The client is a large NHS Commissioning Support Unit (CSU) responsible for providing high-quality and cost-effective healthcare service solutions across the UK. The organisation works as a partner to commissioners and providers to deliver unprecedented transformational change. It develops integrated systems and models of care, to ensure efficiency and deliver outstanding customer satisfaction.
The client had developed a treatment register for Hepatitis C patients, using an SQL database format, containing patient details and information about any treatment they are receiving and the outcomes of that treatment. The client needed a way to efficiently and accurately capture metrics to support the viability of patient treatment, whilst ensuring that all records are held securely, are accurate and are transferable between clinicians in different regions if the patient moved.
During ROQ’s initial planning phase, it became clear that there had been a significant lack of clinician involvement in the process which was hindering the potential effectiveness of the product. The software developers were working remotely, not only from the client, but from one another, and had insufficient insight and data to build a database that was fit for purpose. The client also had nothing in the way of a process to track defects or fixes, and no release management process which meant a lack of consistency in releasing fixes or enhancements.
Due to the lack of an existing test strategy, a robust functional test plan was initially created by the ROQ team, which clearly defined and documented the approach to testing that would be undertaken, the format within which the test cases were to be documented and reported against and a clear process for handling defects.
ROQ had to approach this initial phase of testing using logic and common sense, rather than carrying out testing against structured business requirements, as limited information of this type was available at this stage. A risk based exploratory testing approach was used, utilising a consolidated execution charter to track the functional processes that were being exercised. This also enabled a reference point for any defects identified.
It was important to sensitively build relationships with the developers and to ensure they understood why the functional testing was needed, how it was to be implemented, and what the impact would be to the overall success of the CSU’s work in this area. With a focus on knowledge sharing and collaboration, ROQ was able to engage effectively with the developers to create a workable, mutually beneficial solution.
Following the success of the functional test phase, it was agreed with the Client that a formal phase of User Acceptance Testing would be required to facilitate a positive reception for the go-live of the application. To instigate this phase, ROQ approached the end-user clinicians directly to explain the details of the project and to seek support from them. With medical professionals notoriously being short of time, ROQ defined the user experience (UX) test criteria, then presented it to the clinicians for their input and critique, making the process more efficient and demanding less time from the busy medical staff.
ROQ identified a number of high severity and priority defects that, had they not been detected, would have hindered the functionality of the application, impacting on the end user’s ability to manage patient needs effectively, which would ultimately have a negative impact on clients.
The ROQ team implemented a release management process and defect management process using Spiratest, but it was developed to be tool agnostic to ensure that the client could apply any tool of their choice in the future, saving time and money.
To support the testing, ROQ utilised the NHS Number Generator and Validator Service to generate replica NHS identities. This ensured that results were accurate, without compromising sensitive patient information; a practice that can be adopted for future projects.
Despite the project initially running behind schedule, by introducing a focussed test framework and engaging effectively across all parties, ROQ managed to ensure the project was delivered to the agreed go-live date.