Prepay for NHS prescriptions alpha assessment

The report from the alpha assessment for NHS BSA's prepay for NHS prescriptions service on 5 June 2017.

From: Government Digital Service
Assessment date: 05 June 2017
Stage: Alpha
Result: Met
Service provider: NHS Business Service Authority (NHSBSA)

The service met the Standard because:

  • The service team were able to demonstrate and explain the considerable research they had done to understand the needs of users of the service, including how people access and use the current service across all channels, barriers to access and current pain points.
  • There is a suitably skilled, multidisciplinary team in place to build and iterate the service. A consistent team has been in place during discovery and alpha and it was clear that they were all very knowledgeable about the service and its users. They are working in an agile way and demonstrated how they have iterated and tested their ideas and assumptions frequently during alpha and have good plans to continue in beta, including testing and iterating across all channels.
  • The team have plans to improve on the technology that the service will be built on, the panel were satisfied that they have appropriate plans and measures in place to ensure the service will be secure.

The assessment panel were really impressed with the way that the team is working, within some clear constraints. The panel are more than satisfied that the team in place will make significant improvements to the way that the current service works - having clearly understood and explained existing barriers.

However, the wider service transformation of the administration of prescriptions in England is, in the long term, the work that is needed to fully meet the needs of users of prescription services. Users (people collecting prescriptions and pharmacists) should not have to navigate and understand the existing complexities and technical constraints that underpin them in order to collect and pay for prescriptions.

The service team are already involved in early discovery into the technology changes that are needed to enable this truly transformative work to start, but we encourage the NHS Business Service Authority to be bold in the prioritisation of this work to in order to transform the end to end service.

About the service

Description

The service enables people to save money if they regularly have to pay for more than three prescription items in three months or more than 13 prescription items in 12 months by buying a three month or 12 month certificate.

Service users

The users of this service are members of the public who pay for NHS Prescriptions and are resident in England, pharmacists and pharmacy staff and internal staff.

Detail

User needs

The team have worked well to learn about the different kinds of people who use or might need the service, and the problems and barriers they currently face. They’ve expressed what they have learned in a good set of personas and statements of user needs.

However, some important information about users, and their thinking, behaviour and needs around prescriptions aren’t reflected in the current personas.

The team have done some work to learn about users’ access needs and are using what they have learned to design an accessible service. The team could and should have done more to learn about the barriers that disabled people face when using their prepayment to collect prescriptions.

The team have worked well to understand users’ support needs, and to design a service that will work for users no matter their level of digital skill, access or confidence. They have good plans to test their support routes through beta.

Team

There is a full multidisciplinary team in place to build and iterate the service, the team has been in place during discovery and alpha and they have plans to fill vacancies in beta including a role for Developer and a Business Analyst.

The assessment panel were really impressed with the way the team described how they work, they showed lots of evidence of collaborative working, show and tells, team assumption mapping and full team involvement in user research.

The team have plans to recruit a Business Analyst and currently commission analysis from a central team, during the beta phase the panel would like to see and understand more about how research findings and design ideas will turn into agreed features and changes and become stories, and how will they be tracked and managed.

Technology

The service team are utilising appropriate technology choices within their current scope, they are exhibiting a mature build pipeline at this stage capable of fast iterative deployments.

The service is under some constraints from the current infrastructure provider and the team should aim to transition the service to public cloud infrastructure before moving into beta. This should include a plan for disaster recovery, resilience and appropriately securing user data where necessary.

The team has embraced coding in the open and are utilising open data standards where appropriate. They have done admirable work on extending government UI libraries for their needs and evidenced the necessity of these extensions with user needs.

The assessment panel was pleased to see the utilisation of the GOV.UK Notify service and that the service team has aspirations to explore the use of other GaaP services such as Verify.

The scope of this service is only a transitionary step to a wider transformation programme that should ease the burden on users. It would be sensible for the team to explore the technology constraints preventing a more seamless user experience before moving to public beta.

Design

It is good to see the team thinking beyond the digital service. They demonstrated a user-centred process with design and research fully embedded throughout. They have designed a simple, modern, well-designed alpha that adheres to most NHS Digital and relevant GDS design patterns.

However, in the prototype, it was unclear whether users really need the evidence at the pharmacy. The team need to clarify if the text, email or printed reference number is a confirmation for reassurance, or is it really evidence that they have to show the pharmacist.

They have looked into designing a more accessible journey, as well as assisted digital routes. In beta, the team should do a full accessibility audit as well as testing the user journeys with proper form validation and error messaging.

The panel would have liked to have seen more experimentation, including more ideas thrown away, following the service manual guidance for the alpha stage.

The focus seemed to have been on iterating the current online journey, rather than looking at how users can collect and pay for prescriptions without understanding the underlying systems. The panel encourage the NHS Business Service Authority to prioritise real transformation that will fully meet the needs of users of prescription services.

Analytics

The service team had thought about what they wanted to measure and had plans in place to measure those KPIs and report them on the Performance Platform.

Analysis capability is currently outside of the direct team and the assessment panel would encourage closer collaboration, including involvement in user research during the beta phase.

Recommendations

To pass the next assessment the service team must:

  • contribute to the wider discovery work to look outside the constraints of the existing technology and to consider how needs could be met if these barriers were not present
  • learn about and work to remove any barriers that disabled people face when using their prepayment to collect prescriptions
  • show how analysis is embedded in the team during beta

The service team should also:

  • ensure the wider governance structure within the organisation governance follows the principles set out in the Service Manual and above all is appropriate and doesn’t slow delivery
  • test design patterns within the service and feedback their findings, for example, the address format - making sure the service only asks users to provide the information that is required

Digital Service Standard points

Point Description Result
1 Understanding user needs Met
2 Improving the service based on user research and usability testing Met
3 Having a sustainable, multidisciplinary team in place Met
4 Building using agile, iterative and user-centred methods Met
5 Iterating and improving the service on a frequent basis Met
6 Evaluating tools, systems, and ways of procuring them Met
7 Managing data, security level, legal responsibilities, privacy issues and risks Met
8 Making code available as open source Met
9 Using open standards and common government platforms Met
10 Testing the end-to-end service, and browser and device testing Met
11 Planning for the service being taken temporarily offline Met
12 Creating a simple and intuitive service Met
13 Ensuring consistency with the design and style of GOV.UK Met
14 Encouraging digital take-up Met
15 Using analytics tools to collect and act on performance data Met
16 Defining KPIs and establishing performance benchmarks Met
17 Reporting performance data on the Performance Platform Met
18 Testing the service with the minister responsible for it Met
Published 30 July 2018