Microsoft Visual Studio 2005 Customer Solution Case Study

National Health Service Improves Patient Care for 59 Million Citizens

Country: United Kingdom Industry: Healthcare Customer Profile The Information Authority of the United Kingdom National Health Service produces the Web site that serves the healthcare needs of more than 50 million citizens in England. Business Situation Anticipating growth in the number of site visitors and the need for new capabilities, the National Health Service wanted to improve performance and accessibility. Solution Developers migrated the site to Microsoft® ASP.NET 2.0 in only four months. Benefits  Five-fold increase in performance  Up to 40 percent increase in developer productivity  Enhanced scalability and improved reliability  A solid foundation for future improvements

“The most dramatic result of this migration has been the five-fold increase in performance. Die-hard ASP fans need to seriously consider ASP.NET 2.0. The potential performance increase is enormous.”
Raymond Schofield, Webmaster, NHS Information Authority

The National Health Service (NHS) provides healthcare for 59.6 million citizens of the United Kingdom. Recent initiatives have mandated improvements in the way citizens access healthcare and other government services. As a result, NHS anticipates that greater numbers of patients and healthcare providers will need to access information using the NHS Web site. To meet this challenge, NHS realized it needed to improve site performance. A team of developers migrated the site from ASP to Microsoft® ASP.NET 2.0 in only four months, improving performance five times compared to the previous Web site. With these changes and using Microsoft Visual Studio® 2005 development system, NHS is meeting customer service and accessibility mandates and exceeding performance expectations. Poised to add advanced capabilities to its Web site, NHS is prepared to improve patient service even more in the future.

Fast Facts Time t o complet e ASP .NET 2.0 migra tion Number of develop er s Number of pages b ef ore migra tion Number of pag es af ter migra tion Increa se in per formance with ASP .NET 2.0 Increa se in de veloper productivity with ASP .NET 2.0 Increa se in sit e user s Sinc e implem en ting 4 months

The National Health Service (NHS) was set up 56 years ago and now provides healthcare for some 59.6 million citizens of the United Kingdom. With 1.2 million employees, it is Europe’s largest organization and the third largest employer in the world. State-run, and completely free to all users, the NHS has won acclaim by the World Health Organization as one of the best health services in the world. The NHS Information Authority produces the corporate Web site,, where citizens can find health information and access healthcare services. The impetus to provide improved access to NHS resources and services is being driven from two fronts. First, from within, the NHS is changing the way it works, to make sure patients always come first. Second, from outside the organization, a broader government initiative aims at modernizing public access to government services. Part of that initiative involves mandating increased access to services through the Internet. Until April 2005, the Web site was produced by the NHS Information Authority. This work is now part of NHS Connect, the agency delivering the National Programme for Information Technology. Anticipating greater numbers of site users and a need for advanced capabilities, the NHS Information Authority wanted to improve performance and accessibility.

The NHS Information Authority migrated its Web site to Microsoft® ASP.NET 2.0. Raymond Schofield, Programme Webmaster, led a team of 12 developers to complete the migration in only four months. The site already was running Active Server Pages (ASP) so it was a natural progression to use ASP.NET. Schofield says, “We had been evaluating going to ASP.NET, but when we saw all that ASP.NET 2.0 could do, we decided to go straight to ASP.NET 2.0.” The team used Microsoft Visual Studio® development system and the C# programming language for the migration. Version control was handled using Microsoft Visual SourceSafe® 6.0d version control software. “We liked the fact that there was plenty of documentation and example code for C#,” says Schofield. “We also liked the ability to create automatic documentation.” The NHS team found three features of ASP.NET particularly useful: Master Pages, the ability to develop without solution files, and the App_Code directory. Master Pages Master pages are a new feature in ASP.NET 2.0 to help organizations reduce Web application development time by defining a single location to

12 12,000



30 to 40 percent

40 percent

“Built-in controls in ASP.NET 2.0 to help us manage user accounts and personalize the content and layout of pages will take us several steps closer to the goal of personalized pages.”
Raymond Schofield, Webmaster, NHS Information Authority

maintain a consistent look and feel in a site. By using master pages, developers can design a template that can be used to generate a common layout for many pages in the application. “The NHS Web site has a very strict interface and accessibility requirements, with a single layout. Using master pages made it easier for developers to keep a rigid structure in place,” says Schofield. Master pages greatly simplify the task of making a Web application look consistent, regardless of how many pages are involved, which is beneficial for working with the 800page Web site. Because Schofield and his team avoided having to repeat the layout code, they saved considerable time. In addition, master pages gave them the flexibility they needed because a master page can contain any HTML or control that can be found on a classic ASP.NET page. Developing Without the Solution Files Schofield and his team liked the way ASP.NET 2.0 handled solution files. “The lack of solution files helps us separate Visual Studio from Visual SourceSafe. Without having to worry about solution files and project files, we can use the SourceSafe client quite comfortably outside of Visual Studio,” says Stuart Lawton, Team Leader at the NHS Information Authority.

The NHS Web site architecture benefits from the use of Microsoft software throughout

App_Code Directory The developers also found the app_code directory useful for storing common Dynamic Link Libraries (DLLs) and other functions. “The app_code directory is especially helpful when it comes to underlying code classes and name spaces,” says Schofield.

The Migration The team started with a 12,000-page site and migrated it to an approximately 800-page site running ASP.NET 2.0. Because the site is highly integrated, Schofield’s team was not able to break the project into pieces, and had to elect to migrate it all at once. The team didn’t face any major challenges. “That's the beauty of ASP.NET 2.0. It did everything we wanted it to do,” says Lawton.


The NHS Information Authority and its Web site consumers have benefited from the Microsoft development environment and ASP.NET 2.0, including a massive performance increase, improved productivity, and enhanced scalability. Five-Fold Increase in Performance “The most dramatic result of this migration has been the five-fold increase in performance, an improvement noticed by site users,” comments Schofield. “In fact, we’re getting feedback from site users, congratulating us on having a faster site. Die-hard ASP fans need to seriously consider ASP.NET 2.0. The potential performance increase is enormous.” Up to 40 Percent Increase in Developer Productivity Another difference has been the improved productivity of developers working with ASP.NET 2.0. Compared to development the team did with ASP, Schofield’s team experienced a 30 to 40 percent improvement in productivity. ASP.NET also improves the end product. “ASP.NET 2.0 causes the Web developers to think a lot more about how they go about laying out a page, so both the design and the code is better,” remarks Lawton. Using ASP.NET 2.0, Schofield’s team found it was easy to pre-compile the site, making it easier to find bugs and errors. “Under classic ASP, we just ran things, and nothing was really vetted.

By making extensive use of the app_code directory, we've actually upgraded our internal procedures to include more testing to make sure that the site's correct before it goes live,” comments Schofield. Enhanced Scalability and Improved Reliability The corporate site has met the challenge of the expected increase in usage, with room to grow. “When we went live with the new site, we were getting something like 3,000 users an hour. Seven months later, the site is up to 5,000 users an hour, an increase of 40 percent, and it's still performing at the same levels,” says Schofield. As for scalability, Schofield and his team haven’t yet maximized performance of the code. They haven’t needed to. “We’re nowhere near the limits of what’s possible with ASP.NET 2.0,” remarks Schofield. Lawton adds, “We haven't had to do anything to the code we've written. We haven't used any of the caching capabilities available with ASP.NET 2.0.” The site—and the code—have been completely reliable. “Since we went live, the servers have never crashed,” says Schofield. A Solid Foundation for Future Improvements With plans to improve site performance and the user experience

“That's the beauty of ASP.NET 2.0. It did everything we wanted it to do.”
Stuart Lawton, Team Leader, NHS Information Authority

For More Information
For more information about Microsoft products and services, call the Microsoft Sales Information Center at (800) 426-9400. In Canada, call the Microsoft Canada Information Centre at (877) 5682495. Customers who are deaf or hard-of-hearing can reach Microsoft text telephone (TTY/TDD) services at (800) 892-5234 in the United States or (905) 568-9641 in Canada. Outside the 50 United States and Canada, please contact your local Microsoft subsidiary. To access information using the World Wide Web, go to: For more information about United Kingdom National Health Service products and services, visit the Web site at:

even more, the NHS Information Authority development team has a lot more ASP.NET 2.0 and Visual Studio 2005 features to enjoy. Schofield foresees taking advantage of caching facilities in ASP.NET 2.0. “We expect to benefit greatly from row-level caching, when it becomes available with the release of Microsoft SQL Server™ 2005.” With an emphasis on putting the patient first, the public-facing will become increasingly user friendly, allowing users to personalize the site according to their needs. “Being able to customize our pages with Web Parts will serve people better and help them meet their healthcare needs more easily. Built-in controls in ASP.NET 2.0 to help us manage user accounts and personalize the content and layout of pages will take us several steps closer to the goal of personalized pages,” says Schofield.

Microsoft Visual Studio 2005
Microsoft Visual Studio 2005 is the world’s most popular development environment for designing, developing, and testing nextgeneration Windows®-based solutions and Web applications and services. By improving the development experience for Windows, the Web, mobile devices, and Microsoft Office, Visual Studio 2005 helps organizations deliver a variety of solutions more productively than ever before. Visual Studio Team System expands the product line with new software tools that enable greater communication and collaboration throughout the development life cycle. With Visual Studio 2005, businesses can deliver modern service-oriented solutions more efficiently. For more information on Visual Studio 2005, go to: Acquire Visual Studio: y

Software and Services
© 2005 Microsoft Corporation. All rights reserved. This case study is for informational purposes only. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, IN THIS SUMMARY. Microsoft, MSDN, the .NET logo, Visual Studio, the Visual Studio logo, Visual SourceSafe, and Windows Server System are either registered trademarks or trademarks of Microsoft Corporation in the United States and/or other countries. All other trademarks are property of their respective owners. Document published April 2005

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Microsoft Visual Studio .NET 2003  Microsoft Visual Studio 2005  Windows Server System™ − Microsoft SQL Server 2000

Microsoft Visual SourceSafe 6.0 Technologies − Microsoft ASP .NET 2.0 − C#

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