Case Study: Enabling Scalable Healthcare Data Retention for Birmingham Women's and Children's NHS Foundation Trust

Challenge

Birmingham Women's and Children's NHS Foundation Trust provides a broad range of specialist healthcare services and manages significant volumes of clinical, operational, and research data. As the Trust's digital estate continued to grow, its existing on-premise backup and archive infrastructure was approaching capacity.

A substantial proportion of the archive estate consisted of genomic datasets, including genome sequences and associated reference data generated through clinical and research activities. Regulatory requirements meant that much of this information had to be retained for a minimum of eight years, preventing the Trust from simply deleting older data to manage growth.

The existing approach created a number of challenges. Storage consumption continued to increase year-on-year, requiring ongoing investment in physical storage infrastructure. Capacity planning became increasingly difficult, with future growth dependent on hardware procurement cycles and available data centre space. The Trust also needed assurance that archived healthcare data would remain secure, durable, and accessible throughout its retention period whilst meeting NHS governance and UK data residency requirements.

Without intervention, the Trust faced the prospect of repeated capital expenditure on storage hardware, increasing operational overhead, and growing risk associated with managing ever-larger volumes of healthcare data on-premises.

Solution

Cloudscaler was engaged to design and implement a secure, scalable archive platform on AWS that would extend the Trust's existing backup and archive capability without disrupting operational processes.

Working closely with stakeholders, Cloudscaler assessed current storage consumption, projected future growth, retention requirements, retrieval patterns, and security obligations. The objective was to create a solution that could scale effectively without introducing unnecessary complexity.

Several approaches were evaluated. AWS Storage Gateway was considered due to its integration with traditional backup platforms but was ultimately rejected because it introduced additional appliances, operational dependencies, and cost that were not required for a straightforward archive use case. AWS DataSync was also assessed but was not necessary given the Trust's transfer requirements and existing operational processes.

The selected solution leveraged Amazon S3 as the primary archive platform, with archive data transferred directly from the on-premise environment using AWS CLI synchronisation processes. This approach minimised operational overhead whilst providing full control over archive scheduling and data management.

The new platform introduced several important capabilities:

* Archive data is securely transferred into AWS over private Direct Connect and VPN connectivity, ensuring data never traverses the public internet.

* Amazon S3 provides effectively unlimited storage capacity without the need for future hardware expansion projects.

* Customer-managed AWS KMS keys protect all archived data through encryption at rest.

* S3 Lifecycle Policies automatically transition data between storage tiers based on age, reducing costs as data becomes less frequently accessed.

* S3 Versioning and Object Lock provide additional protection against accidental deletion or modification.

* AWS CloudTrail, AWS Config, Amazon GuardDuty, and Amazon CloudWatch provide continuous monitoring, auditing, and security visibility.

* All data remains within the United Kingdom, supporting NHS governance and data residency requirements.

The solution was deployed within Cloudscaler's Enhanced Landing Zone, providing the Trust with a secure, governed, and operationally mature cloud environment aligned with healthcare security best practices.

Benefits

The most immediate benefit was the removal of storage capacity constraints. The Trust no longer needs to forecast, procure, install, and manage additional storage hardware as archive volumes grow.

At the same time, the platform provides a predictable and scalable operating model. Storage automatically expands in line with demand, whilst lifecycle policies continuously optimise costs by moving older data into lower-cost storage tiers.

Operational overhead was also reduced significantly. The Trust's infrastructure teams no longer need to dedicate time to managing archive storage hardware, capacity upgrades, or associated maintenance activities. Instead, archive storage operates as a managed cloud service that scales transparently behind the scenes.

Security and governance were strengthened through encryption, auditing, centralised monitoring, and immutable storage controls. The Trust gained confidence that critical healthcare data would remain protected and recoverable throughout its retention period.

Most importantly, the solution provides a sustainable long-term platform for retaining clinical and genomic data without repeated infrastructure refresh projects or disruptive capacity expansion exercises.

Value

Cloudscaler's contribution extended beyond simply providing additional storage capacity.

The solution was designed around healthcare governance, security, and operational resilience requirements from the outset. Through the use of the Cloudscaler Enhanced Landing Zone, the platform inherited a comprehensive set of security, monitoring, compliance, and operational controls that would have been difficult and time-consuming for the Trust to implement independently.

The engagement also provided the Trust with a clear long-term cost model. By replacing periodic capital expenditure with a scalable consumption-based operating model, the Trust gained greater visibility into future storage costs whilst avoiding the uncertainty associated with future hardware refresh cycles.

Cloudscaler worked closely with stakeholders throughout the engagement to ensure the platform aligned with both technical requirements and operational objectives. This enabled the Trust to adopt cloud-based archive storage with confidence whilst maintaining compliance with NHS governance expectations.

The result is a secure, scalable, and future-ready archive platform capable of supporting continued growth in healthcare and genomic data volumes for many years to come.

Lessons Learned

The engagement reinforced the importance of understanding data access patterns before selecting storage technologies. Whilst archive workloads often appear straightforward, retention requirements, retrieval expectations, and future growth projections all have a significant impact on long-term cost and operational efficiency.

The project also demonstrated the value of leveraging native AWS services wherever possible. By avoiding unnecessary appliances and additional management layers, the Trust benefited from a simpler architecture that was easier to operate, scale, and support.

These lessons continue to inform Cloudscaler's approach to healthcare data retention and archive modernisation engagements, ensuring future customers benefit from proven patterns that balance scalability, security, operational simplicity, and cost efficiency.