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NHS Institute for Innovation and Improvement Customer Story

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  • The new Alfresco system is enabling the NHS Institute to conduct its work more efficiently. Having a more ordered and robust repository allows quick and easy search and access to content. The process of assimilating and sorting the content is still on-going. The organisation now has a structured repository, which is constantly growing, ready for managing future content or for transfer to a successor organisation.
  • Enhancing categorisation and organisation of files, including classification of keywords, has greatly reduced the amount of time it takes to find materials.
  • The NHS Institute plans to use Alfresco to create meta-tagged and linked content going forward, to help build up a library of expertise. The NHS Institute also plans to introduce a standardised business process for the direct creation of DocBook content as part of a publication workflow, to allow the content to be offered to external users through a web interface.


In 2010, the NHS Institute for Innovation and Improvement started a major transition programme in response to a new UK Government initiative to reduce the number of state-funded Arms Length Bodies (ALB). Despite the absence of any clear mandate about what the new organisational structure or business model would look like, it was clear that whether there was a new organisation or not, the NHS would need to collate and preserve the NHS Institute’s complete body of work representing the collective knowledge of the organisation.

A large number of products and services had been developed by the NHS Institute during its six years of existence, not to mention many thousands of associated documents, all stored across hundreds of shared drive folders. The NHS Institute creates approximately 300 publications per year, each taking an average of 20 man-days to author. However, there was no standardised method of file naming, folder organisation or document templates, making it hard to find relevant materials. In some cases, files that could not be traced had to be completely re-written, exposing the inefficiency of the status quo in the process. The Institute conservatively estimates that each document that needed to be recreated wasted five man-days per document, equivalent to a total of 6,000 man-days each year. With many staff expected to leave when the organisational change takes effect, it became paramount to capture as much of their product knowledge as possible before it was too late.

With things starting to come to a head, the NHS Institute decided to invest in a content management system — one that was flexible enough to meet all of their needs and which could be accessed by all members of staff. It also needed to bring together key intellectual property scattered across multiple internal resources into a homogenous repository with standardised indexing that would allow the NHS Institute to easily manage the look and feel of materials. Furthermore, the system needed to be able to classify the most valuable content according to such factors as Intellectual Property status or document type. All of this had to be achieved without locking data into a proprietary software format and in a way that would easily integrate with whatever systems architecture the succeeding organisation might choose.


After researching other solutions, Alfresco was chosen for its open, flexible and customisable content management system (CMS), which complied with the needs of the NHS Institute. It was already a leading product with an established user base and was the most cost-effective option. Its flexibility gave the NHS Institute the ability to integrate its existing architecture, without losing data and create a more standardised structure.

Just as important was the need for the software solution to be rolled out in a measured way. The NHS Institute was determined to learn from past experiences of specifying everything up front. Instead they demanded an agile, incremental approach that would allow them to thoroughly assess each stage before moving on to the next.


Its proven track record in enterprise standard Open Source-based implementations meant Alfresco was ideally placed to provide the NHS Institute with a solution that could handle their volume of content. There are five Open Source servers for managing content production, a MySQL repository, the Alfresco repository, the Alfresco store and the indexing system. There are also five test servers.

After initial in-house configuration, Alfresco partner Monetical Ltd, was brought in to help fine-tune the system and optimise performance.

In all, the NHS Institute had approximately 400,000 files, equivalent to 2TB of data, copied into the repository from the shared network drives. Around 2,500 of these are classified as valued legacy in relation to around 150 products. To make the system easier to use, Alfresco needed some customising including:

  • Personalisation of advance search
  • Adaptation of Alfresco Share to provide easy access to product locations
  • Daily sync of documents from corporate Microsoft network shared directory structure into corresponding Alfresco copy
  • Creation of DocBook5 content types and methods

The DocBook5 file conversion process helps provide a ‘universal’ file format that is then saved back into Alfresco. This DocBook transformation process is currently being further developed to enable ‘real-time’ rather than batched conversion.

A small number of people are currently using Alfresco, but there are plans to expand this to up to 200 employees in the NHS Institute in due course. In the longer term, the NHS Institute hopes the whole of the NHS could eventually have web access to its knowledge repository.


“Maintaining content in DocBook makes content easy to retrieve and re-use, resulting in dramatic efficiency and time-to-market improvements,” said Nick Gaunt, Chief Information and Knowledge Officer.

“We expect further efficiency gains from the improved publication process that will allow authors to take more responsibility for the publishing, auditing and repurposing of documents,” he added.

The NHS Institute and Monetical Ltd. hope the rest of the Alfresco community will benefit from these developments, and they intend to release all of the Alfresco customisations and coding used to support the Agile development as Open Source.

“Maintaining content in DocBook makes content easy to retrieve and re-use, resulting in dramatic efficiency and time-to-market improvements.”

— Nick Gaunt, Chief Information and Knowledge Officer