The NHS has found itself in an unprecedented global pandemic, dealing with a frontline crisis while continuing to ensure the quality and consistency of primary care. Orange Business has helped the NHS keep its community care running, helping prevent the spread of the virus.

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Primary care is the first line of medical treatment. It is critical in keeping the wider population healthy and supporting patients who can avoid being hospitalized. The NHS has had to transform its primary care services to minimize the spread of COVID-19 and protect vulnerable patients.

To continue primary care services without disruption, the NHS has made providing consultation, diagnosis and prescription capabilities a priority. To this end, the NHS approached Login Consultants, an Orange Business company, and its partner VMware to design a “virtual surgery” solution that could be rapidly deployed to general practitioners (GPs) and primary care workers.

The solution needed to allow GPs and primary care workers to access patient data on their own devices, while in isolation from their clinics, without the need for expensive VPN connections or buying new hardware. At any one time, the NHS had around 15% of its staff self-isolating due to the virus. The virtual surgery solution had to provide secure access from practitioners’ homes on their personal devices. This would allow them to continue to support their patients while self-isolating.

The development of a "virtual surgery"

To meet these needs, Orange came up with a solution based on a VMware virtual desktop infrastructure (VDI). This approach both satisfies the NHS’s stringent security requirements and allows medical practitioners to work from home. In a VDI environment, data remains on the server rather than on the end-client device. It protects data if an endpoint device is ever stolen or compromised and also enables the secure use of personal devices.

Time was of the essence due to the pandemic. Using its expertise, Orange was quickly able to build a prototype that supports line-of-business applications, putting a secure workspace in the cloud. Orange worked closely with VMware to make the VDI solution and the network work together effectively.

Working in emergency mode

Within two weeks, Orange developed a virtual desktop prototype with NHS line-of-business applications, using an agile DevOps approach. Orange then ran a pilot in several hospital environments to fine tune the performance. The VDI solution was then rolled out to GPs and primary care workers, enabling them to consult from homes on their home PCs and Macs and securely access patients’ records.

GPs and primary care workers log onto the virtual desktop using an Internet connection and their own devices. Their identities are linked to a multi-factor authentication app on their mobile phones to certify that they are authorized users.

In addition to the VDI, Orange had to ensure that legacy NHS applications would work on the new virtual desktop. Many of the applications had been created to work on traditional desktops, so Orange had to package these to make sure that the applications were optimized for a virtual desktop.

The scalable VDI solution was finally built in an IBM cloud and, from there, with a secure connection to the medical systems in the hospitals. Orange created a secure connection so that users could log in over the Internet to consume applications on the virtual network.

The NHS now has more than 600 GPs and primary care workers using the Orange VDI solution, which has had a successful roll out. The NHS is now exploring other cases for the virtual surgery with Orange.

GPs and primary care workers using the Orange VDI solution

"The partnership with Ian and his team in the NHS was very significant for Orange. When COVID hit back in March, we took a deep breath; we would typically take...three to six months. We literally built the solution over a weekend and had the pilot users up and running within two weeks."

Bob Smart, Senior Business Development Manager, Orange Business

"When we started using the Orange Virtual Surgery, it seemed to transform things virtually overnight. All of a sudden we could access emails, our clinical systems, and even do video consultations from home. This innovative solution really is a game changer for us. And I think we'll continue to work in this way long after COVID has passed."

Nick Pulman, GP & Vice Chair, West Leicestershire Clinical Commissioning Group

"Previously in IT services we were in the background, now we are part of the solution. We have been digitally enabling healthcare and completely and utterly transforming the NHS."

Ian Wakeford, Head of Informatics, Leicestershire Health Informatics Service