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https://digitalhealth.blog.gov.uk/2022/06/24/nhse-i-standards-directory-alpha-assessment/

NHSE/I Standards Directory alpha assessment

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

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From: NHSX
Assessment date: 20 January 2022
Stage: Alpha
Result: met
Service provider: NHSE/I

Service description

The service brings together different types of information standards needed to support interoperability across health and adult social care. It allows users such as healthcare providers and IT suppliers to find out what standards to use to collect, format and exchange data in real time between systems and across organisational boundaries. The directory makes it easy to browse content that is otherwise spread out across many sites. It helps users understand what standards apply to their use case, and provides key information such as dependencies between standards and if it has been assured or endorsed by professional bodies.

Service users

Primary users are people who adopt standards This group includes:

  • suppliers building technology products
  • health and social care providers
  • regional bodies such as integrated care systems (ICS)

Secondary user groups include:

  • creators and owners of information standards such as the Professional Record Standards Body (PRSB)
  • assurance boards, such as the Data Alliance Partnership Board (DAPB)
  • procurement teams

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 had completed extensive user research, using methods that were appropriate to their goals 
  • the team was very knowledgeable and aware of their users. It was obvious that much of their work was based on the user research they had done 

What the team needs to explore

Before their next assessment, the team needs to:

  • focus on the upcoming accessibility assessment and be sure to involve more users who have access needs early in the process. Make sure to focus on all aspects of accessibility
  • recruit more users who are less familiar with the concept, or are new to the process of using standards
  • try to branch out of usual recruiting methods used to find other groups that may have more niche 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 have used user research to understand the current constraints for users    
  • the team has a good understanding of a complex space and explains the scope of the service to users
  • The team narrowed the project scope to focus on discoverability and understanding of what standards to use   
  • the team has a clear understanding of the importance of updating and maintaining the service 
  • the team is looking at how users can have greater visibility of and contribute to developing standards 
  • the team has an understanding of where it fits in the broader context of standards development and has fed back to policy teams on issues that will be out of scope

What the team needs to explore

Before their next assessment, the team needs to:

  • complete user research with participants who are unfamiliar with interoperability standards to ensure it’s solving a whole problem for potential users
  • test the scope of the service with users less familiar with interoperability standards and whether they understand where it fits in the wider standards space and how this might affect the service name
  • test with users who may be looking for other standards and how they will signpost them to appropriate services
  • connect continually to other service teams and relevant organisations

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 has collaborated with other organisations and teams to integrate this service into the broader work regarding how standards are delivered and adopted    
  • the team has considered how users will find the service and has planned channels of communication  
  • the team has explored how to keep the directory up to date with continuous management, community engagement and more
  • the team has planned the required roles and responsibilities for maintaining the service

What the team needs to explore

Before their next assessment, the team needs to:

  • consider other ways users may come across the service and explore user journeys to and from other products or services, for example, the NHS digital service standard

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 was able to demonstrate how they had tried different solutions and iterated prototypes
  • the team has made good use of the NHS design system 
  • the team has also used the NHS content style guide and language that users will see on related services
  • the team has simplified the user journey and language in response to user research findings

What the team needs to explore

Before their next assessment, the team needs to:

  • explore how they can simplify sometimes lengthy content
  • test further the use of status labels and filters, including the ordering of checkboxes  

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 applied the NHS design system and is already carrying out internal tests for accessibility

What the team needs to explore

Before their next assessment, the team needs to:

  •     plan how they will test for accessibility, including users with cognitive differences

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 included a diverse range of digital skills and expertise
  • the team helped onboard and upskill new NHSX team members
  • the team was closely sighted of user research findings with frequent debrief sessions 
  • the team planned for Private Beta includes key team members from the second Alpha. This will ensure an effective transition into the new project phase
  • the team had a blend of permanent and contractual team members

What the team needs to explore

Before their next assessment, the team needs to:

  • continually dedicate time to upskill and build digital capabilities with permanent staff who shall own this service after Public-Beta. 
  • ensure the work with contractors is done on a sustainable basis    
  • consider recruitment of permanent product owner of this service. Currently an interim NHSX product manager is supporting and the team would benefit from a dedicated product owner from the service team.
  • continually work as a blended team with permanent and contractual team members

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 used agile ways of working to collaborate effectively. For example using daily stand-ups, weekly planning, show and tells, retrospectives and sprints 
  • the team worked in the open and ensured shared access to Google drive and slack channel
  • effective governance is used to escalate key issues. For example using the steering group to escalate decision making on different fields for standards   
  • service owners and delivery team frequently met in daily stand ups and weekly catch-ups 

What the team needs to explore

Before their next assessment, the team needs to:

  • continually use agile ways of working and share access to key information    
  • continually collaborate with service owners and build their capabilities   

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 used multiple rounds of prototype testing to iterate the service
  • the team tested prototypes with a variety of users
  • the service iterations were driven by user feedback from research sessions   
  • the team intends to continually test the service with users for potential iterations in Private Beta

What the team needs to explore

Before their next assessment, the team needs to:

  • test the service with users who have accessibility needs or cognitive differences and iterate     
  • test the service with users unfamiliar with the standards and the subject matter   
  • continually seek opportunities to capture feedback and iterate the service

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 security implications for the service at alpha. In their planning, they have identified the need for security boundaries and the likely threat that might affect their service
  • the team had given some consideration to the types and sensitivity of data that the service might handle  
  • the team is aware of access management challenges and are using CKAN’s role based authorisation and access control
  • the team is aware of the need to monitor the service and are considering switching from statuscake to AWS cloudwatch    

What the team needs to explore

Before their next assessment, the team needs to:

  • complete System Level Security Policy (SLSP) and seek approval
  • complete Data Protection Impact Assessment  and seek approval 
  • develop options to manage sensitive data received in feedback
  • explore different avenues for identity management and ensure the choice aligns with the department strategy

10. Define what success looks like and publish performance data

Decision

The service has met point 10 of the Standard.

What the team has done well

The panel was impressed that:

  • the team are using usability testing sessions to capture feedback 
  • the team has created a clear problem statement that considers how the service can facilitate discoverability and understanding of what standards to use. 
  • the team has identified relevant website analytics to measure progress to their main goal during Private beta
  • the team have identified means to capture the four mandatory KPIs
  • the team have identified short, mid and long term goals with relevant KPIs

What the team needs to explore

Before their next assessment, the team needs to:

  • use KPIs and user testing to continually iterate the service to meet the goals
  • establish project dashboard to enable efficient analysis of key data and KPIs

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 are using out of the box open source solutions
    • SOLR  open source enterprise search platform 
    • CKAN an open source data management system to publish, share and use of data   
  • the team evaluated alternate solutions and selected CKAN as it has features that meets user needs
  • the team are using AWS RDS Postgres database   
  • the team are using Amazon Elastic Kubernetes Service (AWS EKS) to underpin the entire service
  • the team are using GitHub to manage the development
  • the team are using Continuous Integration and Continuous Deployment (CI/CD) methodology to develop and deploy
  • the team are aware of Terraform to make the service cloud agnostic

What the team needs to explore

Before their next assessment, the team needs to:

  • continue to use progressive-enhancement to make the service accessible   
  • explore user interface (UI) for standards owners, creators, admin and any other users who are required to register and login   

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 team is using open principles in their development 
  • the prototype code has been published on GitHub

What the team needs to explore

Before their next assessment, the team needs to:

  • continue to make code open source and ensure the repository is updated
  • make sure CKAN work is TBC in the repository, repository should  be complete
  • keep code closed where appropriate, to retain control of sensitive code

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 used the NHS prototype kit for accessibility and consistency with other NHS systems
  • the team is using common components and patterns from the NHS design system
  • the team is looking at how they might open up standard development to allow users to contribute through GitHub
  • the team has engaged with the NHS digital service manual team via their public Slack channel

What the team needs to explore

Before their next assessment, the team needs to:

  • share learnings and contribute back to the NHS design system
  • explore whether any architecture components might potentially be reused from other government services to avoid duplication. 

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 use of AWS EKS allows for auto scaling of the service
  • the team has tested recovery from failure and the entire recovery process takes under 5 minutes 
  • the team is aware of the need to monitor the service and are considering switching from statuscake to AWS cloudwatch
  • the team have designed the service with a daily backup of the database  

What the team needs to explore

Before their next assessment, the team needs to:

  • continue working on monitoring and alerting to manage potential bot and hack attack as well as support non-functional needs
  • consider moving to a multi-Availability Zone architecture
  • research expected traffic volumes during peak and off peak times to ensure appropriate level of service is maintained
  • continue to test recovery from failure with more contents 
  • test no loss of content as a result of service failures

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