Enabling NHS England to record any vaccine in any care setting with:

• 1.5 million vaccines recorded

• 300+ trusts

• 13,000 users and counting

www.ravs.england.nhs.uk

NHS England (NHSE) is the publicly funded healthcare system in England.

The Vaccination Digital Services (VDS) team specifically help to provide the population with access to preventative vaccine services such as the screening of, booking and the delivery of vaccinations in all care settings across England. 

As the interaction designer I led the design for the project from the end of the discovery phase, through alpha and in to private beta, at which point the team grew from 12 to 25, then further still in to public beta with additional teams of service agents, clinical and legal governance and more. 

The primary aim of the project was to be able to deliver any vaccine, in any care setting.  

The 'Record a Vaccination service' or 'RAVS' as it's known was conceived in earnest after an initial discovery in to the commercial viability and technical feasibility by NHSE.

The discovery indicated that the creation of an in-house service, joined up with other vaccine services such as screening and booking would deliver exponential benefits to the health service in the form of:

• substantially reduced costs of payments to 3rd party providers for recording and flowing of vaccine data

• increased speed of response to new and existing vaccine outbreaks

• improved population health through prevention of disease through vaccines

RAVS would have to be understood and usable for any vaccine and any healthcare professional administering vaccines.

To give an idea of scale, care settings for vaccine delivery include:

• all 1250 primary care networks PCNS with populations of up to 50,000 people

• 12,000 Pharmacies

• 704 hospitals

• 2057 National vaccination centres

All aiming to serve through vaccine prevention the population of England 60.8 million (ONS, 2023)

The designs of RAVS were created via means of sketching, wire-framing and prototype creation. This was done through paper or white-board sketches, Figma and the NHS prototype toolkit as fidelity needs increased. Occasional use of Adobe, Balsamiq as well as collaboration tools such as Mural have also been used when required.

Designs are owned and iterated by the User Centred Design (UCD) team, consisting of interaction, content, service design and user researchers. They are informed by the knowledge and experiences of our users across all care settings via remote and in-person testing.

Collaboration and input also comes in the form of UCD colleagues across the NHS service owners, delivery manager, testers, developers, data analysts, clinical SMEs and many other stakeholders.

This approach provides the right balance of due diligence to our users and their needs, legal and clinical governance and the ability to design and develop at speed.

The discovery was conducted prior to my arrival and consisted of remote user research, desk research, technical feasibility studies and business viability. 

The project at this point consisted of a service owner, service designer, technical architect and user researcher. I would join early in to the alpha phase alongside side a content designer.

The designs created for Alpha were influenced by the learnings and work completed in discovery, as well as bi-weekly rounds of user research during 2 week sprints. 

As a product team, it was established what the key areas which would need to be created to make RAVS a useful product in its most minimal form, this included:

• log in/out

• record key vaccination data

• managing user permission

Extended areas included:

• appointments

• stock management

• reporting

• clinic management

We allowed the designs to be wide ranging in terms of the solution and how they met the needs of our users. Before refining them and taking forward the ones which best met the user needs and product roadmap.

Although the we looked in to the development of many features such as appointments and stock management, the work focussed on the Minimum Viable Product (MVP) to allow users to successfully record vaccines and release RAVS for September 2024.

In order to develop and release RAVS for a select audience known as a private beta, we needed to meet certain requirements relating to clinical safety and the latest national point of care specifications, which would allow RAVS to be used in the market.

We were also unable to develop the service with in-house NHS development and test teams due to time constraints.

This impacted our development as well as the look and of the private beta, which was not strictly developed as per the intended design i.e. the NHS Design system.

This would mean re-work with an in-house development team to bring the service back in line.  

The work was still primarily focussed on creating an MVP:

• log in/out

• record key vaccination data

• finding and editing patient records

• managing user permission  

The public beta included new and iterated features which we had learned from in the alpha and private beta.

We were also able to complete any necessary development refactoring of RAVS to bring it back in line with NHS design standards and accessibility.  

Additional areas worked on included:

• a homepage which doubled as a dashboard for our users

• a product page to promote the service publicly

• a 'streamlined' version of the service to reduce friction of selection each time 

So far RAVS has enabled over 1.5 million vaccines across all care settings in England.

It allows the recording of COVID-19, flU, Pertussis and RSV to be given in any care setting and will continue to expand vaccine types as the UK HSA determines necessary, a key goal for RAVS. This allows NHSE to respond immediately to outbreaks and reduces costs in doing so.

We have also been able to significantly reduce time taken to record vaccines between alpha and beta by 3 minutes per vaccine given to less than 30 seconds, with an average of  <1 minute.

Finally, the introduction of new components, error messages and safety warnings also ensures safer more accurate vaccine recording each time.

RAVS will continue its ambitious aims to deliver more vaccines to more people across all care settings. 

Increasing vaccine uptake is a key aim for the new government in its bid to focus on prevention and reduce health inequalities for a more prosperous UK population.

In the near future the service looks to deliver the following vaccines:

• Measles Mumps and Rubella (MMR)

• Pertussis (Whooping cough)

• RSV (Respiratory syncytial virus)

Long-term RAVS will help to form a wider joined up service which will deliver vaccines to the UK through means of screening for illness, patient bookings and vaccination delivery. 

Data from these vaccine events will help to serve the UK HSA to prepare, plan and respond to future outbreaks.