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https://digitalhealth.blog.gov.uk/2021/04/29/phe-national-disease-registration-service-ndrs-alpha-assessment/

PHE National Disease Registration Service (NDRS) alpha assessment

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

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From: NHSX
Assessment date: 15 April 2021
Stage: Alpha
Result: Met
Service provider: Public Health England

Service description

The National Disease Registration Service (NDRS) consists of the National Cancer Registration and Analysis Service (NCRAS) and the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS.) The purpose of the NDRS is to collect and quality-assure high-quality, timely data on a wide range of diseases and provide robust surveillance to monitor and detect changes in health and disease in the population.

Ongoing growth and organisational changes to the service have resulted in fragmented and multiple online services. The aim of the Alpha project is to user test and iterate prototypes for the purpose of transitioning the legacy website content to achieve a consolidated and streamlined service to enable users to access and use NDRS data and data outputs, permitting improved discoverability and navigation of its tools and products. 

Service users

The four key user groups are:

  • charities
  • researchers
  • patients (members of the public)
  • commissioners

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 a good understanding of the pain points the users face and have conducted research to test design concepts and iterate their prototype
  • the team have used the findings from Discovery to engage with the identified 5 key user groups throughout the Alpha
  • the team used multiple research methods throughout the testing of the prototype

What the team needs to explore

Before their next assessment, the team needs to:

  • test the website with a range of users, rather than conducting further research with individuals that have already participated in multiple rounds of research
  • conduct testing with users with low digital skills and accessibility 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 were able to explain how the services they’re working on will join up multiple distinct journeys for the users
  • the team is bringing together multiple websites offering the same or similar services under one banner to improve the experience
  • work has been done across organisational boundaries to bring fragmented information into one place to allow streamlined access for users  

What the team needs to explore

Before their next assessment, the team needs to:  

  • consider the different user groups in more detail - how do different types of patients and clinicians access and use different data
  •  make sure that the team look at the journey end to end – how users find this service and checking that users achieved what they needed and expected
  • continue to explore whether the service addresses the whole problem for users including those with accessibility needs and assisted digital needs; and that the approach of having one service for varied users is still meeting differing needs

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 were consciously aware of different channels in developing the service (including help desk and enquiry line) as well as testing on different browsers and platforms
  • the team seemed to have started to think about digital take up and how to reach out to users through different channels

What the team needs to explore

Before their next assessment, the team needs to:

  • examine the end-to-end user journeys in more detail
  • do further research across channels and with users who have low digital skills, invite others to observe (for example, operational colleagues) so that internal users understand how the service works across multiple channels and whether it addresses needs

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 used the GOV.UK and NHS.UK design patterns to create a NDRS branded library of components based on well researched ideas
  • the team are simplifying multiple pathways into one service that will make it easier for users to access the data they need
  • the team have tested and iterated their service with multiple users

What the team needs to explore

Before their next assessment, the team needs to:

  • do usability testing with a variety of users outside of the group they have used for testing so far, including those with accessibility and digital inclusion needs
  • design for mobile and tablet and ensure they build a responsive service that does not break off desktop

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 have designed their patterns and components based on GOV.UK and NHS.UK libraries and working to WCAG AA and AAA standards
  • they have started to carry out research and testing with users with accessibility needs
  • the team are ensuring their content is simple and accessible, not just the website content but in the documents and publications created for the website

What the team needs to explore

Before their next assessment, the team needs to:

  • explore and design for the needs of users with low digital literacy and those who are digitally excluded
  • do more research and design for accessibility needs. Don’t just rely on online tools to check accessibility, make sure to test your service with real users

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 recognised where there were gaps in expertise and recruited suppliers to partner with them to ensure appropriate skills were covered
  • changed the team from discovery to alpha to reflect the change of emphasis – bringing in content, design and development colleagues
  • the blended team are working in the open, collaborating and ensuring regular knowledge sharing from suppliers which has benefitted the team and PHE in general

What the team needs to explore

Before their next assessment, the team needs to:

  • think about the technical skills needed within the team based on decisions such as platform, hosting and so on    
  • identify a Performance Analyst who can help with the measurement of the benefits of the service and how it is meeting user needs
  • make sure there is sustainable input from operational colleagues who support the service (from an end to end perspective)

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 have regular cycle of agile ceremonies including sprint planning, retros and stand ups, using tools such as Trello and Slack to allow visibility and collaboration across the team
  • the team are communicating through show and tell sessions to showcase progress and engaging with other stakeholders to invite input, in addition to SMEs
  • prioritisation is being driven by user research  

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 adapted the service to reflect user feedback around navigation, accessibility and so on, and could demonstrate evidence    
  • the team has a process for prioritising based on user research feedback, with regular playback sessions for the team to discuss    

What the team needs to explore

Before their next assessment, the team needs to:

  • keep working on iteration approach, and how to focus on improvements that have the most value
  • make a plan that demonstrates how you will continue to iterate based on the end to end user experience and changing user needs

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 service doesn’t process any sensitive data
  • any sensitive data is accessed via another authenticated service and secure network (HSCN) access

What the team needs to explore

Before their next assessment, the team needs to:

  • ensure the implementation of Google Analytics complies with GDPR and PECR

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 has thought about some performance indicators that they want to achieve – quantitative and qualitative – in private beta

What the team needs to explore

Before their next assessment, the team needs to:

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 recognised the immaturity of the current ICT team on supporting public facing websites - the team are focused on different organisational goals
  • the existing skills within the team on WordPress has led to this to be the expected CMS
  • using a commodity managed service for hosting would be better than self-hosting or starting from scratch on Azure/AWS/GCP
  • the team is empowered to make their own decisions
    • although, counter to this, actual decisions on what is a simple tech stack are yet to be pinned down

What the team needs to explore

Before their next assessment, the team needs to:

  • confirm WordPress decision for the CMS
  • confirm and procure hosting platform - believed to be currently using TSO
    • consolidation and management of managed hosting should be under the control of ICT and not the departments that are responsible for the content
  • confirm and implement Google Analytics as the choice of analytics service
  • identify where these decisions will leave gaps in the team (see point 6) and find an individual or team via DOS or recruitment of required skills

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:

  • the organisation is already coding in the open and have shared the PHE github link
  • the team are committing to continuing this approach

What the team needs to explore

Before their next assessment, the team needs to:

  • look at how they might develop and contribute to NHS Design System compliant WordPress themes (based on an assumed use of WordPress). For example, the Nightingale Theme User Guide from the NHS Digital Leadership Academy
  • consider joining the conversation on the NHS Service Manual on Slack (open to all NHS staff) 

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 have tested and found the limits of the service with the NHS frontend library
  • the team recognised that a purely content based services doesn’t need over-engineering and can be developed on a commodity CMS such as WordPress

What the team needs to explore

Before their next assessment, the team needs to:

  • explore existing NHS-wide WordPress development; who’s already doing this, what can the team learn from this and contribute to

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 team is focusing on where the skills in the team are
  • the team is leaning on managed hosting to fill the gaps of organisational capability in web hosting

What the team needs to explore

Before their next assessment, the team needs to:

  • ensure that while capability of hosting can be outsourced, the team (or organisation) remain responsible for the service
  • ensure that picking the right hosting provider, configuring and securing the service remains the responsibility of the organisation
  • obtain the additional skills needed to build the service. This should be obtained either by recruitment, DOS, or the wider NHS

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