We recently started a new Discovery project here at North East Lincolnshire Council. We are looking at the process of getting consent from parents/guardians to give vaccinations to school children.
This is a paper process where children take a letter home from school containing a consent form for their parent/guardian to sign, if they agree that their child should have the injection. There are a few different immunisation programmes running, including Flu and HPV, which has now expanded to include girls and boys.
A commitment to making processes like this one paperless by 2020 is integral to the contract we have with the NHS to deliver the immunisation programme. We started discussions about how we could create a digital end-to-end process, but as you might expect from a Service Design team, we wanted to spend some time getting to know the whole service first. To their credit, the Childrens Health team were really enthusiastic about us doing this and wanted to get involved.
At our kick-off meeting we tried a variation on our usual hopes, fears and goals activity, using dxws “Good questions to kick off a discovery”. We’ve been able to use the outputs of this to help plan the user research and other discovery activities.
Discovery so far
We are now on our 3rd sprint of the Discovery phase. This has included interview/observation of admin staff in their role, mapping out the process from their point of view, lots of desk research around national policies and learning about how other councils and health trusts have approached the problem. We also published a survey for parents to get their views of the paper process.
We will be following up with user research with parents and schools after the summer holidays. There will be further research with staff too after the summer holidays, as some work term-time only contracts.
We will try to blog further about how we get on as the project progresses.
A wider problem?
It’s still early days, but an issue highlighted from the beginning is that of getting data into the child’s health record. It needs to be recorded what vaccinations have been given or if any haven’t been given, either for health reasons, absence, or consent not being given. This seems to be quite labour intensive.
As you can imagine, this has turned into a bit of a research rabbit hole, doing some further research into these systems and the opportunities for automating the task of updating records. As we often find with legacy systems like TPP SystmOne and others, that have been around for many years, they were not originally designed to allow other systems to add or amend data.
This looks to be changing with work ongoing in NHS programmes that are opening up access to care records through things like the NHS App, as well as ways of increasing interoperability through things like the GP Connect programme.
This got us thinking. If it can be done for accessing records and updating records across healthcare setting boundaries, maybe the system suppliers would work with Local Authorities that provide healthcare services?
Immunisation Consent isn’t the only service provided via Local Authorities that interacts with SystmOne and other similar systems. Could there be a case for jointly developing APIs that would allow us to securely and reliably update health care records? Would this help us to make efficiencies and make things work better for service users?
We think it might, so we are discussing the idea of launching a bid for Discovery funding from MHCLGs Local Digital Fund to find out.
If you work at a Local Authority and know of scenarios where integration to update health records would be desirable, or you work at NHS Digital/NHSx and could offer help/advice, maybe you and your organisation could join us as partners in the bid? Please get in touch if you want to get involved. My email address is email@example.com.