, especially when your organization and your executive have to approve it.”
The approval process involves multiple layers, including the local integrated care system (ICS) and NHS England, which meets infrequently. This bureaucratic structure can lead to pricing discrepancies, as seen in Ciezak’s comments: “Before you get everything done, they say, ‘Oh, now the price changed.’ And right now, we do not know what is actually going on with the dollar.”
Future Outlook and Market Impact
Looking ahead, Ciezak believes that clarity may come within the next 18 months, but the window of uncertainty remains a pressing issue. “I’m waiting for what will happen in the next one and a half years, when things become stable in global terms,” he reiterated. This sentiment resonates with other organizations that adopted cloud solutions in the past, many of whom are now reconsidering their cloud strategies due to increased expenses linked to ongoing tariff alterations and rising operational costs.
PAH’s initial foray into Nutanix in 2019 was prompted by the obsolescence of its EMC equipment, which had reached the end of its support lifecycle. Ciezak recalls the rapid decision-making process, stating, “We went to the market to see what was out there, and at the time we never knew who Nutanix was.” Ultimately, the decision to work with Nutanix was influenced by the latter’s ability to deliver a solution under a tight deadline of three weeks, whereas larger vendors could not meet the same urgency. This rapid deployment led to significant cost savings compared to traditional storage solutions, further emphasizing the importance of flexibility in procurement processes.
Benefits and Performance Gains
The efficiency of Nutanix’s HCI system has yielded substantial operational improvements. By downsizing from a sprawling EMC setup, which utilized 30 nodes and required significant power and space, to a streamlined setup with 16 Nutanix nodes, PAH has saved around 75% on power consumption, cooling, and necessary datacentre footprint. Additionally, the system currently supports around 450 virtual machines and 260 different applications, showcasing the scalability and performance of the architecture.
Initially, the migration to Nutanix utilized the Microsoft Hyper-V hypervisor, a platform Ciezak was already familiar with. However, as time passed and some functionalities became unsupported, he reconsidered the switch to Nutanix’s Acropolis hypervisor (AHV). The transition, which took place during the Christmas period of 2024, was prompted by the substantial gains in latency and management ease that AHV provided. Ciezak noted that latency with Hyper-V was over 15 milliseconds, while AHV brought that down to sub-millisecond levels, a significant improvement that highlights the advantages of cloud-native technologies.
Conclusion: A Path Forward
Despite the current challenges facing the Princess Alexandra Hospital NHS Trust, the lessons learned from past migrations and cost-saving opportunities pave the way for a more informed approach to future cloud strategies. As the healthcare landscape continues to evolve, the need for flexible and efficient IT solutions remains critical, urging organizations to innovate while navigating a complex regulatory environment.
Quick Reference Table
| Item | Details |
|---|---|
| Initial Savings | £500,000 |
| Current Setup | 16 Nutanix nodes |
| Supported Virtual Machines | 450 |
| Applications in Use | 260 |
| Hypervisor | Nutanix Acropolis (AHV) |
| Latency Improvement | Sub-millisecond on AHV |