The NHS Offers Improved Vaccination Services Through Consistently Excellent Quality Assurance

Client overview 

The NHS’s Vaccination Program in the UK provides better health outcomes for the population of England by enabling timely interventions throughout a person’s life. It allows them to identify, invite, book, and deliver vaccination services safely and efficiently to the general public to avoid preventable illnesses. 

Ensuring a stronger and healthier UK via robust vaccination services 

The NHS’s vaccination program was set out to:

• Streamline data commissioning and IG processes to enable staff to identify and manage vaccination cohorts efficiently and effectively. 
• Reduce the cost of scheduling and sending campaigns through increased automation. 
• Make it easier for the general public to find and book appointments. 
• Empower NHS staff to manage bookings in the way that best suits their setting and individual needs. 
• Ensure that staff have their point of care tools optimized for the safe and efficient delivery of treatment and that data is captured consistently. 
• Give NHS staff tools which allow them to efficiently monitor the service, help understand efficacy and drive targeted interventions. 
• Provide services that process and flow data between local and national systems in real time to give a holistic view of an individual’s care. 
• Ensure staff are paid accurately and on time for care delivered across a range of settings. 

The product release cadence per service is typically one per fortnight, but each workstream works on a different timeline so the number and type of releases each week will differ and can alter to meet NHS policy decision dates. 

The NHS needed additional help to grow their existing team to allow them to focus on strategic work while bringing in a partner to act on their behalf to assure other 3^rd parties processes and deliverables in the NHSE space. 

Some of the NHS’s requirements included: 

• The expertise to run (and expand) a mature business as usual (BAU) quality assurance (QA) service that could also provide Assurance on cases that were not standard using previous experience. 
• Mirroring of the intentions and direction of the program over time in terms of duties carried out and numbers of roles/personnel in the team. 
• Assurance and quality improvement work with suppliers, facilitation and assurance of integration testing and risk assessment/execution of end-to-end tests for which individual suppliers are not accountable. 
• To establish a quality assurance partner that understood its industry and business rationale, as part of the goal of a multi-stream, on-going engagement. 
• Suggestions and improvements to be put forward and implemented for testing and assurance solutions to improve the extent and accuracy of the service. 
• Automation of testing and processes where it was valuable. 

The NHS contracted Qualitest to help with BAU testing and assurance activities for various workstreams and build an automated regression pack. We worked with them to build a strong assurance and testing team that fluctuated over time in accordance with the needs of the program. 

Providing a streamlined vaccination program and service to protect public health in the UK 

Qualitest worked in two well-defined roles across various workstreams/teams:  

• Role 1 – end-to-end testing and assurance (currently two FTEs) 
• Role 2 – test automation (currently one FTE) 

Role 1 – end to end testing and assurance 

This role involves performing end-to-end manual testing in the test environment not only for a seamless delivery, but to ensure objectives of the program were met. 

Manual testing included: 

• Third party supplier roadmap sessions to gain a view of the service changes needed in upcoming releases. 
• When available, the full release scope, including all the individual items/tickets, was reviewed. If any uncertainties/issues were identified, they were raised and clarified with the third-party suppliers. 
• Alongside the new tests a set of manual regression tests were executed. These were updated regularly to accommodate the changes made to specific services. 
• If any issues/defects were found during test execution, these were reported and tracked to closure. 
• An assurance statement was created for each ticket which ultimately feeds into the assurance statement for the sprint as a whole. 

Role 2 – test automation

• This started with building an automated regression test pack to cover happy-path regression scenarios. 
• The automated scenarios were tested regularly with a focus on go-live dates for various workstreams. 
• The test suite was subsequently expanded to cover negative tests, specifically data issues that were noticed over the past releases and those found in production. 
• Over time, with multiple changes to the services, the test coverage was regularly reviewed, amended, and increased. 

  Key benefits 

• The NHS improved the efficiency of the program by up to 75%.
• The NHS achieved a significant 60% saving on the project costs in the NHS’s live environment as issues were identified and fixed much earlier in the testing process. 
• The NHS implemented a continuous delivery working pattern to meet the newly introduced changes that came late into the program.  
• The NHS was able to focus on other strategic planning and projects and deal with the impact of an internal merger as a result of the Qualitest assurance capability. 
• The NHS was able to operate and deliver independently and consistently when it came to key deliverables and achieve an 80% improvement in terms of time saved.