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Reducing technical debt for UK healthcare - Peru Consulting case study


NHS Digital is the information and technology partner to the UK health and social care system, responsible for managing the large complex systems which serve thousands of clinicians and millions of patients every day.
Due to the complex nature of the systems, many use legacy technologies, posing substantial risk, vulnerability, and accumulation of technical debt.
NHS Digital knew of the issue, but not the scope, size, or complexity.


  • Peru undertook a discovery exercise to assess the technology underpinning the application estate (including national systems), providing a technical debt view for the first time.
  • Given the nature of the organisation and multiple inflight national programmes of work we had to carefully navigate the environment gathering knowledge from key service and business stakeholders across the whole organisation and other related national bodies. 
  • We identified a best practice approach and tooling for capturing the current application and architecture estate enabling us to identify opportunities for reuse, rationalisation and rework.


  • We helped identify over 300 technologies serving 106 applications, 60% of which were already utilising end of life technology
  • Designed and created a technology roadmap and categorisation formula, including a technology radar which plotted technology on a timeline.  
  • Supporting evidence to a business case worth £15m GBP to address technology debt.
  • Reduced risk within the organisation reducing business vulnerability exposure

Healthcare & Life Sciences



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