Cloud computing means storing data and/or running software on remote servers [1]; that are accessed over the internet rather than using local hardware on the user's device or local network [1].

SaaS (Software as a Service) provides ready-to-use software applications — the provider manages everything including the software itself; the user just uses it [1]; example: Microsoft 365 / Google Workspace / Salesforce [1]; IaaS (Infrastructure as a Service) provides virtualised hardware — servers, storage, networking; the user manages the operating system and applications [1]; example: Amazon Web Services EC2 / Microsoft Azure VMs [1].

Any three: Files/applications accessible from any device with internet [1]; Scalable — can increase/decrease storage/processing without buying hardware [1]; Cost savings — subscription-based, no large upfront hardware investment [1]; Automatic software updates by provider [1]; Improved collaboration — multiple users can work on same document simultaneously [1]; Better disaster recovery — data replicated across multiple locations [1].

Internet dependency — cloud storage requires internet access; if internet is down or slow the user cannot access their files [2]; Security/privacy risk — data is stored on third-party servers, so there is a risk of provider breaches, hacking, or the provider accessing user data; data may be stored in countries with different data protection laws [2]. (Accept other valid disadvantages with explanation, 2 marks each.)

Advantages: Records accessible from any surgery computer or by authorised GPs remotely [1]; Scalable as patient numbers grow [1]; Provider handles backups and disaster recovery [1]; Potential cost savings over local server infrastructure [1]. Disadvantages: Patient records are highly sensitive — storing on third-party servers creates data breach risk [1]; GDPR compliance issues if data stored outside UK/EU [1]; Internet dependency — if connection fails, patient records inaccessible [1]; Limited control over server security measures [1]. Conclusion: For a GP surgery, the sensitivity of health data means security and privacy concerns may outweigh the benefits — a private cloud or hybrid approach might be preferable [1]. Max 6.

Scalability means the ability to increase or decrease computing resources (storage, processing power) quickly and easily [1]; in cloud computing this is done by the provider on demand without the user needing to buy or install new hardware [1]; beneficial because a business can handle sudden increases in demand (e.g. a retail website during Christmas) without expensive over-provisioning, and scale back down to save costs when demand is lower [1].

Vendor lock-in means a customer becomes dependent on a specific cloud provider [1]; because their data may be stored in proprietary formats, or their systems are deeply integrated with provider-specific tools, making it difficult and costly to switch to a competitor [1]; this is a concern because the provider can raise prices or reduce service quality and the customer has little choice but to stay [1].

Access: Cloud — any device/location with internet; Local — only the specific device or local network [2]; Cost: Cloud — low upfront, ongoing subscription; Local — high upfront hardware cost, lower long-term cost [2]; Security: Cloud — provider manages security professionally, but data on third-party servers; risk of provider breaches; Local — full control of security, but dependent on user's own measures [2]; Reliability: Cloud — dependent on internet connection; provider offers high uptime guarantees; Local — available without internet but vulnerable to hardware failure; cloud typically offers better disaster recovery [2].