For John Speight, Deputy CDIO, and his Digital IT team at Leeds Teaching Hospitals NHS Trust, cloud technology was never about chasing innovation for its own sake. It was about something far more fundamental: keeping critical patient services running 24/7 across seven hospitals, while managing one of the UK’s largest and busiest acute trusts.

Leeds Teaching Hospitals cares for around 1.8 million patients every year. Behind the scenes, this responsibility rests on IT systems and infrastructure that must be resilient, secure, and always available — even as budgets tighten and complexity grows.

“Our IT systems and infrastructure play a critical role in supporting this. It’s important that we work with strategic partners who we can depend on,” John says.

Cloud Risk, Patient Impact

Like many large NHS organisations, LTHT had embraced Azure to support critical systems. Over time, however, the cloud estate grew complex. Costs were rising, reliability was inconsistent, and governance was fragmented. Legacy deployment patterns and underused infrastructure made it harder for John’s team to maintain a clear view of risk and value.

With patient-facing systems running in the cloud, any change carried real-world consequences. The Trust needed to restore control and reduce risk — without disrupting services or adding pressure to stretched teams.

Gaining Clarity, Without Disruption

Rather than a generalist consultancy, LTHT sought a partner who understood the realities of the NHS, where resilience, governance, and accountability are essential. SPG Intelligence worked alongside John’s team with a clear objective: reduce operational risk, optimise cloud spend, and strengthen resilience — all while ensuring continuity of care.

Using SPG’s CloudOps framework, the teams conducted a non-invasive, estate-wide review of LTHT’s Azure environment. Within four weeks, they had a clear view of the estate, identifying architectural weaknesses, underused resources, and critical risk areas. The review revealed up to 80% in potential savings, with around 30% realised immediately through targeted re-architecting — all without impacting live patient services.

With clarity established, the focus shifted to long-term improvement. SPG worked closely with LTHT’s internal teams to establish Infrastructure as Code foundations using Terraform and Azure DevOps, bringing consistency, repeatability, and control to cloud deployments.

“SPG is responsive and forward thinking, with an in-depth understanding of current challenges in the NHS, helping us assure 24/7 resilient, scalable infrastructure to support patient care across our seven hospitals,” says John.