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https://digitalhealth.blog.gov.uk/2020/11/19/phe-tuberculosis-pre-entry-screening-alpha-assessment/

PHE Tuberculosis Pre-Entry Screening Alpha Assessment

Posted by: , Posted on: - Categories: Alpha, Assurance, Service assessments

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From: NHSX
Assessment date: 5th November 2020
Stage: Alpha
Result: Met
Service provider: PHE

Service description

This service aims to ensure the pre-entry Tuberculosis screening process is of high quality. 

As screening is administered by a number of accredited clinics around the world and plays a part in Visa applications, it is important for both the Home Office and PHE to have the confidence in the quality of tests and the accuracy of results. The current service and processes do not necessarily ensure confidence and quality, and carry a number of risks (for example, applicants can ‘panel shop’), as well administrative overheads (for example, when trying to link information generated at different stages of the process). 

The new service is intended to facilitate the process for both clinics assessing the patients, and the PHE personnel reviewing the sample of submitted results of tests.

Report contents

  1. Understand users and their needs
  2. Solve a whole problem for users
  3. Provide a joined-up experience across all channels
  4. Make the service simple to use
  5. Make sure everyone can use the service
  6. Have a multidisciplinary team
  7. Use agile ways of working
  8. Iterate and improve frequently
  9. Create a secure service which protects users’ privacy
  10. Define what success looks like and publish performance data
  11. Choose the right tools and technology
  12. Make new source code open
  13. Use and contribute to open standards, common components and patterns
  14. Operate a reliable service

1. Understand users and their needs

Decision

The service met point 1 of the Standard.

What the team has done well

The panel was impressed that:

  • The team have conducted research with a diverse range of clinics, taking into consideration country of origin and size of the clinic.    
  • The team have used their research findings to feed into the design process.        

What the team needs to explore

Before their next assessment, the team needs to:

  • Continue to build their understanding of the offline elements of the UKTBI screening process across a variety of users in order to build an understanding of how this service will fit into the wider work flow process. This will help alleviate potential pain points that the introduction of this service may bring.
  • Conduct research with clinics which they’ve been unable to conduct research with, rather than completely depend on conducting further research with clinics which have already been engaged in the process.
  • Continue to engage with PHE/ Home Office policy colleagues to ensure the service meets these user needs.

2. Solve a whole problem for users

Decision

The service met point 2 of the Standard.

What the team has done well

The panel was impressed that:

  • The team considered the needs of a variety of users in the clinics (across a variety of sizes and countries), as well as internally to PHE iterating functionality and scope to accommodate newly discovered needs.     

What the team needs to explore

Before their next assessment, the team needs to:

  •  Continue to engage with the Home Office regarding data sharing for consistency. 

3. Provide a joined-up experience across all channels

Decision

The service met point 3 of the Standard.

What the team has done well

The panel was impressed that:

  • The team investigated and discovered needs of the users across the journey. Good examples of which were the reconsideration of user permissions in relation to every record; and the legitimate need for users to restart the process, including in another clinic (and how the system could facilitate it). 

What the team needs to explore

Before their next assessment, the team needs to:

  • Continue to investigate how paper workarounds across some later parts of the process can be eliminated. 

4. Make the service simple to use

Decision

The service met point 4 of the Standard.

What the team has done well

The panel was impressed that:

  • The team is using common design components, and using these to build a step-by-step in-system process.
  • The team have iterated their designs based on user feedback.   

What the team needs to explore

Before their next assessment, the team needs to:

  • Conduct end-to-end testing of each journey within the system, with a variety of users.

5. Make sure everyone can use the service

Decision

The service met point 5 of the Standard.

What the team has done well

The panel was impressed that:

  • The team has iterated their designs, taking into consideration the different needs of clinics globally.    

What the team needs to explore

Before their next assessment, the team needs to:

  • Ensure they conduct research with a range of users with accessibility needs.    
  • Conduct an accessibility audit.   

6. Have a multidisciplinary team

Decision

The service met point 6 of the Standard.

What the team has done well

The panel was impressed that:

  • The team managed to achieve excellent results in terms of iteration and user insight with a small number of roles and despite the current circumstances meaning their access to the internal stakeholders and service owners was reduced. 

What the team needs to explore

Before their next assessment, the team needs to:

  • Ensure there is at least one dedicated user researcher on the team.
  • Establish a plan for ongoing iteration and maintenance once the service is live. 
  • It would be great if the service owner from PHE could be present at the next phase assessment, even if only to introduce the service and some aspect of how it iterated based on user need (if they cannot attend the entire session). 

7. Use agile ways of working

Decision

The service met point 7 of the Standard.

What the team has done well

The panel was impressed that:

  • The team worked well together (despite coming from different organisations/suppliers) and managed to involve their busy stakeholders in some sessions that cemented the value of iterative working and research.  

What the team needs to explore

Before their next assessment, the team needs to:

  • Try to involve the PHE team in ceremonies and user research more to further increase their understanding of the processes and user needs. 

8. Iterate and improve frequently

Decision

The service met point 8 of the Standard.

What the team has done well

The panel was impressed that:

  • The team iterated the design based on research adding features and functionality to reflect user needs, for example by changing or adding input fields or based on their responsibility in a bigger clinic, and surface the necessary information.

What the team needs to explore

Before their next assessment, the team needs to:

  • Continue testing and iterating, including by enabling the use of the new service under unsupervised circumstances and analysing errors, data, and feedback.

9. Create a secure service which protects users’ privacy

Decision

The service met point 9 of the Standard.

What the team has done well

The panel was impressed that:

  • The team has considered potential security threats for the service and has designed mitigations from them such as role based access for updating elements of the applicant records and utilizing PHE’s active directory for authentication of users.    
  • A full audit log of changes to records will be held. 

What the team needs to explore

Before their next assessment, the team needs to:

  • Continue working with PHE cyber security and information Governance teams to ensure they are adhering to best practice. 

10. Define what success looks like and publish performance data

Decision

The service met point 10 of the Standard.

What the team has done well

The panel was impressed that:

  •  The team had a good grasp on what success meant for all their user groups.

What the team needs to explore

Before their next assessment, the team needs to:

  • Ensure there’s an analytics mechanism in place, and a person on the team with skills to analyse it and feed back more broadly to ensure any interesting insights are discussed and further researched if needed.

11. Choose the right tools and technology

Decision

The service met point 11 of the Standard.

What the team has done well

The panel was impressed that:

  • The team has balanced making use of PHE’s mandated inhouse tools with ensuring that they will be able to meet user needs considering arage of options which could be supported by PHE’s existing  infrastructure.     

What the team needs to explore

Before their next assessment, the team needs to:

  • Test the service on PHE’s infrastructure.    

12. Make new source code open

Decision

The service met point 12 of the Standard.

What the team has done well

The panel was impressed that:

  • While no code has been written to date the team are committed to coding in the open.    

What the team needs to explore

Before their next assessment, the team needs to:

  • Host the source code on an appropriate public repository.

13. Use and contribute to open standards, common components and patterns

Decision

The service met point 13 of the Standard.

What the team has done well

The panel was impressed that:

  • The team is using open source software where possible.     
  • The team is making good use of gov.uk design system and is considering how they can support the development of new patterns such as international date formats.

14. Operate a reliable service

Decision

The service met point 14 of the Standard.

What the team has done well

The panel was impressed that:

  • The service will be deployed on PHE’s existing infrastructure     

What the team needs to explore

Before their next assessment, the team needs to:

  • Develop a disaster recovery plan for the service.     

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