DHSC still mulling AGNI ruling's implications for Liberty Protection Safeguards implementation - Community Care

Think Digital Partners Data Bites Join us for Data Bites! A series of fast-paced, eight-minute talks bringing together ideas, insight and expertise from

Two strengths of the blood pressure drug lacidipine are out of stock, the Department of Health and Social Care has announced.

Communication, transparency, and preparedness are essential

**From:** DHSC **Assessment date:** 04/12/2025 **Amber review date:** 30/04/2026 **Stage:** Beta reassessment **Result:** Green at reassessment **Service provider:** UKHSA ## **Service description** The 'Complete UK pre-entry health screening' service provides a **secure, digitised platform for overseas clinic staff** (administrators, panel physicians and radiologists) to record data required for a pulmonary tuberculosis screening of visa applicants from high-incidence countries. It clarifies expectations set by the UK Tuberculosis Technical Instructions (UKTBTIs), streamlines reporting to UKHSA, improves data quality and timeliness, enhances fraud detection and supports national TB prevent efforts. Over **300 international clinics** across 6 continents participate in this programme. This enables UKHSA to deliver on its "prepare" strategy: identifying future health threats and building tools to protect against them. ## **Service users** **Primary users** – directly interact with the service : **Overseas clinic staff** who need to record TB UK pre-entry health screenings on behalf of UK visa applicants: * Clinic administrative staff * Clinic panel physicians * Clinic radiologists **Secondary users** – indirectly or occasionally use the service **Additional clinic staff** who have supportive roles that facilitate the TB UK pre-entry health screening: * Radiographers * Lab technicians * IT administrator The **Heathrow Health Control Unit** has backstage roles that minimise risk of UK TB cases rising and supporting service users: * Level 1 support agent ## Report contents 1. Understand users and their needs 2. Solve a whole problem for users 3. Provide a joined-up experience across all channels 4. Make the service simple to use 5. Make sure everyone can use the service 6. Have a multidisciplinary team 7. Use agile ways of working 8. Iterate and improve frequently 9. Create a secure service which protects users’ privacy 10. Define what success looks like and publish performance data 11. Choose the right tools and technology 12. Make new source code open 13. Use and contribute to open standards, common components and patterns 14. Operate a reliable service ## **1. Understand users and their needs** ### **Decision** The service was rated **green** for point 1 of the Standard. **Optional advice to help the service team continually improve the service:** * Conduct more user research (beyond existing survey research) with visa applicants, to better understand their needs when interacting with the service. This is particularly important for any proposed future work concerning digital certification * More user research with clinic radiologists (particularly from the beta clinic sites) to understand their experience of the service and user needs, to ensure these are well understood and met ## **2. Solve a whole problem for users** ### **Decision** The service was rated **amber** for point 2 of the Standard. This is amber because: * The service relies on offline process’ to operate, for example users are expected to use the UK Tuberculosis Technical Instructions to understand next steps, pass work to other members of the team or see screenings in progress by using email or other systems. This could further add to the problem around inconsistency in following instructions or add delays into the system ### **Reassessment** : The service was rated **green** for point 2 of the Standard ## **3. Provide a joined-up experience across all channels** ### **Decision** The service was rated **green** for point 3 of the Standard. ## **4. Make the service simple to use** ### **Decision** The service was rated **amber** for point 4 of the Standard. This is amber because: * The service currently asks the same set of questions for every journey, meaning users are asked about things that are irrelevant * Check input fields do not have relevant labels. For example, on the ‘Enter applicant information’ screen, it asks for multiple things but it is not clear (especially if using a screen reader) what issue or expiry date or address it is asking for. Use the guidance for ‘Asking multiple questions on a page’ * The service uses the select component which is a ‘last resort’ pattern, consider if this could be iterated especially for short lists, like visa category * Of the poor data quality: the team should investigate opportunities to solve the problem around for poor data quality, for example when a user mishears or mistypes data incorrectly. One example of this could be using an address lookup for UK address ### **Reassessment** : ### **Decision** The service was rated **green** for point 4 of the Standard. ## **5. Make sure everyone can use the servic** e ### **Decision** The service was rated **amber** for point 5 of the Standard. This is amber because: * The service relies on JavaScript being enabled which can exclude some users, use guidance on ‘Building a robust frontend using progressive enhancement’ * It is not clear if the ‘page loading’ pattern is accessible. The service should maximise speed of response * The service team have not been able to test with assistive technology users from other countries, they have completed testing with proxy users in the UK (using software designed for UK use) to address this, however it is not clear if assistive technology in other countries would work with the service * The service team rely on a third party to complete manual accessibility testing; it would be beneficial to bring accessibility skills in house as part of the whole team's responsibility. Read more about accessibility testing in the Service Manual * The service is currently partially compliant with issues listed in the accessibility statement, the panel recognise the service team have plans to resolve the issues ### **Reassessment** : The service was rated **green** for point 5 of the Standard. ## **6. Have a multidisciplinary team** ### **Decision** The service was rated **green** for point 6 of the Standard. **Optional advice to help the service team continually improve the service:** * With funding being a factor, the service team should emphasise the importance of the full multidisciplinary team being available, going into Public Beta ## **7. Use agile ways of working** ### **Decision** The service was rated **green** for point 7 of the Standard. ## **8. Iterate and improve frequently** ### **Decision** The service was rated **amber** for point 8 of the Standard. This is amber because: * The team has successfully demonstrated iterative design based on user feedback however, they have not sufficiently demonstrated the impact of said iterations with quantitative data, which could surface any errors. This needs to be demonstrated by next assessment. ### **Reassessment** : The service was rated **green** for point 8 of the Standard. ## **9. Create a secure service which protects users’ privacy** ### **Decision** The service was rated **green** for point 9 of the Standard. ## **10. Define what success looks like and publish performance data** ### **Decision** The service was rated **amber** for point 10 of the Standard. This is amber because: * There is no performance analysis expertise in the team to lead on the development of a performance framework, to advise on GA4 tracking and to measure and monitor performance of the service * There is a lack of developed ways of working with data, whereby data fields and GA4 tracking are considered as part of the development process, success measures are built into the design hypotheses of iterations and quantitative data is used to inform decision-making ### **Reassessment** : The service was rated **green** for point 10 of the Standard. **Optional advice to help the service team continually improve the service:** * Develop a performance framework document, outlining the objectives and user needs of the service as well as the KPIs that align to those * Conduct statistical tests on quantitative data to ensure any increases or decreases aren’t due to external factors ## **11. Choose the right tools and technology** ### **Decision** The service was rated**green** for point 11 of the Standard. **Optional advice to help the service team continually improve the service:** * A notable achievement is the robust implementation of the event-based architecture and the successful addressing of crucial concerns like lost and duplicate messages. However, given that this is a very low-volume service, we propose a review of the current architectural complexity: 1. Potential simplification: For lower operational costs and simpler maintenance, the design could be simplified by replacing the real-time event stream with overnight or minimum batch processing at an appropriate cadence 2. Alternative data transfer: Instead of a complex event queue, clinics could potentially push completed forms using a simpler, secure mechanism, such as an SSH/SFTP connection 3. API option: Team should also explore whether a standard, lightweight API endpoint could achieve the same reliable data ingestion with less operational overhead than the current event-based model * This discussion is intended to ensure the architecture is scaled to the actual service volume, balancing technical needs with long-term simplicity and cost-effectiveness ## **12. Make new source code open** ### **Decision** The service was rated **green** for point 12 of the Standard. **Optional advice to help the service team continually improve the service:** * To further enhance collaboration and facilitate future deployment we propose expanding this commitment to include the **Infrastructure-as-Code (IaC)** used to provision the service * This approach should be manageable. While the team must obviously **exclude sensitive files** (like environment variables, API secrets, and encryption keys), the core IaC files (such as Terraform) that describe the structure and configuration of the servers, databases, and networking components can be released under the open license. This provides immense value to the community without exposing any security-critical information * For the open-sourced code and IaC to be usable by other teams developing similar services, we must ensure they are accompanied by robust and user-centric documentation. This documentation should include: * **A high-level architecture overview:** A clear explanation of how the service components fit together (application code, database, networking, and IaC) * **A comprehensive 'How-To' guide:** This guide should include a clear, step-by-step pathway for a new user to successfully deploy and run the service locally or in a sandbox environment. The documentation should provide concrete examples that demonstrate common use cases, such as: - how to spin up a minimal version of this service in AWS using the provided Terraform - how to integrate a new backend API into the existing architecture. - how to run the unit and integration tests locally * The team will truly maximise the benefit of their open approach, significantly lowering the barrier to entry for collaboration and reuse ## **13. Use and contribute to open standards, common components and patterns** ### **Decision** The service was rated **green** for point 13 of the Standard. ## **14. Operate a reliable service** ### **Decision** The service was rated **green** for point 14 of the Standard. ## **Next Steps** This service can now move into a public beta phase, subject to addressing the amber points within three months time and GDS spend approval. This service now has permission to launch on a GOV.UK service domain with a beta banner. These instructions explain how to set up your *.service.gov.uk domain.

Independent review into prevalence and support for mental health conditions, ADHD and autism published

Independent review into prevalence and support for mental health conditions, ADHD and autism published

NHS England pay packages are, on average, more than 15 per cent, or £9,500, higher than in the Department of Health and Social Care, an analysis by HSJ has found.

**From:** DHSC **Assessment date:** 25/06/2026 **Stage:** Live assessment **Result:** Green **Service provider:** NHS Business Service Authority (BSA) ## **Service description** The Request a Baby Loss Certificate service was born out of the Pregnancy Loss Review. Currently, there is no formal recognition of baby losses prior to 24 weeks gestation, leaving some bereaved parents struggling to find closure. DHSC commissioned NHSBSA to create the service to fill this gap. It is an online application form which, upon successful completion, results in a physical certificate of loss. The aim is to provide recognition of a life lost and to provide comfort to bereaved parents. It is an optional service, and it is not a legal document. ## **Service users** ###### This service is for... Anyone who has a parental relationship to a baby which was lost before 24 weeks of pregnancy who lives in England and their baby loss was in England. **High level user needs this service aims to meet** : * As a user, I need a certificate to commemorate my baby's life after they have passed * As a user, I need to do this using a service which is easy to find, access and complete * As a user, I need to know where to find answers to my questions about my certificate * As a user, I need the option of adding the details that are important to me on the certificate * As a user, I need to know what to do if there are any problems or difficulties I experience when completing my application * As a user, I need to be able to complete this form without causing myself or others additional distress ## Report contents 1. Understand users and their needs 2. Solve a whole problem for users 3. Provide a joined-up experience across all channels 4. Make the service simple to use 5. Make sure everyone can use the service 6. Have a multidisciplinary team 7. Use agile ways of working 8. Iterate and improve frequently 9. Create a secure service which protects users’ privacy 10. Define what success looks like and publish performance data 11. Choose the right tools and technology 12. Make new source code open 13. Use and contribute to open standards, common components and patterns 14. Operate a reliable service ## **1. Understand users and their needs** ### **Decision** The service was rated **green** for point 1 of the Standard. **Optional advice to help the service team continually improve the service:** * The panel support the team’s plan to continue researching with groups that have had limited representation in the sample so far including other parents and surrogates to ensure all user needs are considered. * The team are doing a lot to follow an inclusive approach to research, but it would be advisable to conduct in-person as well as remote research to include users who may be excluded from remote only methods. ## **2. Solve a whole problem for users** ### **Decision** The service was rated **green** for point 2 of the Standard. **Optional advice to help the service team continually improve the service:** * This service works across two departments NHSBSA and DHSC and is currently working well. As the project moves into Live, continue to ensure the recommendations and responsibilities are clear between the two. ## **3. Provide a joined-up experience across all channels** ### **Decision** The service was rated **green** for point 3 of the Standard. **Optional advice to help the service team continually improve the service:** * While the service does well signposting resources such as relevant charities, it could do more to signpost within their own adjacent information pages. For example, the NHS has an information page about ectopic pregnancy. There could be NHS-owned pages that are appropriate to signpost this service that are worth considering. ## **4. Make the service simple to use** ### **Decision** The service was rated **green** for point 4 of the Standard. ## **5. Make sure everyone can use the service** ### **Decision** The service was rated **green** for point 5 of the Standard. **Optional advice to help the service team continually improve the service****:****** * There is no provision for Welsh users, and the team has done an initial discovery on this. Continue to make progress so that all devolved nations have an opportunity to use this service or similar. ## **6. Have a multidisciplinary team** ### **Decision** The service was rated **green** for point 6 of the Standard. ## **7. Use agile ways of working** ### **Decision** The service was rated **green** ****for point 7 of the Standard. ## **8. Iterate and improve frequently** ### **Decision** The service was rated **green** ****for point 8 of the Standard. ## **9. Create a secure service which protects users’ privacy** ### **Decision** The service was rated **green** for point 9 of the Standard. The team demonstrated a strong and proportionate approach to security and privacy for a service handling sensitive personal information. Evidence provided during assessment gave confidence that both platform-level and service-level controls have been considered and implemented. **Optional advice to help the service team continually improve the service:****** * Whilst no significant concerns were identified, the team should continue to mature its monitoring and assurance approach as the service moves into longer-term operational support. In particular, periodic review of privileged access, audit retention, anomalous access monitoring and investigation capabilities will help ensure security controls remain effective as the service evolves and user volumes, features and operating models change. ## **10. Define what success looks like and publish performance data** ### **Decision** The service was rated **green** for point 10 of the Standard. The existing KPIs are useful, but they do not provide a sufficiently strong view of user outcomes, journey friction, service quality or improvement priorities. We should retain operational SLA measures but introduce a more decision-focused KPI framework that demonstrates whether the service is delivering timely and accurate recognition to bereaved parents, where users are encountering difficulties, and where investment or service improvements should be targeted. **Optional advice to help the service team continually improve the service:** * the panel’s **strongest** recommendation would be to replace the current "completion rate" with separate measures for: * digital journey conversion * submitted-to-issued conversion * resolved application outcome mix For example: This would provide business owners and service managers with a clearer understanding of what happens to applications once they enter the service, enabling more informed decisions about where users are struggling, and where improvement efforts should be focused. The team may also wish to consider whether additional measures could add value, such as: * unhappy path completion rate * average time from journey start to submission * application drop-off by journey stage The panel not necessarily recommending these as formal KPIs; however, it would be useful for team to explore whether they provide actionable insights that support decision-making. ## **11. Choose the right tools and technology** ### **Decision** The service was rated **green** for point 11 of the Standard. The team has consciously chosen technologies that fit the problem rather than over-engineering the solution. The team demonstrated that its technology choices are aligned to the service's needs and operating model. The architecture makes effective use of managed cloud services and a decoupled design. The use of SQS to separate user-facing journeys from downstream fulfilment processes provides an appropriate buffer against failures or delays in dependent services and supports efficient event-driven processing. **Optional advice to help the service team continually improve the service****:** * As the service continues to mature, the team should continue to periodically review technology choices, service dependencies and operational costs to ensure the architecture remains sustainable, cost-effective and aligned to future service needs. ## **12. Make new source code open** ### **Decision** The service was rated **green** for point 12 of the Standard. The greatest value is realised not through publication alone, but through enabling successful reuse. The team has made positive progress towards open sourcing service code. **Optional advice to help the service team continually improve the service:****** * To maximise the value of this work: 1. The team should improve discoverability through appropriate tagging, clear repository descriptions and supporting documentation. Documentation should focus not only on how the solution was built, but also on how other teams can adopt, configure and adapt the components within their own services. 2. Repositories should be supported by clear README documentation covering architecture, prerequisites, deployment considerations and step-by-step guidance for adoption and adaptation. This will maximise the practical value of open sourcing and increase the likelihood that other teams can successfully reuse the work rather than recreate similar solutions independently. ## **13. Use and contribute to open standards, common components and patterns** ## **Decision** The service was rated **green** for point 13 of the Standard. The team demonstrated appropriate use of open standards, common components and established patterns. Technology decisions prioritised reuse of proven capabilities over bespoke implementation, helping to reduce delivery risk and ongoing support overhead. **Optional advice to help the service team continually improve the service****:** * Whilst the service has made effective use of existing common components, the team should seek opportunities to identify reusable capabilities developed as part of the service and package them for wider organisational reuse. For example, print-and-dispatch integration patterns, operational processes and supporting documentation could potentially provide value to other services with similar fulfilment requirements. Doing so would extend the benefits of reuse beyond consumption of common components and contribute reusable patterns back into the wider organisation. ## **14. Operate a reliable service** ### **Decision** The service was rated **green** for point 14 of the Standard. The team demonstrated a pragmatic and proportionate approach to service reliability. Resilience considerations have been built into the architecture through the use of multi-AZ deployment, clearly defined recovery objectives, monitoring and alerting, operational runbooks and a decoupled design that reduces dependency on downstream systems. The approach appears appropriately aligned to the service's criticality and operational needs, avoiding unnecessary complexity whilst maintaining an appropriate level of resilience. **Optional advice to help the service team continually improve the service:****** * As the service continues to mature, the team should ensure disaster recovery arrangements are exercised on a regular basis to validate recovery procedures, recovery objectives and operational readiness. For a service of this nature, a six-monthly disaster recovery exercise would provide ongoing assurance that recovery plans remain effective and reflect any changes to the service, team or supporting infrastructure. ## Next Steps ### Green - Live This service can now move into a Live phase, subject to getting approval from the GDS spend control team. The team should repeat the development phases (Discovery, Alpha, Beta and Live) for smaller pieces of work as the service continues running, following spend control processes as necessary.