The PSC case-studies: entry

Case Study - Designing a Real-Time Messaging Service for NHS England

Working with the NHS and Social Care to share information in real-time and design a solution that could save £57m over 10 years

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What was the challenge?

There are circa 800k individuals in England receiving care at home, all at a greater-than-average risk of hospital admission, yet there is currently no system informing care workers of admission occurrences.

Case Study - Designing a Real-Time Messaging Service for NHS England

The PSC user researchers conducting research with social care providers.

NHS England’s Innovation Lab tasked The PSC with conducting a Discovery and Alpha into the creation of a scalable, user-facing solution alerting homecare workers to their client’s location in the event of hospital admission. The solution needed to improve communication between hospitals and care providers, reduce wasted care visits, and improve service user flow and experience.

What did The PSC Digital Team do?

We assessed existing studies, then conducted research via interviews and ethnographic observation of >25 people working in home care, including carers, managers and operations directors. We interviewed staff from local authorities, software providers, acute and emergency care staff, and patient advocacy groups, enabling us to map trigger points, data sources, and identify wider use cases.


We then began iterative development of high-fidelity prototypes, using the NHS prototype kit and adhering to Government Digital Service and NHS style guide, standards and design system. In order to maximise efficiencies, also noting from research that many staff already had 15+ logins, we looked to leverage existing technologies rather than ‘building from scratch’.


We tested our proposed solutions to ascertain usability and viability - ensuring solution interoperability. Our research and pre-existing knowledge of the NHS digital landscape allowed us to prioritise the features most useful to care providers, and to refine the content of proposed notifications.


We were able to specify a technical pilot architecture which utilised existing systems and messaging formats where possible (e.g. HL7v2 ADT messages), carrying out detailed profiling of FHIR messages where required. 


We developed an open-source technical pilot using AWS technologies, including a Django-based administration portal hosted on Elastic Container Service (ECS) and an API-first backend using API Gateway and Lambda serverless technologies.


What did NHS England achieve?

  • NHS England left with a working technical solution alongside relevant documentation such as Data Protection Impact Assessments (DPIA) and clinical safety governance documentation.

  • Economic projections calculate that the solution will provide potential savings of £57 million over 10 years, and be fully compatible with WCAG accessibility requirements.

  • The solution is awaiting final approvals before proceeding to a live pilot launch.


The PSC exists to make public services brilliant. We work with our clients, using data science and user centred-design to co-create new digital services, ensuring they deliver strong financial results, are in harmony with teams and working practices, and include everyone. If you would like to speak to our Digital Team please email: or contact us

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