Across the NHS, digital transformation has accelerated at clinical and analytical levels more rapidly than ever before. Trusts are making swift progress in areas such as Electronic Patient Records (EPR), digital consent (Concentric), command-centre analytics, medical device tracking, voice-recognition clinical documentation, and improved patient-flow systems. These innovations are unlocking new efficiencies and transforming care delivery.
But there is a challenge that many Trusts are now starting to feel acutely:
Clinical and analytics maturity is outpacing operational ITSM maturity.
The systems supporting the clinical estate have advanced, but the underlying service models, CMDB structures, dependency mappings, and real-time operational insights are not keeping pace.
For many regional NHS Trusts, especially those operating within multi-tenant ITSM environments shared across various organisations, the maturity gap is widening.
NHS Trusts have achieved significant progress in clinical digitisation. Recently, the pace of adoption has increased rapidly:
These platforms generate immense value, but they create highly complex, interconnected digital supply chains.
Behind every clinical workflow today, a network of infrastructure, integrations, APIs, legacy applications, shared services, on-premises dependencies, cloud workloads, and ICS-level components exists. It forms an ecosystem of interdependent elements that need to be fully understood and managed proactively.
And that’s where the ITSM challenge begins.
Read: From Visibility To Value
Operational ITSM - the processes, models, and data structures that underpin service reliability - have not evolved at the same pace. This gap is most evident in three foundational areas:
Service Models That Don’t Reflect Modern Clinical Reality
Many Trusts still depend on generic service models that map applications in isolation rather than considering end-to-end dependencies, clinical workflows, and integration chains.
As a result:
Operational teams face fragmented visibility, leading to clinical disruptions that are more difficult to diagnose.
CMDB Accuracy Has Become a Critical Weak Point
Most NHS CMDBs were not built for the hybrid, highly interconnected architecture now typical across Trusts. Data often becomes:
This affects everything from incident response to change risk assessment and AI-driven insights. Without an accurate CMDB, even the best ITSM tools are operating at half capacity.
Read: You Can't Automate What You Can't Trust
No Real-Time Dependency Visibility
NHS services evolve daily. Devices move. Virtual servers start up and shut down. Cloud workloads adjust in scale. Integrations change. New clinical modules are deployed. Legacy applications are phased out or only partially replaced.
Static service maps, especially manually maintained ones, can’t keep pace.
The result is that NHS Trust Service Desks often know what is down, but not why, where, or what else is at risk.
Many regional NHS organisations now use centralised platforms across multiple entities.
There are clear, well-understood benefits:
Multi-tenant ITSM also presents a significant operational limitation:
Shared ITSM platforms provide scale but lack the local specificity required by each Trust.
In practice, this leads to:
For Trusts that rely on unique combinations of systems EPR, Concentric, device tracking, voice recognition, bed management, and legacy applications, multi-tenant ITSM seldom provides the end-to-end clarity needed to support:
Without an accurate, real-time, Trust-specific view of dependencies, operational maturity stalls even as clinical maturity accelerates.
When dependencies aren’t modelled correctly or kept current:
For Trusts facing intense regulatory pressures, financial constraints, and increasing clinical demand, this lack of operational clarity is no longer sustainable.
The NHS doesn’t just need faster digital innovation. It needs operational control.
This is where TekWurx uControl becomes a transformational capability.
Learn more: TekWurx uControl - Discover, map and optimised your IT environment
uControl is designed to provide NHS Trusts with the one aspect that multi-tenant ITSM environments find challenging to sustain:
uControl enables Trusts to:
Eliminating stale CMDB records and accelerating operational maturity.
Including EPR, Concentric, device tracking, voice-recognition platforms, bed management, imaging integrations, and legacy clinical systems.
Reducing clinical disruption and improving service availability.
By giving the Trust its own tailored, accurate service view — even when the core platform is shared.
Because AI on poor data simply accelerates poor decision-making.
Learn more: See the TekWurx uControl Case Study
Conclusion: NHS Trusts Don’t Just Need Tools. They Need Control
Regional NHS Trusts have developed exceptional clinical and analytical capability. However, without a corresponding increase in ITSM maturity, the NHS's operational core will continue to fall behind the innovations that enhance patient care.
Multi-tenant ITSM environments offer scalability, but they cannot provide the deep, Trust-specific dependency insight required for safe, resilient, and modern digital operations.
To close the maturity gap, Trusts require accurate data, real-time dependency mapping, and actionable service intelligence tailored to their estate.
That’s precisely what uControl delivers: clarity, confidence, and control.