In November of 2020, the country’s GPs were about to embark on the largest vaccination programme in British history - but their usual process of contacting patients one by one to book them in wasn’t going to provide them with the necessary scale and speed.
In December, accuRx launched its vaccine booking solution which has since supported 1 in 3 vaccinations nationally.
This session will relive what happened in those 4 short weeks, and reflect on some of the factors that led to the product being such a success - as well as some of the unintended consequences of delivering something so quickly
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Thank you so much for that intro. Not sure about the bit about not wanting to be the speaker after lunch, so I don't really feel like that set me up for success, but here we go. So, yeah, I'm here to talk about how to build a company, that responds quickly to opportunities as well as saving not the world, but ten thousand lives in the process.
But before we get into some of that, I wanna kind of touch on some of the points I'm gonna go through today. I'm gonna start out with who I am and why I'm here, start with the basics before we get into anything else.
And then I'm gonna go through kind of some of the reflections I've had on building this product just under a year ago now that I think really helped us in that success. The first one is don't wait to be told what to build.
Resilient teams can pivot quickly and acting fast as problems arise. These are the things that I think really, really helped us. And also, there's lots of people from Accurix here. I'd get told off if I didn't also say to you that Accurix is high, so I'll tell you a bit more about that at the end as well.
But first thing first, who am I? I'm Jen. I started out in working for different charities and nonprofits in the UK, really trying to figure out how to make the donor experience as good as it could be. So kind of like users, we had donors, people that were donating to charities.
How do we make sure that interacting with our brand was really good, and they had a great time parting with their hard earned cash? And from there, I moved into a startup called Lightful, employee number four. So a really, really small startup. And what we were trying to do there was help charities with their social and digital fundraising.
They weren't very good at it, so we're really trying to help them out there. I started out in customer success, and then like anyone else I know that works in product, I kind of fell into product management. So I moved over to being a product manager there, and then eighteen months ago, moved over to Accurix, where I was a product manager, and now I'm a product director.
So I've worked on a few different features and products in my time at Accurix, and I'm here to talk to you about one of them, which is this one. So my team built a product that helped over twenty million people in England and the UK get their COVID nineteen vaccinations.
And we also had a part in accelerating that rollout in the UK as well. And this might seem a bit of a bold claim, but I definitely stand by it. I'll talk to you a bit about what the alternatives were. And this was something that we really, really helped with that ramp up.
So let's go through a couple of the bits there. So this is AccuBook, one of the most important products that you've probably never heard of, and you definitely won't have seen this bit even if you have heard of it. So this was really where GPs were logging in.
So people in general practice, primary care, they were uploading lists of patients, sending out texts to loads of patients at once, and then they were getting them to book in through themselves and manually booking those people that hadn't followed up. But you may have used it.
If you ever got a text to book in for your COVID nineteen vaccinations, the chances are that was from us. In fact, if you had have a text from your GP, chances are that was from Accurix. That is what we did beforehand and what we still do today.
So that kind of text system was something we already had that so sets us up really, really well to build something on top of that. So that was us. This is what that text kind of looked like. And through Accubook counting, so we're still getting people booked in for boosters.
At last count, twenty four point two million people had had their vaccines booked through Accubook. And like I said at the beginning, over ten thousand lives saved. So that's trying to figure out how many vaccines saved a life. Rough calculations. It's definitely over that, but here we are.
And so let's go back to the beginning. This all started about a year ago now. You may remember some of these headlines that were coming out about what was going to be the first vaccine to get approved, what did that look like, how are we going to get people booked in, and these kind of glimmers of hope almost that we could come out of lockdown, see our friends again, and go to the pub, which is all very, very exciting.
But GPs were actually given not that much notice for getting involved and how they were going to play such a massive pivotal part in the delivery. You can see here, given ten days notice for the vaccine rollout, and they were going to be the main delivery sites.
They were going to be the most important part of this, especially in England, but they didn't have much time to get ready to start doing that. And also, they'd never done this before. This vaccination rollout was the the first the biggest of its kind in the UK, and no one had ever done anything at this scale before.
So when we started talking to GPs about how they were going to try and do this, as well as deliver their services at the same time, this kind of quote came up more than once of we don't have the tech to do this.
We don't know how we're going to do this. So their only option was people. This might be a bit of an exaggeration, this image, but it's actually not that far from the truth. What they plan to do is have people on phones, calling patients to get them booked in one by one, And that was kind of the more tech savvy ones amongst them.
Otherwise, it was going to be letters. Send out a letter to a patient with an appointment time, and if they couldn't make that time, well, tough luck. They'd have to go around again and start again. And so we knew that this wasn't something that was going to scale.
It wasn't something that was going to be quick enough to get as many people booked in as we knew they needed to at the speed necessary. And we knew there had to be a better way to do this. So we wrote a write a white paper, as you can see here, even before we started to build anything that was really trying to figure out what we thought would be kind of a better way to do this, a quicker way to do this, more efficient.
And so we were thinking about things like maybe patients could book themselves in. Maybe you could send them a text, and they could choose a slot from a long list. And that would mean that the uptake would maybe be better because they could pick a time that suited them.
And maybe that meant that the DNA rates or do not attend rates would be lower. So how might we use software to try and make this quicker, faster, more efficient, and easier? But we had a challenge. The timelines here were really, really tight.
So we started talking to practices in November, the start of November. And we made that decision to build Accubook on the thirteenth of November. But we also knew we had to have something live by the first of January. So this new year, which was when the national vaccine program is really going to ramp up.
It was when people really starting to get vaccines to GP practices across the country. So we knew we had to have something live by them, which left us seven weeks in the beginning to start out figuring out what we were going to build, design it, actually build it and get people rolled out and get people set up on it.
But because of some of the stuff I'm going to talk about today, we were actually set up really well, and we got something live before that. So we did a demo webinar to hundreds of GPs on the fifth of December, which was kind of showing them a bit of a shonky prototype, but it kind of worked.
And then on the tenth of December, we were actually ready to go live with our MVP and get the first people booked in. And by the fifteenth, we had over ten thousand patients booked in. So that meant that we weren't just there for the massive ramp up of the national program, but also the kind of pilot sites.
So the first GP practices that were there to get the vaccines, we were there to help them as well. And they didn't have to use other more manual processes in the meantime. So I covered these at the beginning, but I want to go back to these three kind of learnings that I've had over the last year and reflecting on this really of what I think helped us to do this so quickly.
Don't wait to be told what to build, resilient teams can pivot quickly and acting fast as problems arise. So digging into that first one a little bit more, don't wait to be told what to bill. We are experts in the field of primary care.
This is something like I said, we've been doing for a few years now. We're set up in twenty sixteen. And so we've definitely lived the lives of our GP practice users. We go on visits with them all the time. We do user research calls. And we also hire doctors.
So this is Vivek, Satya and Lucy, and they are three people who we hire as our clinical leads, but they're also practicing medicine at the same time. So it's amazing to have that almost instant validation of the stuff that we're talking about. And Vivek, on the left there, is a GP.
So when we were thinking about what to build to act for Accubook, we could say to him, we're thinking about doing this thing. And he could quite quickly say if that was something that would solve a problem or we were building something ridiculous and barking completely up the wrong tree.
So having that kind of instant validation for our thoughts right at the beginning was massively, massively helpful. And user research really is the backbone of our product process. It really is how we start out with any feature or product build. I haven't built anything at Accurix without going to talk to users first and having a conversation about their current problems and how we might look to solve them for them.
By the way, this is a product called Dovetail, which some of you may use. It's really helpful for kind of keeping all of our user research recordings and tags and all things like that to have a digital record to come back to later, which is massively helpful for us.
You can see here kind of some of the things that GPs were thinking about when we started talking about to them. But there was an issue this time around. Like I said before, no one had done this before. So it's really, really hard to do user research for something that people hadn't done yet.
So when we were going out and we had our discussion guides and we had the questions we wanted to ask, these were some of the answers we were getting back. Or we're not sure yet. We're getting told soon. Or we have no idea what the DNA did not attend rate would be.
We're thinking low. We'll copy what we've done for other stuff. So we couldn't actually go to our users and use what they're telling us to build. We had to try and figure it out ourselves. So as well as being experts in the field, we also make sure we were experts on the topic.
So even before, again, this white paper, before we decided to build anything, we knew intimately what was going to happen and some of the facts that we already had about the vaccination rollout and how it was going to work. I know intimately the differences between Pfizer and AstraZeneca, the gaps between the two, which temperatures you have to store each of them at, some of the supply chain issues.
Luckily, I've repressed a lot of that information now and put it to the back of my mind, but at the time, I knew everything about the rollout. And that was really, really important for us because, like I said, GPs didn't really know what they were going to be doing, so they were really experimenting with different methods.
And if we tried to build something that was going to work for everyone and everyone's ways of working, then it would have worked for no one and solve no one's problems. So we had to be really clear in our kind of opinionated best practice approach and kind of be the guiding people to say, this is how you should do it and get people to follow us.
And it paid off. So in that timeline, you saw in the four days, we got ten thousand patients booked in. And what we saw immediately was that word-of-mouth spread. So people saying, I've just heard from my friend who's a GP who's using this.
We need to use this now. And that kind of ramped up and that usage is still there to this day. People are still using Accubook to book in for their boosters jabs because it solved all their problems for them at the beginning. So that was very much around the kind of what how we decided what to build and how we decided what the product would be.
What about the people within that team? What about the people who did build it? So this team structure might look quite familiar. It's a cross functional team. We've got I was the product manager in the team. We've got tech lead. We've got the designer who's in that team is in the audience somewhere as well.
Hi, Valentina. And so it's probably familiar. It was an independent unit that could work by itself and didn't really have to have sign off from other people for some of the ways of working that they wanted. So we could choose whether we wanted to do Kanban or sprints or have weekly goals, etcetera.
But really, our teams look more like this. So we give our teams time to be teams. So we encourage them to have team photos and team names. And this is just a couple of examples of some very, very good punny names of our teams.
And for us, it's really important that teams know why they're a team, what their mission is, and why they've been brought together to do a thing. And so we encourage them not just to work on their kind of delivery side, but also work on things like working agreements, figure out how to work with each other, and get to know each other as people.
They also set their own vision, roadmap, and OKRs. And so this is really how they know where they're going. And also not just they know where they're going, but also they can communicate it to the rest of the company as well. This is what we think we're gonna do next.
What do you think? It's a really great communication and alignment tool. And we also found it really important that while we might ask a team to change what it is they're working on, we won't change who it is they're working on that thing with.
So teams don't have ultimate autonomy because there might be something that comes up like a top company priority, a new thing that's a time sensitive opportunity, like Accubook was and like the vaccination program was. But what we didn't do is also break that team up and trying to get that team to work on that thing as well and form this new team over here.
We took one team that were working really well together and we moved them onto a thing, which meant that we already knew a lot about each other and we could really hit the ground running and just start getting **** done. And we also made it really transparent to the rest of the company what it was we were working on.
So this was a post I did in our general channel on Slack, really talking about progress we were making and designs that we were working on, and encouraging people to come and work and join our Slack channel as well, our team Slack channel.
It was important that it was transparent to the rest of the company why we'd made this choice and start working on another thing. And so it was an opportunity for people to ask questions or challenge as well, and also ask if they could help at all.
This was something that I'm kind of talking about my team a lot here, but it was the whole company that were involved in this effort to get this this product live and make it the success it was. And what this all added up to was that the teams had a real high level of psychological safety.
It meant that when I was asking the team if they were ready to go and work on this thing, I knew the answer was going be honest when they said they wanted to do it. And everyone definitely did have a choice. This wasn't something that anyone was forced into, but we had a kind of open and honest communication already going.
And so we were ready to go as soon as we had had the call to say we were going to do it. It's also something that features in our product manager progression framework as well. So we care not just that product managers can work on delivery and visioning, but also that they know how to build good teams.
For example, they can build high performing teams. It's something that we really care about all of our product managers being able to do. And by the way, if you want to know more about this, you can Google it. So our Accurex product progression framework is public.
If you Google it or you can just come and ask me about it, and I'm more than happy to go through any of it with you. So we had the what we wanted to build. We had the who of who was gonna build it, and then what happened.
It wasn't something that was all sunshine and daisies, and everything went perfectly according to plan. So we needed to be able to act fast as problems were arising. And even before we started building, actually, we knew the importance of moving quickly. So you can see here on the left, a meeting invite about a vaccine go, no go.
And so this was a session that was kind of at the end of a week of conversations that our senior leadership team were having around whether we should do this or not. It was a big undertaking for us to take on, and we had to draw that line in the sand for whether or not we were going to go full feet into this or if it's something we decided we weren't going to do.
And then on the left there, there's a message from my VP of product. You can see the timings there. It was six minutes after that meeting ended. I got a message to say vaccine was go. Now I'm not being that fair. I was given more of a heads up than just a Slack message saying vaccine was go.
I was talking to him about it already, but this was just how quickly we knew we had to move. And you can see the second line there popped in a story mapping session for later. So that same day, we got into a room, unfortunately, some of us remote, and we did a story mapping session.
And we used that to decide what would go into our MVP. Now I'm not gonna spend a long time talking about story mapping. If you haven't read Jeff's book, I would highly encourage it. It's a great, great tool, story mapping, to kind of decide what should go into your MVP, what should come later, and it's also a really great communication and alignment tool for stakeholders that you may have.
So we had my CEO and my CTO in this as well, so that everyone was on the same page from the beginning, and we all made that decision together of what was going into our first version and what would have to come later.
And there was tons of stuff that had to come later because we were working on such a short time scale. So we started going. We started building this thing, but it soon became very obvious that the ways of working that we had weren't going to work for this new product and this new thing we had to work on.
So this is a Slack conversation between me and my tech lead, Mike, saying that kind of we had a session, and we tried to do everything together as a team, and it slowed everyone down. So how do we want to change some of these ways of working?
So this is something we did very regularly, kind of review our ways of working and see what would work. So we moved quickly and we found new ways of working that were going to suit us better. So we moved from Mike and I talking twice a week to every day.
I think during that four weeks, I talked more to Mike than I did to my husband, still a bone of contention. And we moved away from weekly goals onto daily goals. So aligning with a whole team around the most important thing that had to happen that day, and that actually might change day to day, both on stuff that we were hearing from our users that was new information or stuff that was being released from kind of external guidelines from NHSE or D or whatever other NHS body we were talking to at that time.
And that might change the priority of stuff we were working on. So this allowed us to be a lot more flexible to say, what do we need to do today? What do we need to do tomorrow? One big learning I had, don't skip retros.
So we skipped a few of our weekly team retros, trying to give the team some time back and trying to give them more time to get head down and building and designing the stuff that they needed to. But what this actually meant was we missed out on some of that information that we really needed.
We began to burn out. Everyone started feeling really overworked and overwhelmed. They we were finding that actually they were working evenings and weekends as well as not being able to take breaks in the day because this was such an intense time of building a product, and it had such a big impact.
Everyone was really motivated about building this thing, but we actually didn't have that expectation at all, and it wasn't necessary for people to work in that way. It's just that we weren't talking about it. So we quickly reestablished our retros. We did one that week, and all of this amazing information came out about how people were feeling and how they were working, stuff they were worried about, stuff they were worried about for the future.
And that set us up really, really well to be able to figure out what we needed to change and quickly as well. So we went ahead and started to reset some of those expectations and make it really clear that we didn't want anyone to be working without breaks.
It was tough as well because we were in the middle of lockdown. So it wasn't like anyone had much else to do, which made it even more easy for them to just keep working all the time. So we set up this new document called a how we're working right now document, which was a bit of a an amendment really to our ways of working document.
And so people were able to say the times of day they were going to be available, when they like to take breaks, and if they had times like family time that they were trying to keep sacred as well. And what this did was really helped us communicate to each other of I'm not around at this time and set really realistic expectations for how people were going to be working going forward and tried to break some of those unsustainable habits that we'd got into.
And this then encouraged more of an open dialogue about it. I love these two examples of two of the engineers on the team talking about these things that they were going and taking breaks, which was great to see. It sounds so simple, but it was something that was really, really good to see after such a intense period of working.
And then the last example I want to talk through here is what happened after we went live. So the product team were really overwhelmed during that build period, but as soon as we went live, it was actually the support team that became overwhelmed.
And you can see here that kind of national uptake that I talked about in January, meaning so many more support requests. So these weren't so much bugs or issues, but things like people who wanted to get up and running, or they had questions about what they should be doing.
Because remember, we'd set ourselves as the experts of this topic. So they had loads of questions for us about how they should be rolling this out. And that meant that the support team were overwhelmed, and they had so many more requests than they would do usually because because everyone was coming to them with these questions.
And they were doing an incredible job of having, again, being the experts on this topic, as well as keeping all of the other information of our other products in their head at the same time. So we doubled the team. We acted quickly, and we made sure we didn't fall into those same things that we did before of unsustainable ways of working.
We acted quick to make sure it didn't happen for the support team. So we hired four people in two days, and they got trained up really, really quickly and got to a place where they were hire they were answering Accubook requests by the end of that week.
So these are just a few examples that I wanted to run through. There's many more examples of how we had to react to kind of external guidelines that changed just over Christmas and things like that, but I'm not going to go into it.
Happy to talk more about it in the Q and A session. So I wanted to go back and recap those kind of three steps that I thought was really, really important for us to have success during this period. Firstly, don't wait to be told what to build.
Resilient teams can pivot really, really quickly and you have to act fast as problems arise. And I also want to end on saying just how incredibly proud we are of what we built. And I'm going to show you some user quotes, not to say again how great we were and how amazing we are, but this was a real, real measure for us of the impact that we were having.
So these user quotes are talking about speed and how much quicker it was for them to use it versus what they were meant to be using. And so that was something that was super important to us and really showed us actually that what we set out to do at the beginning, which was speed up the process, more efficient ways of working to get patients booked in, was something that we actually managed to achieve in those four weeks.
And especially that one in the top right there talks about a thousand vaccines that would have been destroyed because no one else had time to pick it up. Because of our system, they could actually go and pick up those thousand vaccines, and thousand people got vaccinated because of us.
And we had a massive impact as well. So obviously, we weren't the only people involved in the vaccination rollout, but we did play a small part, which we're really proud of. And this is trying to calculate that impact that we did have. So trying to think about how many vaccinations saved lives.
In one week in January, we supported the NHS in giving twenty five thousand extra years of life, which is something that we were all so, so motivated. How can you not be motivated about that? Which is wonderful to work on as a team.
And I know the team that worked on it as well were so proud of being a part of it. And finally, while I'm here, I promised to plug at the end. So like I said at the beginning, I'm from Accurex. We're hiring. There's actually more of us than there are on this slide here now.
I think more people than that are probably here today. And so you can head to our website if you want to see if any of our roles that are open or maybe of interest to you. We've got some technical roles and also some more business facing roles as well.
There's also my Twitter handle there if you want to reach out. So more than more than happy to chat. And that's everything I wanted to go through today. So thank you so much for your time. Head to the q and a if you want to chat later, but otherwise, I'll see you around. Thanks so much.
