Digitising Family Deployment

THE CHALLENGE

SSAFA, the Armed Forces charity, recognise the first five years of a child’s life as being the most important for health and happiness in adulthood and with this in mind were looking to make it easier for parents and their children as they are posted overseas by providing an enhanced digital service that supports SSAFA in the delivery of Community Health Services to these families particularly during periods of transition.

The military population is a highly mobile population often moving on a 2-3 yearly basis into and out of the UK.  Within this, serving spouses can be away from the family unit for significant lengths of time. 

SSAFA support and provide Community Health Services, such as Health Visiting services for UK families posted abroad. Parents can often find out at short notice that they are being deployed and the SSAFA Community Health Service in the destination country, is not always aware of their full family situation in advance of their arrival.  The lack of interoperability of medical record systems often means that no medical notes are able to accompany the family on their move and delay in accessing historical information is variable.

At the point of posting SSAFA identified a need to be able to collect health information digitally from parents about to deploy to British Forces overseas bases in a safe and secure way. This may include information about a pregnancy, immunisation data or information on any specialised support they may have been receiving in the UK, it is also useful to include any worries or anxieties parents may have about their move.

During the period leading up to the posting, SSAFA wanted to be able to communicate with parents, in order to send them relevant information about their new location, how to access services and to be able to signpost to services they may need on arrival. Once in their new location, SSAFA Community Health staff need to be able to contact parents to send further relevant information and enable them to access local services.

This project has enabled SSAFA Community Health staff to deliver more fully against the Military Covenant ensuring that families posted overseas get the same access to services, underpinned by the same access to health data, as their civilian counterparts in the UK.

“The ability to act on information provided in the questionnaires and contact parents ahead of their arrival can be invaluable.  It provides an opportunity for parents to ask questions, book appointments for their arrival and gain some reassurance, smoothing the transition for themselves as well as their families.”

Ceri Henderson, Health Visitor, SSAFA

THE CLIENT

SSAFA is a tri-service military charity which supports serving personnel, veterans and their families.  SSAFA also has a commercial arm which provides community health services to military families posted overseas and social work services to RAF personnel in the UK, both under contract to the Ministry of Defence. 

SSAFA, along and in collaboration with NHS England, London Region have led the way for parent-held digital health records for children under 5 years. SSAFA and Sitekit have a history of working together to deliver this innovation for parents in military communities overseas by designing a product that addresses the particular requirements of this group and were shortlisted for an HSJ award for “Healthtech Partnership of the Year” in 2019.

THE SOLUTION

Sitekit ultimately added features to eRedbook and eRedbook Pro that enable Health Professionals working with military families to manage the unique complications provided by deployment. 

Sitekit collaborated with SSAFA to develop a design for custom features to be added to eRedbook to enable the secure and controlled flow of data from parents using eRedbook to their health visitors and other members of the community health team. This collaboration included analysis of the existing manual process, understanding how and where digital tools could improve the process, then designing the required features and alterations needed. SSAFA provided Sitekit with access to relevant staff members and provided a clear outline of their current processes. Close collaborative working made it  possible to design the successful new process.

At the centre of the development was the capability for a parent to sign up for eRedbook, enter information about where they were about to move to and then receive information from the SSAFA Community Health Team in the destination location.

The new functionality allows professional users, with the appropriate user permissions, to send questionnaires to the child’s eRedbook record. The questionnaires are fully configurable by the SSAFA Community Health Team in the destination country enabling SSAFA to request key relevant information ahead of the families move in order to improve the quality of their transition. 

The questionnaires are child based not family based, and can be targeted by age of child, attribute and location. Parents can include health information, such as immunisation history, weights etc in their response to the questionnaire directly from the child’s eRedbook record without having to retype it.

Once the parents have completed the questionnaire it can be viewed in eRedbook Pro where the SSAFA staff in the destination country can review and plan in advance of their arrival in their new location. This enables the Community Health Team to prioritise and plan support for families early and seamlessly before  arrival supporting  transition  and often reducing anxiety and increasing a sense of well-being.

In the background, FHIR is used to store data created in eRedbook. This ultimately makes the data portable, meeting GDPR requirements, and meaning that the parent could in the future use the data in other FHIR compatible applications. Sitekit and SSAFA are committed to the NHSx interoperability agenda meaning that providers, and parents, remain flexible about which software suppliers they use.

“The work undertaken in partnership with Sitekit demonstrates our commitment to ensuring that our military families have access to the best possible care and support wherever in the world they are posted.  We are extremely proud to be at the forefront of digitising child health records, and also finding innovative solutions to support families during what can be a stressful transition to an overseas posting.”

Jan Dowlen-Gilliland, Director of Community Healthcare Operations, SSAFA

THE OUTCOME

Parents are able to access the information they need during their parenting careers, from trusted sources and based on their child’s age or their stage in pregnancy, wherever they are in the world.

The medium for communication is in a format familiar to the age group that is targeted and can be easily accessed through their phone which is for most of our community a constant companion.

This ability for the SSAFA team to plan for the families’ arrival based on information provided by the families themselves provides the ability to tailor support, plan care and get in contact with families before they arrive, answering questions, providing information and ensuring a seamless transition their new posting, whether this is booking pregnancy scans or immunisations or providing immediate support for anxious or worried mums immediately on arrival.

“Ensuring parents feel they have access to a wide range of trusted sources of advice, is vital for ​children's early development as well as maintaining wellbeing and mental health ​of their parents. To develop this relationship with a digital exchange prior to a move acknowledges the importance of them as a parent, increases confidence in local services available in their new location and enables ​SSAFA Community Health Teams to support at the earliest opportunity by providing information that allows an individual plan to be formulated with their child at the centre of focus.”

Jane Bojdys, Named Safeguarding Professional Lead Public Health Nurse, SSAFA