Overview

• Organization: NHS Integrated Care
• Industry: Public Healthcare
• Challenge: Reducing hospital readmissions and improving chronic disease management
• Solution: AI-powered predictive analytics and virtual care using Microsoft Azure

NHS Greater Manchester Integrated Care, a major provider serving over 2.8 million residents, sought to modernize its approach to managing chronic conditions such as heart failure, COPD, and diabetes. With pressure mounting from increasing readmission rates and stretched clinical staff, leadership recognized the need for proactive, data-informed care coordination across primary, secondary, and community providers.

The challenge was twofold: unify fragmented clinical and social care data into a single, actionable framework, and leverage AI to support early intervention before patient conditions escalated. Clinicians needed a way to predict deterioration, prioritize outreach, and coordinate responses—all while protecting patient data and complying with NHS information governance policies.

As part of the transformation effort, NHS Greater Manchester engaged CloudFabric, a specialist in public-sector cloud migration and AI architecture. CloudFabric conducted technical discovery workshops with the Integrated Care Board (ICB), Trust IT leaders, and frontline clinicians to define a use case around predictive readmission analytics. By aligning Azure-native capabilities with clinical workflows and governance standards, CloudFabric designed a modular AI platform that could be scaled across multiple NHS trusts while integrating with legacy EMR systems and community health apps.

The result was a secure, AI-powered care orchestration framework hosted entirely on Microsoft Azure—bridging real-time insights, automated outreach, and data-driven triage into a single clinical support layer.

The Challenge

NHS Greater Manchester faced increasing readmissions due to chronic illnesses like heart failure and COPD. Clinical teams lacked a unified view of patient data across hospitals, GPs, and community services.

The Azure AI-Driven Solution

• Unified Data Lake with Azure Synapse: Integrated EHRs, GP logs, and discharge records.
• Predictive Models via Azure Machine Learning: Risk scoring and Power BI dashboards alerted clinicians.
• Conversational AI for Patient Follow-Up: Azure Bot Service provided post-discharge triage and symptom tracking.
• IoT Monitoring with Azure Health Data Services: Remote devices fed real-time vitals to care teams.

Results in Year One

Key Takeaways

• AI supported clinical decisions without replacing human care.
• Azure scalability enabled secure rollout across 60+ practices.
• Interoperability through FHIR and API Management was critical.