Support vaccinating children in post-16 education

Author: paulrobertlloyd

app/controllers/patient.js

@@ -36,9 +36,10 @@ export const patientController = {
 
     const patient = Patient.findOne(patient_uuid, data)
 
-    const recordTitle = patient.post16
-      ? __('patient.label').replace('Child', 'Patient')
-      : __('patient.label')
+    const recordTitle =
+      patient?.age >= 18
+        ? __('patient.label').replace('Child', 'Patient')
+        : __('patient.label')
 
     response.locals.patient = patient
 
@@ -190,11 +191,11 @@ export const patientController = {
 
     // Filter by display option
     for (const key of [
+      'agedOutOfProgrammes',
       'archived',
       'hasImpairment',
       'hasAdjustment',
-      'hasMissingNhsNumber',
-      'post16'
+      'hasMissingNhsNumber'
     ]) {
       if (option?.includes(key)) {
         results = results.filter((patient) => patient[key])
@@ -224,7 +225,7 @@ export const patientController = {
     }))
 
     // Year group filter options
-    response.locals.yearGroupItems = [...Array(12).keys()].map((yearGroup) => ({
+    response.locals.yearGroupItems = [...Array(14).keys()].map((yearGroup) => ({
       text: formatYearGroup(yearGroup),
       value: yearGroup,
       checked: yearGroups?.includes(yearGroup) ?? false

app/controllers/reply.js

@@ -63,15 +63,23 @@ export const replyController = {
         patient_uuid: patientSession.patient.uuid,
         programme_id: patientSession.programme.id,
         session_id: patientSession.session.id,
-        createdBy_uid: account.uid
+        createdBy_uid: account.uid,
+        selfConsent: patientSession?.patient?.post16
       },
       data
     )
 
     // TODO: Use presenter
     const reply = new Reply(createdReply, data)
 
-    response.redirect(`${reply.uri}/new/respondent`)
+    let next
+    if (patientSession?.patient?.post16) {
+      next = `${reply.uri}/new/decision`
+    } else {
+      next = `${reply.uri}/new/respondent`
+    }
+
+    response.redirect(next)
   },
 
   update(type) {
@@ -180,10 +188,6 @@ export const replyController = {
       response.locals.reply = new Reply(reply, data)
       response.locals.patient = patientSession.patient
 
-      // Child can self consent if assessed as Gillick competent
-      const canSelfConsent =
-        patientSession.gillick?.competent === GillickCompetent.True
-
       // Only ask for programme if more than 1 administered in a session
       const isMultiProgrammeSession =
         patientSession.session.programmes.length > 1
@@ -215,7 +219,7 @@ export const replyController = {
           [`/${reply_uuid}/${type}/programme`]: {}
         }),
         [`/${reply_uuid}/${type}/decision`]: {
-          [`/${reply_uuid}/${type}/${reply?.selfConsent ? 'notify-parent' : 'health-answers'}`]:
+          [`/${reply_uuid}/${type}/${reply?.selfConsent && !patientSession.patient.post16 ? 'notify-parent' : 'health-answers'}`]:
             {
               data: 'reply.decision',
               value: ReplyDecision.Given
@@ -291,9 +295,10 @@ export const replyController = {
         )
       }
 
-      if (canSelfConsent) {
+      // Child can self consent if assessed as Gillick competent
+      if (patientSession.gillick?.competent === GillickCompetent.True) {
         response.locals.respondentItems.unshift({
-          text: 'Child (Gillick competent)',
+          text: `${reply?.patient?.fullName} (child)`,
           value: 'self'
         })
       }

app/controllers/school.js

@@ -204,11 +204,11 @@ export const schoolController = {
 
     // Filter by display option
     for (const key of [
+      'agedOutOfProgrammes',
       'archived',
       'hasImpairment',
       'hasAdjustment',
-      'hasMissingNhsNumber',
-      'post16'
+      'hasMissingNhsNumber'
     ]) {
       if (option?.includes(key)) {
         results = results.filter((patient) => patient[key])

app/controllers/session.js

@@ -337,11 +337,11 @@ export const sessionController = {
 
     // Filter patient by display option
     for (const key of [
+      'agedOutOfProgrammes',
       'archived',
       'hasImpairment',
       'hasAdjustment',
-      'hasMissingNhsNumber',
-      'post16'
+      'hasMissingNhsNumber'
     ]) {
       if (option?.includes(key)) {
         results = results.filter(({ patient }) => patient[key])

app/datasets/activity.js

@@ -7,9 +7,9 @@ export default {
     absent: (session) => `Absent from session at ${session.location.name}`
   },
   consent: {
-    created: ({ decision, parent, selfConsent }) =>
+    created: ({ child, decision, parent, selfConsent }) =>
       selfConsent
-        ? `${decision} by child (Gillick competent)`
+        ? `${decision} by ${child?.fullName} (child)`
         : `${decision} by ${parent.fullNameAndRelationship}`,
     updated: ({ decision, parent }) =>
       `${decision} in updated response from ${parent.fullNameAndRelationship}`,

app/enums.js

@@ -352,6 +352,7 @@ export const PatientClinicStatus = {
  * @enum {string}
  */
 export const PatientConsentStatus = {
+  SelfConsent: 'Can self-consent',
   NotScheduled: 'No request scheduled',
   Scheduled: 'Request scheduled',
   NoDetails: 'No contact details',

app/generators/child.js

@@ -111,7 +111,9 @@ export function generateChild() {
       { value: 12, weight: 8 },
       { value: 13, weight: 4 },
       { value: 14, weight: 2 },
-      { value: 15, weight: 1 }
+      { value: 15, weight: 1 },
+      { value: 16, weight: 1 },
+      { value: 17, weight: 1 }
     ])
 
     // Calculate birth year
@@ -131,9 +133,15 @@ export function generateChild() {
     school_id = faker.helpers.arrayElement(['888888', '999999'])
   }
 
-  // Add examples of children who have aged out (over 16)
+  // Add examples of children in post-16 education
   if (faker.datatype.boolean(0.05)) {
     dob = faker.date.birthdate({ min: 17, max: 18, mode: 'age' })
+    school_id = '888888'
+  }
+
+  // Add examples of children who have aged out (over 18)
+  if (faker.datatype.boolean(0.1)) {
+    dob = faker.date.birthdate({ min: 19, max: 21, mode: 'age' })
     school_id = ''
   }
 

app/locales/en.js

@@ -1414,7 +1414,7 @@ export const en = {
       hasAdjustment: 'Children needing reasonable adjustments',
       hasImpairment: 'Children with impairments',
       hasMissingNhsNumber: 'Children missing an NHS number',
-      post16: 'Children aged out of programmes'
+      agedOutOfProgrammes: 'Children aged out of programmes'
     },
     archiveReason: {
       label: 'Reason archived'
@@ -1440,8 +1440,8 @@ export const en = {
     hasMissingNhsNumber: {
       label: 'Missing NHS number'
     },
-    post16: {
-      label: 'Over 16 years old?',
+    agedOutOfProgrammes: {
+      label: 'Aged out of programmes?',
       status:
         '{{patient.fullName}} is no longer eligible for school age immunisations'
     },

app/models/child.js

@@ -179,12 +179,22 @@ export class Child {
   }
 
   /**
-   * Is the child over the age of 16?
+   * Is the child aged 16 or over?
+   * Children over the age of 16 can self-consent
    *
-   * @returns {boolean} Child is over the age of 16
+   * @returns {boolean} Child is aged 16 or over
    */
   get post16() {
-    return this.age >= 17
+    return this.age >= 16
+  }
+
+  /**
+   * Is the child still eligible for SAIS vaccinations?
+   *
+   * @returns {boolean} Child still eligible for SAIS vaccinations
+   */
+  get agedOutOfProgrammes() {
+    return this.age >= 18
   }
 
   /**
@@ -193,7 +203,7 @@ export class Child {
    * @returns {number|undefined} Year group, for example 8
    */
   get yearGroup() {
-    if (!this.post16) {
+    if (!this.agedOutOfProgrammes) {
       return getYearGroup(this.dob)
     }
   }
@@ -283,7 +293,7 @@ export class Child {
         Object.values(this.address)
           .filter((string) => string)
           .join('<br>'),
-      ...(!this.post16 && {
+      ...(!this.agedOutOfProgrammes && {
         yearGroup,
         yearGroupWithRegistration:
           this.registrationGroup && yearGroup

app/models/patient-programme.js

@@ -219,7 +219,7 @@ export class PatientProgramme {
         }
       }
       case PatientStatus.Consent:
-        return !this.patient?.hasNoContactDetails
+        return !this.patient?.hasNoContactDetails || this.patient.post16
       case PatientStatus.Refused:
         return (
           this.lastPatientSession?.patientRefused ===
@@ -270,7 +270,10 @@ export class PatientProgramme {
    * @returns {boolean} Eligible for programme
    */
   get eligible() {
-    return getCurrentAcademicYear() >= this.year
+    return (
+      !this.patient?.agedOutOfProgrammes &&
+      getCurrentAcademicYear() >= this.year
+    )
   }
 
   /**
@@ -507,7 +510,7 @@ export class PatientProgramme {
   get statusNotes() {
     switch (this.status) {
       case PatientStatus.Ineligible:
-        return this.patient.post16
+        return this.patient?.agedOutOfProgrammes
           ? 'Not eligible for school age immunisation'
           : `Eligible from 1 September ${this.year}`
       case PatientStatus.Vaccinated: