The Data Processing Service (DPS)
Pivotal to bringing these different models together was the development of a single data processing architecture with NHS Digital’s Data Processing Service at its heart.
The DPS is an Amazon Web Services (AWS) service running Databricks and making use of many cloud-native AWS managed components.
It is capable of receiving large amounts of vaccine event data from the point-of-care applications and processing this using a set of data quality and other business rules.
The Data Processing Service can also forward the relevant data to authorised 3rd parties such as the patient’s GP record and the Medical and Healthcare Products Regulatory Agency (MRHA) to allow them to monitor adverse reactions.
One of the key functions of DPS is to undertake data quality checks to drive up the quality of data captured, received and processed downstream. We are currently on target to drive down the error rate to 0.11% which, given the scale of the programme and the diversity of delivery models, is a massive achievement. This has been very important to the recently launched NHS COVID Pass service, which uses this data.
The National Booking Service
Our NHS.UK team developed the National Booking Service, which allows the public to book into the mass vaccination and community pharmacy sites. There is a lot of tech behind the public-facing Book a Coronavirus Vaccination service to identify the individual booking and to ensure they are eligible to book.
It also includes a staff-facing system for contact centre teams, vaccination site administrators and a check-in app for when the patient arrives at the vaccination site. My colleague James Higgott published a really interesting blog on the National Booking Service, which focuses on the importance of service design.
Given this is an open and publicly available service, we needed to manage volumes and protect the user experience and overall service during spikes. For instance, we see large spikes in volumes when media outlets, such as the BBC, run news stories.
Behind the scenes we have implemented “waiting room” technology, which people are more familiar seeing when booking tickets for popular events such as stadium concerts. In addition, the overall NHS.UK service supporting National Booking Service utilises the Akamai content delivery network to ensure static content such as web page text and images is delivered to end user’s devices more efficiently.
The booking service has been designed to scale up (and down) through use of Azure cloud-based services, with the waiting room technology kicking in when the extreme spikes occur. This allows users to be held in a queue and then go on to book their appointment after a short wait.
NBS has exemplified our API-first strategy, adopting our latest set of FHIR based APIs for accessing patient demographic data alongside other supplier-based APIs.
Tried and trusted….
Alongside the new services in other parts of the architecture, we have reused and repurposed tried and tested services such as MESH (Message Exchange for Social Care and Health) to flow data between services such as the patient’s GP. MESH has dealt with extreme volumes as it processes vaccination data, as well as Covid-19 test results alongside the existing traffic across the NHS.
We made use of standardised mechanisms of data exchange, such as the FHIR Digital Medicines APIs which we had originally developed to allow pharmacy systems to update a patient's GP record following a flu vaccination.
The combination of developing new services alongside the reuse and repurposing of existing services has been fundamental to the success of the programme combined with blood, sweat and tears across the teams and suppliers involved.