Feature Content, NHS trust

Case Study: Delivering an electronic vaccination process for The Rotherham NHS Foundation Trust

Case Study OX.DH

The Rotherham NHS Foundation Trust is a combined acute and community trust providing services at a number of sites across the borough. As part of their vaccination programme, a team from Rotherham NHS Foundation Trust regularly visits local schools and holds clinics to vaccinate children of secondary school age.  

The original process was paper-heavy and time-consuming. The trust sought to build on their experience using an electronic process to deliver COVID-19 vaccinations during the pandemic. They approached OX.DH to see if the cloud-native health tech supplier could extend their infrastructure to digitalise the child and adolescent vaccination process.    

Project Summary  

  • £30,000 saved in administration time / equivalent to 45.5 hours saved per week;  
  • £5,000 saved in resources;  
  • Saving nursing time through digital, secure, audited processes;   
  • Removing administrative processes, travel and costs;  
  • Making is easier for parents, guardians and school staff;  
  • Digitising up to 10,000 consent packs per year;  
  • Leveraging Microsoft technology.   

Lindsey Palmer, administration lead at Rotherham NHS Foundation Trust: “I love the simplicity of it and the fact that we have more control over the consent forms so we can make sure that parents get them. Another massive bonus for me is the amount of admin time we save. Previously, as soon as documentation came back from schools, it was all hands on deck to juggle paper. There’s none of that now – we just download the information from the vaccination team, upload it to our system, and it’s done. It makes such a huge difference.”  

Tracey Dewick, clinical lead at Rotherham NHS Foundation Trust: “We needed an electronic consent system that would replace the paper consent forms so all the pertinent questions were asked.  The consent form needed to make sure that the parent answered all questions before submitting it in order to not have to make those follow phone calls for incomplete paper forms.  It also had to be user friendly for the team, school admin teams, parents and carers.  As we struggled to get finance approval everyone had a close eye on costs too.”  

Original process

  • Nurses/child health administrators would prepare paper consent packs, including vaccination consent forms, information leaflets and covering letter.  
  • All stationery was ordered and photocopied ahead.  
  • Nurses delivered these packs to each individual schools: 16 secondary schools, 6 special schools, 6 pupil referrals units.  
  • Paper forms required to gain consent for each vaccination, often leading to each child being handed three separate forms.  
  • Children were responsible for taking the forms to their parents/carers and returning them to staff.  
  • The nurses then had to drive back to each school to collect the completed consent forms, and go through each one to make sure the forms were completed correctly. Missing information would then prompt the nurses to have to make a phone call to parent to gain missing information.  
  • Any do not consent forms received would also prompt a phone call to parents and discharge letter sent out and GP informed.   
  • Nurses had to complete vaccination details on the paper forms on day of administration  
  • Completed documentation transported back to the trust and scanned before it could be digitally entered into the trust’s electronic patient record.  
  • The paper forms had to be filed and saved once scanned.  
  • Lots of risks with transporting paper with personal identifiable data.   

Impact of the paper trail

  • This process was labour, cost and resource intensive, with approximately 10,000 packs of forms created by the administrative team each year and three full-time administrative roles required to assist with documentation.  
  • Paper forms were often misplaced whilst in the child’s care, leading to missed vaccinations, unclear communication with parents and carers and further work for the healthcare team.  
  • Sensitive information such as the child’s date of birth and address was displayed on the paper forms.  
  • The level of paper required posed an ongoing sustainability challenge for the trust.  

How does the OX.DH digital system work? 

A digital, secure and 100% cloud native platform, the process is streamlined to enable:   

  • The school to send an email to the targeted year group asking parents and carers to complete vaccination consent by clicking a link and seeing a familiar form.   
  • Responses returned electronically to the trust, enabling the healthcare team to cross-reference the consent against the child and input the relevant vaccine information.  
  • The data to be exported and uploaded into the trust’s EPR.  
  • The trust to send a reminder text to parents and carers shortly before their visit.  
  • The trust to automatically inform patients and carers when vaccines have been administered and potential side effects to look for. 
  • The visualisation of data via their digital dashboard, so the trust can view the percentage of completed consent forms.   

What are the benefits? 

  • Saves nursing time by removing physical documentation processes.  
  • Reduces communication processes when information is missing.  
  • No longer reliant on children to be responsible for the couriering paper forms between trust, school and family. This simplifies the process and has led to an increase in the number of consent forms completed and returned to the trust.   
  • Sensitive data is better protected in the digital form due to more restricted access.  
  • Administrative time is vastly reduced with only one person required to manage the consent process and upload of the vaccines.  
  • With all vaccination data available at a glance via the digital dashboard, the healthcare team can organise their workload and plan ahead with more ease.   
  • The digital process is much more sustainable, with less paper used, no scanning and less travel required between the trust and the school.  
  • The trust is achieving cost savings primarily due to reduced need for resources and printing.   
  • If a child attends the vaccination session without having received consent, the healthcare team has the opportunity to call up the parent or carer, check if they would like the child to be vaccinated, and ask them to complete the consent form there and then by texting a link.  

Collaboration – “Everybody got involved in developing the system, so we could see it from every angle”  Administrator, Rotherham NHS Foundation Trust   

OX.DH and Rotherham NHS Foundation Trust have worked closely to develop and deliver the digital solution, with regular project meetings in place since the start. These frequent touch points provided the trust with the opportunity to provide feedback and make course corrections, allowing OX.DH to act upon feedback and turn around requests quickly to ensure that the trust received a solution that addressed their specific needs.  

A multi-disciplinary team from across the trust was involved in the process, with expertise spanning data, nursing, administration, training and more.  

Protecting against digital exclusion 

With some parents and carers unable or reluctant to engage digitally, Rotherham and OX.DH offer two alternatives to ensure that all parents are included in the system, and all children have the chance of receiving the relevant vaccinations.  

For those without the means to receive a text, a small number of paper packs are still prepared. If parents or carers can receive the text from the trust but lack the confidence to complete the consent form digitally, an option is provided to call the trust so that a member of the healthcare team can fill it in on their behalf.  

Programme to date 

Since go-live in October 2022, OX.DH and the trust have regular calls, ensuring that the healthcare team is supported in their ongoing journey and enabling OX.DH to accommodate change and introduce enhancements to further improve the service.