The National Immunisation and Vaccination System (NIVS) has played a key role the in safe and effective implementation of the COVID-19 vaccination programme, capturing real time data at the point of delivery for more than 11 million vaccinations in its first year of use.
Developed by NHS Arden & GEM CSU, working in collaboration with the national programme team and hospital hubs, NIVS provides a cost effective, clinically assured, interoperable solution.
The challenge
As the first COVID vaccines were approved for use and the first cohorts of patients were identified, administering vaccines as quickly as possible was crucial to preventing further deaths and serious illness from coronavirus. But, in order to administer vaccines safely and to capture real time data on vaccine take-up, new information systems were needed.
A cost effective, clinically assured solution was needed which would have a high level of interoperability with existing patient records and reporting systems to enable accurate call, recall and operational planning.
Our approach
Our Data and Systems team had previously built a similar solution, the National Immunisation and Vaccination System (NIVS), to capture vaccinations for the flu immunisation programme. Extending NIVS, through additional development, to COVID vaccinations would offer a rapid, clinically proven solution.
Developing a bespoke solution
Working in close partnership with the national programme team and hospitals designated as vaccination hubs, we were able to scope, design and build a bespoke module within NIVS to deliver real time data capture at the point of delivery.
This was achieved through a series of user discovery sessions with clinicians and vaccinators to ensure that the system offered a positive user experience and was easy to navigate within a live clinic environment.
The NIVS module also enables:
- Use of the NHS number to automatically access an individual’s vaccination history
- Vaccinators to be guided through a clinical decision support process to ensure the intended recipient is suitable for the vaccine
- Batch information to be captured, by vaccine type and manufacturer, along with expiry dates
- Assurance that patients are receiving vaccine doses within specified timeframes.
Safety, security and resilience
NIVS is hosted within Arden & GEM’s robust application and data warehouse environment to ensure system security and resilience. Our team worked closely with NHS Digital to successfully pass through a robust assurance process including clinical safety and information governance approval. In addition to following a secure registration process, users are only assigned ‘vaccinator’ role status within NIVS once approval has been granted by organisational leads.
The system also has a full audit history which can be provided as evidence, where required, to counter fraud operations.
Effective implementation
The system was rapidly deployed to the first hospital vaccination hubs in December 2020 and has since been rolled out to mass vaccination centres. The web-based application is now live in 457 vaccination settings with users from 188 different organisations supported via a dedicated help desk, web page, enewsletter, user guides and manuals, and training videos.
Users have directly informed improvements in system functionality through contact with the helpdesk and liaison with their organisational leads. Further improvements have been made in response to feedback from the national programme team to accommodate changes to the vaccination programme, for example, the booster programme rollout and to continually improve user experience.
Data capture and reporting functionality
As an integral part of the NHS family, we fully understand how data flows – and the associated governance requirements – across the health system. Combining this knowledge with an understanding of the information needs of key stakeholders allowed us to design reports and dashboards that could drive effective decision-making.
Using the NHS Digital API framework, NIVS is able to automatically connect to the Personal Demographics Service (PDS), the national electronic database of NHS patient details, to help identify patients attending for vaccination and match them to their health records.
"Delivering COVID-19 vaccinations is a huge challenge for everyone involved. Oxford University Hospitals NHS Foundation Trust are very appreciative to the team at NHS Arden & GEM CSU for building the NIVS solution, which works very well, in rapid time and for evolving this solution with us to meet our needs. This is a notable success story for an NHS developed agile solution."
David Walliker, Chief Digital and Partnerships Officer at Oxford University Hospital NHS Foundation Trust
Outcomes
In the first 12 months of the COVID-19 vaccination programme, NIVS captured more than 11 million vaccination events. Event data was validated and consolidated each day before being submitted to NHS Digital to automatically update GP records and the NHS COVID pass.
Not only does this ensure that up to date information about a patient is stored in one place, to maintain safety, it also informs ‘call and recall’ services to increase vaccine uptake.
Live reporting is available as a home screen dashboard within NIVS which allows users to monitor numbers vaccinated in the current day, previous day and a running total, by key cohorts. This information has proved vital for operational planning to ensure the correct capacity for administering second doses and boosters.
For healthcare workers, NIVS also records the Electronic Staff Record (ESR) number so that Trusts can quickly and easily monitor vaccine take-up and status among their employees.
By combining data expertise, system development experience and reporting insight with ongoing stakeholder engagement, Arden & GEM has provided the NHS with an information solution to support the safe and effective delivery of the COVID-19 vaccination programme.
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