Warwickshire software firm's secret success is driving the Covid vaccine programme

THE rollout of Covid-19 vaccines across the country has been widely praised for its organisation and efficiency.

It’s no easy task to handle the data of an entire nation, inviting the right people at the right time to the correct location to receive their jab – and making sure there’s enough stock available to fulfil that day’s quota.

Some of the credit for that vaccination system lies in Stratford-upon-Avon.

And no, we’re not talking about the role played by the town’s MP Nadhim Zahawi, the vaccines minister.

Delve behind the scenes, away from the frontline and the amazing volunteers, beyond the politicians, medics, scientists and drivers, and you’re left with a sophisticated computer software system running the show.

Scrape away the NHS badge and you’ll discover a creation from System C, a software company which has its headquarters in Arden Street.

It’s a bit of a secret that the entire immunisation programme is dependent upon the technical knowhow of System C and its NHS partners at the South Central West Commissioning Support Unit (CSU).

Anyone who knows the company will not be surprised – it has form in the immunisation arena, having created software platforms for the NHS to control children’s inoculations. Its systems are responsible for the data of about seven million children, information that has to be made available to thousands and thousands of GP surgeries, chemists and schools.

System C’s immunisation management system handles the lot, which is why the country came calling when it needed to extend the software structure to drive the Covid-19 vaccination rollout.

But that was not the original task, as Markus Bolton – who set up the firm in 1983 at the age of 26 – explained.

“Right at the beginning of Covid, they realised that if the hospitals were full of flu patients during what they call the winter pressures, it was going to be a disaster as you were going to have Covid and flu patients at the same time.

“People think of flu as something unpleasant, but a lot of people get hospitalised with flu.”

A national flu vaccination programme was needed and because System C had been working with the South Central West Commissioning Support Unit on child vaccinations, the company was seen as the best bet for rapidly turning around a software system.

“We were approached in May/July and asked if it would be possible to do a flu vaccination programme and then, obviously, that very rapidly became a Covid vaccination programme,” said Markus.

In fact, Stratford’s involvement is a double-header.

System C handles the data while its sister company, Graphnet, presents the data dashboards and handles the interfacing, making sure GPs, vaccinations centres and all the others who need to know have access to the rollout information.

“The vaccination programme was done by both companies because there’s two sides to it and we needed both specialist companies to provide it,” said Markus.

The firms, which are run jointly by Markus and his co-chief executive Ian Denley, have an enviable track record in IT – “no screw-ups”.

“The company started off doing hospital electronic patient records and we are the second largest supplier of hospital computer systems,” said Markus. “We have got 33 hospital trusts signed up now.

“We win about half of the deals on that – we’re British and low-cost and we’ve never screwed one up. If you go back over our history, we have never had an IT disaster in 38 years.”

The firm’s software is also used by more than half of the councils in England for their adult and children’s social care systems, while it also provides a system to link together data from hospitals, primary care practices and mental health trusts.

The Covid system is pretty rapid – it will know within 30 minutes when someone has had their jab. But there’s a lot more to it than that.

“We have to be able to take requests about whether someone has been vaccinated or not, when they were vaccinated, when they are due their second vaccination, whether or not a relative ought to be vaccinated, whether they have been invited already,” said Markus.

“We had all sorts of systems that needed to know that information. We had to build an integration system that handles two million requests a day.”

The system also sends you those text messages and is responsible for the reminder you receive in the post – Markus said about 20m letters have been sent out.

But the volumes of data do not seem to have caused Markus any sleepless nights. It was more the demands of getting the system delivered quickly that occupied his hours.

“The reason I was involved personally was because it was so important – and quite political. There were a lot of people to deal with, a lot of different arms of government.

“We had to have a really firm grip on it to get it delivered.

“I had to drop out of running the business to work on it – it very quickly became huge. I didn’t get a day off between the end of May and my first day at home, which was Christmas Day.

“It was really, really full-on for the team. We had quite a large team working on it, all working flat out, and so did the team at our partner, the CSU.

“The challenges were that it had to be done incredibly quickly, that it had to link to information from a shed load of places. That’s quite a chunky piece of software to be able to do that and that had to be ready within 90 days of being asked.”

The system went live in September and was then tweaked and changed as requested, ready to get a nation vaccinated and out of lockdown.

All of System C’s vaccination team are Stratford-based – the firm has about 100 staff in the town and about 800 in all. Their work has also created a system that feeds back side-effects of the vaccines to Public Health England and the MHRA.

But that’s not all. System C has also provided the software behind a Covid testing service (nothing to do with the test-and-trace system) which has helped cut mortality rates.

The system, Markus explained, can forecast who are the people most likely to end up in hospital after a positive Covid test.

“We send out referrals to community matrons, who go out to visit those patients who have tested positive and are at risk. They give them pulse oximeters and an app and three times a day they type in their oxygen levels and how they’re feeling.

“If a patient deteriorates, you can bring them straight into hospital.

“They have just done the first evaluation of that 11-week programme and it reduced mortality by 50 per cent in non-vulnerable patients and 43 per cent of vulnerable patients.”

Its current Covid-related project could also help restore a bit more normality to our lives and allow crowds to watch gigs, films and theatre.

“We are doing the event management stuff at the moment. When you have a club night or something like that, everyone has to register to be able to go and we check transmission of Covid following these trial events,” he said.

Both the national flu and Covid vaccination programmes look like they are here to stay as the country deals with coronavirus booster shots and variants.

Markus describes the programme as being “welded into the country’s infrastructure now” and the system may become welded into other countries’ systems as well – he admits that there has been some interest from elsewhere.

However, he says System C’s work is primarily dedicated to the NHS, with profits being poured back into research into healthcare systems.

Indeed, System C has only recently exported for the first time – a social care system to Australia.

But that could soon change as more people learn about the firm’s involvement in the success of Britain’s Covid vaccination system.

“It was invented in Stratford,” Markus added.