T21 CareFlow — Platform Capabilities Guide
Version: 4.0 |
Last Updated: March 2026
Platform: https://app.t21services.co.uk
Built by: T21 Services
Executive Summary
T21 CareFlow is an enterprise-grade NHS Patient Tracking List (PTL) management platform designed for insourcing companies and NHS trusts. It provides end-to-end management of RTT (Referral to Treatment), Cancer 2WW, Cancer 62-Day, PIFU (Patient Initiated Follow-Up), and Surveillance pathways — from data import through validation, QA review, clinical coding, and executive reporting.
CareFlow is a multi-organisation platform, meaning one secure instance serves multiple NHS trusts simultaneously, each with their own data, users, and configuration — fully isolated and independently managed.
Table of Contents
[Platform Overview](#1-platform-overview)
[My Work (Task Dashboard)](#2-my-work)
[Operational Dashboard](#3-operational-dashboard)
[Pathways (Incomplete PTL)](#4-pathways)
[Validation Workspace](#5-validation-workspace)
[QA Review](#6-qa-review)
[Analytics & Waiting List Intelligence](#7-analytics)
[Staff Performance](#8-staff-performance)
[Patient Contact](#9-patient-contact)
[Booking Support](#10-booking-support)
[Coding Support](#11-coding-support)
[Virtual Clinic](#12-virtual-clinic)
[Data Quality](#13-data-quality)
[Exception Hub](#14-exception-hub)
[Board Assurance Report](#15-board-report)
[Reports Hub](#16-reports-hub)
[Contract Performance](#17-contracts)
[Capacity & Utilisation](#18-capacity)
[Weekly/Monthly Pack](#19-weekly-pack)
[CSV Import](#20-csv-import)
[Automation Rules](#21-automation-rules)
[User Management](#22-user-management)
[Audit Logs](#23-audit-logs)
[Organisation Settings](#24-settings)
[Super Admin: Organisation Management](#25-org-management)
[Super Admin: Activity Monitoring](#26-activity-monitoring)
[Security & Access Controls](#27-security)
[Role-Based Access Control (RBAC)](#28-rbac)
[AI Co-Pilot](#29-ai-copilot)
[Why CareFlow](#30-why-careflow)
1. Platform Overview
| Component | Detail |
|---|
| Hosting | Secure UK-hosted cloud infrastructure with global CDN for fast performance |
| Database | Enterprise-grade database with row-level security — each organisation's data is fully isolated |
| Authentication | Secure login with email/password, magic-link invitations, and automatic session management |
| Multi-Tenancy | Each NHS Trust has its own isolated workspace, users, and configuration |
| PII Protection | Patient names and NHS numbers are masked by default, revealed on click with full audit trail |
| Email Notifications | Automated transactional emails for invitations, work assignments, and notifications |
| AI Co-Pilot | Intelligent validation assistant that suggests RTT status, outcomes, and next steps |
2. My Work
Available to: All roles
What it does:
Personal task dashboard showing action items assigned to the logged-in user. Tasks are generated automatically by the system or manually by team leads.
| Feature | Detail |
|---|
| Task types | Validation assignments, QA rework items, escalations, breach warnings |
| Priority levels | Critical, High, Medium, Low — colour-coded |
| Status tracking | Open → In Progress → Completed |
| Task counts | Badge counts by status for quick triage |
Problem it solves: Validators and staff know exactly what to work on each day without searching through the full PTL.
3. Operational Dashboard
Available to: All roles
What it does:
Real-time operational overview of the trust's incomplete pathway position.
| KPI Card | What It Shows |
|---|
| Active Pathways | Total open pathways + unvalidated count + over-18-week count |
| Breached | Pathways past their target date + at-risk count (≤14 days remaining) |
| Validation Rate | % of pathways validated + count validated today |
| Activity | Pathways closed this week + total staff count |
Additional features:
- Quality Alerts — Amber/red banners when QA failures or at-risk volumes exceed thresholds
- Waiting for Booking — Live list of pathways needing booking, sorted by breach date
- Diagnostic Tracker — Pathways awaiting diagnostics with type and breach proximity
- Recent Activity Feed — Last 8 audit events showing who did what and when
Problem it solves: Programme leads and client admins get an at-a-glance view of operational health without running manual reports.
4. Pathways (Incomplete PTL)
Available to: All roles
What it does:
The full Incomplete Pathway Tracking List — the core dataset of CareFlow.
| Feature | Detail |
|---|
| Pathway types | RTT, Cancer 2WW, Cancer 62-Day, PIFU, Surveillance — each in its own tab |
| IPT Tracker tab | Inter-Provider Transfers with status tracking (Pending → Sent → Acknowledged → Received) |
| Surveillance tab | Non-RTT surveillance pathways with follow-up date monitoring |
| Closed Pathways tab | Historical view of all closed/removed pathways with closure reasons |
| RAG status | Automatic Red/Amber/Green colour coding based on days to breach |
| Clinical Risk column | P-Code clinical risk level (P1 Critical → P4 Routine) |
| Sorting & filtering | Sort by any column, filter by specialty, type, status, priority |
| Search | Instant search across PAS number, patient name, specialty, consultant |
| Column visibility | Customisable — show/hide columns to suit the workflow |
| Weeks wait | Auto-calculated from referral date, colour-coded at 14w/18w thresholds |
Data per pathway:
- Patient identifiers (PAS, NHS number, DOB — PII masked)
- Referral date, first seen date, diagnosis date, TCI date
- Clock status (Active, Paused, Stopped, Breached, Dormant PIFU, etc.)
- Next step required (Follow-up, Diagnostic, Procedure, Discharge, TCI Booking)
- Booking status, diagnostic type, letter status
- Clinical priority (Routine, Urgent, 2WW) + P-Code (P1–P4)
- RTT status codes (10–99, full NHS RTT dataset)
- Cancer FDS outcomes
- Consultant, specialty, breach date
- Validation status, QA status, assigned validator
Problem it solves: Replaces Excel-based PTL tracking with a real-time, multi-user, audited system.
5. Validation Workspace
Available to: Validators, QA Reviewers, Programme Leads, Admins
What it does:
The core clinical validation workflow — validators review each pathway against PAS/clinic letters and update clinical fields.
| Feature | Detail |
|---|
| Personal queue | Each validator sees only their assigned pathways |
| Team lead view | Programme leads see all assigned + unassigned queues |
| Specialty allocation | Shows unassigned vs assigned counts by specialty |
| Bulk assign | Team leads can assign unassigned pathways to validators by specialty |
| Reassign | Drag work between validators for load balancing |
| Claim next | One-click to claim the next unassigned pathway |
| Quick Edit Sheet | Side panel with all validation fields grouped logically |
| Save & Close / Save & Next | Rapid workflow — validate one, auto-advance to the next |
| Keyboard shortcut | Ctrl+Enter = Save & Next for power users |
| Recently Validated | Shows today's completed work with QA status |
| Daily target | Progress bar showing validated today vs daily target |
Quick Edit Sheet sections:
Patient identifiers — NHS No, PAS, DOB, weeks wait (read-only context)
RAG status banner — colour-coded with countdown label
Validation warnings — Real-time advisory checks (e.g. "breach date passed but clock Active")
One-click fixes — Warning badges offer "Set clock to Breached" buttons
AI Analysis — Validation assistant suggests RTT status, outcome, and next step
Referral & dates — Referral date, first seen, diagnosis, TCI
Clock status & validation — Clock status dropdown + "Is the clock correct?" validation
Clinical Outcome — Outcome from PAS letter (Add to W/L, Discharged, DNA, etc.) + date
Next Steps & Booking — Next step required, booking status, diagnostic type, letter status
Clinical Priority — Priority level + P-Code (P1–P4)
Letter confirmation — Checkbox: "I confirm I have seen the Clinic Letter in PAS"
Clinical Narrative — Cancer FDS outcome, referral source, DTT date, DPI date
Complex pathway flag — Checkbox for multi-comorbidity/secondary referral cases + notes
Validation notes — Free text clinical narrative
Close pathway — Removal reason, clock stop date, removal date
Pathway metadata — Consultant, breach date, priority badge
Problem it solves: Replaces manual spreadsheet validation with a structured, audited, quality-controlled workflow. Reduces validation time from ~5 minutes to ~90 seconds per pathway.
6. QA Review
Available to: QA Reviewers, Programme Leads, Admins
What it does:
Second-line quality assurance. QA reviewers check validated pathways for accuracy.
| Feature | Detail |
|---|
| QA queue | All validated pathways pending QA review |
| Pass/Fail | One-click approve or return for rework |
| Rework flow | Failed pathways go back to the original validator with notes |
| Rework badge | REWORK tag on returned pathways so validators prioritise them |
| QA lock | Once passed, pathways are QA-locked and cannot be re-validated without admin override |
| Undo | QA reviewers can undo a pass/fail decision if needed |
Problem it solves: Ensures data quality before it reaches reports. Catches validation errors before they become reporting issues.
7. Analytics & Waiting List Intelligence
Available to: All roles (staff productivity table restricted to leads/admins)
What it does:
Holistic waiting list analytics combining validation metrics with waiting time intelligence.
| Section | What It Shows |
|---|
| Daily Target | Validated today vs target with progress bar |
| Unvalidated Backlog | Total pathways still needing validation |
| Weekly Progress | Validated this week running total |
| Staff Productivity | Table: each validator's today/this-week count, QA pass rate, rework pending |
| Waiting Time Distribution | Visual bar chart: 0-4w, 4-12w, 12-18w, 18-26w, 26-40w, 40-52w, 52w+ |
| By Pathway Type | Active/breached/validated counts per type (RTT, Cancer, PIFU, etc.) |
| Top Specialties | Horizontal bar chart of the 10 busiest specialties |
| Next Step Pipeline | Badge cloud showing demand by next step (Follow-up, Diagnostic, etc.) |
Problem it solves: Gives programme leads and analysts a single view of both operational demand and team performance.
8. Staff Performance
Available to: Programme Leads, Client Admins, Super Admins
What it does:
Detailed 30-day staff performance analysis for validators and QA reviewers.
| Feature | Detail |
|---|
| Per-validator stats | Validated count, QA pass rate, rework count, daily average |
| Activity breakdown | Logins, validations, closures per day |
| Specialty coverage | Which specialties each validator has worked on |
| Trend data | 30-day rolling performance |
Problem it solves: Enables fair workload distribution and identifies training needs.
9. Patient Contact
Available to: All roles
What it does:
Identifies patients who may need proactive contact — PIFU patients, long waiters approaching breach, and those with pending bookings.
| Tab | Shows |
|---|
| PIFU Patients | Patient-initiated follow-up pathways needing check-in |
| Long Waiters | Pathways within 28 days of breach — proactive call list |
| Pending Booking | Patients waiting for appointment booking |
Problem it solves: Supports proactive patient communication to reduce DNAs and prevent breaches.
10. Booking Support
Available to: All roles
What it does:
Operational booking management dashboard showing appointment pipeline.
| Tab | Shows |
|---|
| Pending Booking | Pathways needing appointments, sorted by breach urgency |
| Booked | Confirmed appointments with dates |
| DNA/Cancellations | Did Not Attend cases for rebooking |
| Partial Bookings | Pathways with incomplete booking chains |
Problem it solves: Booking teams can see exactly which patients need appointments and prioritise by breach risk.
11. Coding Support
Available to: Programme Leads, Analysts, Admins
What it does:
Helps clinical coders identify pathways needing RTT status code assignment or correction.
| Feature | Detail |
|---|
| Missing RTT codes | Pathways without RTT status codes assigned |
| Code validation | Checks for incorrect code combinations |
| Outcome coding | Flags pathways needing clinical outcome codes |
Problem it solves: Reduces RTT coding errors that lead to incorrect national submissions.
12. Virtual Clinic
Available to: All roles
What it does:
Identifies pathways suitable for virtual (non-face-to-face) clinical review.
| Feature | Detail |
|---|
| Follow-up candidates | Pathways with "Follow-up" as next step |
| Diagnostic review | Pathways awaiting diagnostic results review |
| PIFU candidates | Active PIFU patients suitable for virtual check |
Problem it solves: Supports the NHS drive for virtual consultations by identifying suitable patients.
13. Data Quality
Available to: All roles
What it does:
Automated data quality scanning across all active pathways.
| Check | What It Detects |
|---|
| Missing NHS numbers | Pathways without NHS number |
| Missing referral dates | No referral received date |
| Missing breach dates | Active pathways with no breach date calculated |
| Date anomalies | First seen before referral, diagnosis before first seen, etc. |
| Duplicate PAS numbers | Multiple pathways with same PAS number |
| Stale pathways | Active pathways with no recent activity |
| Missing clinical fields | No outcome, no next step, no booking status |
Problem it solves: Proactively identifies data issues before they cause reporting problems or breach miscalculations.
14. Exception Hub
Available to: Analysts, Programme Leads, Admins
What it does:
Advanced exception management system — identifies, tracks, and resolves data anomalies.
| Feature | Detail |
|---|
| Automatic scanning | Rules engine scans all pathways for exceptions |
| Exception types | Date conflicts, missing mandatory data, impossible durations, coding errors |
| Resolution tracking | Each exception has a resolution workflow with status and notes |
| Metrics dashboard | Open/resolved/in-progress counts with resolution time analytics |
Problem it solves: Provides a structured process for handling data exceptions rather than ad-hoc spreadsheet fixes.
15. Board Assurance Report
Available to: Programme Leads, Analysts, Admins
What it does:
Executive-level board assurance report suitable for Trust Board or ICB submissions.
| Section | Content |
|---|
| Headline KPIs | Total active, breached, at-risk, validation rate, QA pass rate |
| Clinical Risk Summary | High clinical risk count, overdue surveillance, IPT compliance % |
| Trend comparison | This week vs last week directional indicators |
| Breach forecast | Predicted breaches in next 7/14/28 days |
| Specialty breakdown | Per-specialty active/breached/validated counts |
| Closed pathway analysis | Removal reasons and closure patterns |
| Long waiters | 40w+, 52w+, 65w+, 78w+, 104w+ bands |
Problem it solves: Replaces hours of manual report compilation. Board-ready output in real time.
16. Reports Hub
Available to: Programme Leads, Analysts, QA Reviewers, Admins
What it does:
Comprehensive reporting suite with filterable, multi-dimensional analytics.
| Report | What It Shows |
|---|
| Executive KPIs | Headline numbers with week-on-week comparison |
| Specialty Metrics | Per-specialty deep dive: volumes, breach rates, validation rates |
| Pathway Leakage | Identifies pathways that may have "leaked" out of tracking |
| Breach Forecast | Predictive model showing upcoming breaches by timeframe |
| Clinician DNA Rates | DNA rates by consultant for targeted intervention |
| Closed Pathway Stats | Closure reason analysis and trends |
| Long Waiters | Stratified long-waiter analysis with wait bands |
| Admitted/Non-Admitted Split | IP vs OP pathway analysis |
| RTT by Specialty | RTT-specific metrics per specialty |
| Validator Workload | Per-person validation volumes and QA outcomes |
Filtering: All reports support date range, specialty, consultant, and location filters.
Problem it solves: One-stop reporting that eliminates the need for separate Business Intelligence tools for PTL analysis.
17. Contract Performance
Available to: Programme Leads, Analysts, Admins
What it does:
Tracks insourcing contract performance — planned vs delivered activity.
| Feature | Detail |
|---|
| Planned volumes | Target pathway volumes per contract period |
| Delivered volumes | Actual validated/closed pathway counts |
| Variance analysis | Over/under delivery by pathway type |
| Efficiency metrics | Cost-per-pathway, throughput rates |
Problem it solves: Insourcing companies can demonstrate contract delivery to commissioners.
18. Capacity & Utilisation
Available to: Programme Leads, Analysts, Admins
What it does:
Clinic slot tracking and utilisation monitoring.
| Feature | Detail |
|---|
| Slot utilisation | Booked vs available slots by location and specialty |
| Utilisation alerts | Flags under-utilised or over-booked clinics |
| Location breakdown | Per-site capacity analysis |
| Demand vs supply | Maps pathway demand against available capacity |
Problem it solves: Identifies wasted clinic capacity and helps optimise appointment scheduling.
19. Weekly/Monthly Pack
Available to: All roles
What it does:
Auto-generated executive summary packs for weekly operational meetings or monthly reviews.
| Feature | Detail |
|---|
| Weekly pack | Monday-to-date snapshot of key metrics |
| Monthly pack | Full calendar month analysis |
| Key metrics | Active pathways, breached, validated, closed, by type |
| Clinical risk | High clinical risk count, overdue surveillance, IPT compliance |
| Contract metrics | Planned vs delivered summary |
| Capacity metrics | Utilisation percentage and alerts |
| Printable | Clean layout designed for printing/PDF |
| Email subscriptions | Users can subscribe to receive packs automatically |
Problem it solves: Eliminates hours of weekly pack compilation — always up-to-date and consistent.
20. CSV Import
Available to: Client Admins, Super Admins
What it does:
Bulk pathway data import from PAS/EPR CSV extracts.
| Feature | Detail |
|---|
| Column mapping | Automatic header detection + manual column mapping wizard |
| Supported types | RTT, Cancer 2WW, Cancer 62-Day, PIFU, Surveillance |
| Validation | Pre-import validation checks for data quality |
| Duplicate detection | Warns about existing PAS numbers before import |
| Batch processing | Handles thousands of pathways in a single upload |
| Audit trail | Full audit log of what was imported, by whom, when |
Problem it solves: Enables rapid data onboarding from any PAS system without API integration.
21. Automation Rules
Available to: Client Admins, Super Admins
What it does:
Configurable automation rules that generate tasks and escalations automatically.
| Feature | Detail |
|---|
| Rule types | Breach warning, DNA escalation, stale pathway, unvalidated backlog |
| Triggers | Time-based (e.g. "7 days before breach"), event-based (e.g. "DNA recorded") |
| Actions | Create task, send email notification, flag for review |
| Execution log | Full history of when rules fired and what they produced |
| Enable/disable | Toggle rules on/off without deleting them |
Problem it solves: Reduces reliance on manual monitoring by automating routine operational checks.
22. User Management
Available to: Client Admins, Super Admins
What it does:
Full user lifecycle management for the organisation.
| Feature | Detail |
|---|
| Manual creation | Create user with name, email, role |
| Email invite | Send magic-link invite email — user sets own password |
| Role assignment | 7 roles with different permission levels |
| Activate/Deactivate | Toggle user access with mandatory reason prompt |
| Access expiry | Set date when user access auto-expires (e.g. contract end) |
| Last login | Shows when each user last logged in |
| Deactivation reason | Records why a user was deactivated (contract ended, role change, etc.) |
Problem it solves: Professional user onboarding and offboarding with full audit trail.
23. Audit Logs
Available to: QA Reviewers, Programme Leads, Admins
What it does:
Complete audit trail of every action taken in the system.
| Tracked Events | Detail |
|---|
| User actions | Login, logout, role changes, account activation/deactivation |
| Pathway actions | Validated, unvalidated, closed, reopened, assigned, reassigned |
| QA actions | Passed, failed, rework sent |
| Import actions | CSV imports with row counts |
| Admin actions | Org created, org updated, user invited |
| PII access | When masked patient data is revealed |
Problem it solves: Full CQC/NHSE audit compliance. Every action is traceable to a specific user at a specific time.
24. Organisation Settings
Available to: All roles (view), Admins (edit)
What it does:
Per-organisation configuration for targets, thresholds, and clinical rules.
| Setting | Detail |
|---|
| RTT target weeks | Default 18 weeks — configurable per trust |
| Cancer 2WW target days | Default 14 days |
| Cancer 62-day target | Default 62 days |
| Daily validation target | Pathways per day target for progress tracking |
| DNA escalation threshold | Number of DNAs before auto-escalation |
| Task escalation days | Days before unactioned tasks escalate |
| P2 risk threshold days | Days remaining for P2 clinical risk flag |
| Surveillance amber days | Days before follow-up for amber warning |
| Disabled validation rules | Toggle specific validation warnings on/off |
| Mandatory outcomes | Configure which outcome fields are required |
| Email notifications | Per-user notification preferences |
Problem it solves: Each trust can configure CareFlow to match their specific operational policies.
25. Super Admin: Organisation Management
Available to: Super Admins only (T21 Services staff)
What it does:
Multi-tenant organisation management for T21 Services to manage all client trusts.
| Feature | Detail |
|---|
| Create organisation | Name, URL slug, contact details |
| Contract dates | Start date + end date — system auto-blocks all users when contract expires |
| Working hours | Set allowed access hours (e.g. 07:00–19:00) — users blocked outside hours |
| 24-hour access | Leave working hours empty for unlimited access |
| Max users | Set user cap per contract |
| Contact details | Client contact name and email for reference |
| Internal notes | Private notes about the contract |
| Activate/Suspend | One-click to suspend entire organisation |
| Contract status | Visual badges: "45d left" (green), "12d left" (amber), "Expired" (red) |
| Active sessions | Shows how many users are currently online per org |
Problem it solves: T21 manages multiple NHS trusts from a single admin panel with full contract lifecycle control.
26. Super Admin: Activity Monitoring
Available to: Super Admins only (T21 Services staff)
What it does:
Real-time session monitoring dashboard across all organisations.
| Feature | Detail |
|---|
| Currently online | Live list: user name, org, role, session duration, IP address |
| Green pulse indicator | Visual confirmation of active sessions |
| Session history | Last 7 days of all login sessions |
| Per-session data | User, org, login time, duration, IP address, status (online/ended) |
| Summary stats | Online now, unique users this week, average session duration, total sessions |
Problem it solves: Enables monitoring of staff activity patterns, unusual access, and system usage for billing/reporting.
27. Security & Access Controls
| Feature | Detail |
|---|
| Authentication | Secure login with industry-standard password encryption |
| Session management | Automatic secure sessions with token refresh |
| Data Isolation | Row-level security — users can only access their own organisation's data |
| PII masking | Patient names and NHS numbers masked by default |
| Access expiry | Per-user expiry dates with automatic enforcement |
| Contract expiry | Per-organisation contract end dates with automatic blocking |
| Working hours | Configurable access windows (e.g. 7am–7pm) enforced automatically |
| Deactivation | Instant user deactivation with reason logging |
| Org suspension | One-click organisation suspension |
| Session tracking | IP address, user agent, login time, session duration logged |
| Audit trail | Every action logged with user ID, timestamp, and metadata |
Continuous enforcement: All access controls are checked on every page request — not just at login. If a contract expires mid-session, the user is signed out immediately.
28. Role-Based Access Control (RBAC)
CareFlow has 7 user roles with hierarchical permissions:
| Role | Level | What They Can Do |
|---|
| Super Admin | 7 | Everything. Manages all organisations, users, and platform settings. T21 Services staff only. |
| Client Admin | 6 | Manages their trust's users, imports data, configures settings. Trust IT/operational lead. |
| Programme Lead | 5 | Oversees validation team, assigns work, views all reports and performance data. Team lead role. |
| Validator | 3 | Validates assigned pathways in the validation workspace. Core clinical validation staff. |
| QA Reviewer | 4 | Reviews validated pathways for quality assurance. Second-line quality check. |
| Analyst | 2 | Views reports, analytics, data quality, and exception hubs. Read-heavy role for analysts. |
| Read Only | 1 | Can view dashboards only. Observer/stakeholder role. |
Permission matrix:
| Permission | Super Admin | Client Admin | Programme Lead | QA Reviewer | Validator | Analyst | Read Only |
|---|
| View dashboard | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ |
| View reports | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ❌ |
| Export data | ✅ | ✅ | ✅ | ❌ | ❌ | ✅ | ❌ |
| Validate pathways | ✅ | ✅ | ✅ | ❌ | ✅ | ❌ | ❌ |
| QA review | ✅ | ✅ | ✅ | ✅ | ❌ | ❌ | ❌ |
| Manage users | ✅ | ✅ | ❌ | ❌ | ❌ | ❌ | ❌ |
| Import data | ✅ | ✅ | ❌ | ❌ | ❌ | ❌ | ❌ |
| View audit logs | ✅ | ✅ | ✅ | ✅ | ❌ | ❌ | ❌ |
| Manage org settings | ✅ | ✅ | ❌ | ❌ | ❌ | ❌ | ❌ |
| Manage organisations | ✅ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ |
29. AI Co-Pilot
Available in: Validation Workspace quick-edit panel
What it does:
AI-powered validation assistant that analyses pathway data and suggests:
| Suggestion | Detail |
|---|
| RTT status code | Recommends the correct RTT status code based on pathway state |
| Clinical outcome | Suggests likely outcome based on dates and pathway type |
| Next step | Recommends next action (Follow-up, Diagnostic, Discharge, etc.) |
| Booking status | Suggests booking status based on available data |
Controls:
- Rate-limited per user (configurable)
- Suggestions are advisory only — validator always decides
- Accept/reject feedback tracked for model improvement
- Usage remaining counter shown to user
Problem it solves: Accelerates validation for less experienced staff. Provides a "second opinion" on complex pathways.
30. Why CareFlow
| Advantage | Detail |
|---|
| Purpose-built | Designed specifically for NHS PTL management and RTT compliance — not a generic tool adapted for healthcare |
| Proven & scalable | Secure, scalable cloud platform designed for Trust-wide deployment |
| Data security | Row-level data isolation, encrypted at rest and in transit, PII masking |
| Rapid onboarding | Go live in as little as 2 weeks using standard PAS/PTL CSV exports |
| No IT overhead | Fully managed cloud service — no servers to maintain, no software to install |
| Continuous updates | New features and improvements delivered automatically |
| UK hosted | Data hosted in UK-based cloud infrastructure |
| NHS compliant | Designed for CQC/NHSE audit requirements with full traceability |
Pathway Types Supported
| Type | Target | What It Tracks |
|---|
| RTT | 18 weeks | Referral to Treatment incomplete pathways |
| Cancer 2WW | 14 days | Two-Week Wait cancer referrals |
| Cancer 62-Day | 62 days | Cancer treatment target from urgent referral |
| PIFU | Configurable | Patient Initiated Follow-Up monitoring |
| Surveillance | Configurable | Non-RTT follow-up and surveillance pathways |
Clinical Fields Captured
| Category | Fields |
|---|
| Patient | NHS Number, PAS/MRN, Full Name, DOB, Hospital Number |
| Referral | Referral date, referral source (GP, A&E, C2C, Self), referring clinician |
| Clock | Clock start, clock status, breach date, weeks wait |
| Clinical | First seen date, diagnosis date, TCI date, consultant, specialty |
| Outcome | Clinical outcome (22 options), outcome date, next step, booking status |
| Cancer | FDS outcome, decision-to-treat date, date patient informed |
| Priority | Clinical priority (Routine/Urgent/2WW), P-Code (P1–P4) |
| Coding | RTT status code (full national dataset), letter status |
| Governance | Clock validation status, letter confirmed, validation notes |
| Complexity | Complex pathway flag, complexity notes |
| Closure | Removal reason, clock stop date, removal date |
| Transfer | Target provider, transfer date, transfer status (IPT tracker) |
| Surveillance | Last seen date, planned follow-up date |
Email Notifications
| Event | Email Sent To |
|---|
| User invited | New user receives magic-link invite email |
| Work assigned | Validator receives email when pathways are assigned |
| Work reassigned | Validator notified when work is reassigned to them |
| Weekly pack | Subscribed users receive weekly summary (configurable) |
Coding Recovery & Financial ROI Engine
What it does: Identifies clinical coding gaps across all NHS data domains, quantifies the estimated financial and national target impact, and manages the resolution workflow through T21's managed coding service.
How It Works
Automated Issue Detection — runCodingChecks() scans every pathway and flags issues across 10+ categories
Activity Value Mapping — Each issue is mapped to an NHS National Tariff HRG bracket estimate
Recovery Pipeline — Issues flow through: Uncoded → Assigned → In Progress → Resolved / Not Applicable
T21 Managed Resolution — T21 qualified coders are assigned items via the "Assign to T21 Team" button
Resolution Audit — Every resolution is recorded with reason, notes, resolver name, and timestamp
Issue Categories Detected
| Category | Risk Type | Est. Tariff Range |
|---|
| Missing Outcome | Financial Risk | £150–£450 |
| Missing Clock Status | Financial Risk | £200–£600 |
| Missing Removal Reason | Financial Risk | £100–£350 |
| Missing Specialty/TFC | Financial Risk | £150–£450 |
| Cancer FDS Missing | National Target Risk | N/A (target impact) |
| Priority Review (267-week Routine) | Clinical Safety & Litigation Risk | Alert only |
| Status Mismatch | Data Quality | £80–£250 |
| Missing Next Step | Data Quality | £80–£200 |
| Missing Referral Source | Data Quality | £50–£150 |
| Missing Consultant | Data Quality | £50–£150 |
> Disclaimer: All tariff values are estimates based on national average NHS tariffs. Actual values are subject to local ICB contract variations and should not be used for financial reporting without validation by the Trust's Finance team.
Dashboard Features
| Feature | Description |
|---|
| Estimated Uncaptured Value Banner | Shows total estimated £ value at risk from un-coded items |
| Coding Completeness Progress Bar | Visual indicator of activity capture rate (replaces static % score) |
| Risk Type Classification | Each issue colour-coded: Red=Financial, Purple=National Target, Orange=Clinical Safety, Blue=Data Quality |
| Assign to T21 Team | Single-click or bulk-select to add items to the T21 recovery queue |
| Coding Audit Status Column | Per-row pipeline status: Uncoded / Assigned / In Progress / Resolved / N/A |
| Resolution Modal | Structured resolution with reason dropdown, notes field, and timestamp |
| Enhanced CSV Export | Exports financial data (low/high/mid tariff estimates) with disclaimer row |
| Select All + Bulk Assign | Select multiple issues at once and assign them to T21 in one click |
Board Report Integration
The Financial & Coding Integrity section of the Board Assurance Report shows:
- Total un-coded items requiring attention
- Items resolved by T21 team (with % resolution rate)
- Estimated uncaptured tariff value
- 8-week trend bar chart — un-coded volume over time (lower = better recovery performance)
Weekly/Monthly Pack Integration
The Financial & Coding Integrity section appears in all operational packs, showing the period's coding recovery metrics for Finance Director and Medical Director visibility.
Database Table: coding_recovery_queue
| Column | Purpose |
|---|
issue_id | Unique identifier for the specific coding issue |
issue_category | Category (Missing Outcome, Missing Clock, etc.) |
risk_type | financial_risk / national_target_risk / clinical_safety_risk / data_quality |
tariff_value_low/high/mid | NHS national tariff bracket estimates |
status | uncoded / assigned / in_progress / resolved / not_applicable |
assigned_to / assigned_to_name | T21 coder assigned to resolve |
resolution_reason | genuinely_uncoded / data_correction / not_applicable / awaiting_documentation / trust_action_required |
resolution_notes | Free text notes with evidence reference |
week_number / year_number | ISO week tracking for trend analysis |
SQL Migration: supabase/035_coding_recovery_queue.sql
Activity Monitoring & Security Intelligence
Location: Super Admin → Activity Monitoring
IP Geolocation (Migration 034)
Every login session is enriched with geolocation data via ip-api.com:
| Data Point | Purpose |
|---|
| Country / Country Code | Detect non-UK access |
| City | More granular location context |
| ISP / Organisation | Identify corporate vs. residential vs. cloud connections |
| VPN Detection | Flag sessions connecting via VPN or hosting/datacenter IPs |
| Proxy Detection | Flag sessions using web proxies |
| Connection Risk | safe / warning / danger classification |
Security Alerts
| Condition | Risk Level | Display |
|---|
| Proxy detected | Danger | 🔴 Red badge + Security Alert panel |
| VPN / Hosting IP | Warning | 🟡 Amber badge |
| Non-UK country | Warning | Country flag + ⚠ indicator |
| Direct UK connection | Safe | 🟢 Green badge |
Session Columns (Activity Monitor Table)
- Connection Type — Direct / VPN / Proxy badge
- Country + City — Flag emoji + country name + city
- ISP — Internet service provider name
- IP Address — Full IP for audit purposes
- Login Time / Duration — Session tracking
- User / Organisation — Who was connected and from which org
SQL Migration: supabase/034_session_geo_columns.sql
Access Control & Contract Management
User Access Expiry (Migration 032)
- Admins can set an
access_expires_at date on any user account
- Useful for agency staff, contractors, and time-limited roles
- Access is automatically blocked after the expiry date
- Deactivation reasons are recorded for audit purposes
Organisation Contract Management (Migration 033)
| Field | Purpose |
|---|
contract_start / contract_end | Org access blocked after contract end |
access_hours_start / access_hours_end | Restrict logins to approved hours (e.g. 7am–7pm) |
max_users | Enforce user count limit per contract |
contact_name / contact_email | Trust contact details for T21 account managers |
SQL Migrations Reference
All migrations are cumulative and use IF NOT EXISTS / DO $$ BEGIN ... EXCEPTION WHEN OTHERS THEN NULL; END $$ guards so they are safe to re-run.
| Migration | Description | Status |
|---|
| 001–020 | Core schema, RLS, pathway types, governance, QA, automation | ✅ Run at setup |
| 021 | Patient & pathway identifiers (NHS number, hospital number, DOB, UBRN) | ✅ Run at setup |
| 022 | Clinical & operational fields (clock dates, TFC, GP code, removal reason) | ✅ Run at setup |
| 023 | P-Code clinical prioritisation (P1–P4, threshold configuration) | ✅ Run at setup |
| 024 | IPT tracker (target provider, transfer date, transfer status) | ✅ Run at setup |
| 025 | Non-RTT Surveillance pathway (last seen, planned follow-up) | ✅ Run at setup |
| 030–031 | Seed data for testing | ✅ Optional |
| 032 | User access expiry (access_expires_at, deactivation_reason) | ⚠ Must run |
| 033 | Org contracts + user_sessions table | ⚠ Must run |
| 034 | Session geo columns (IP geolocation, VPN/proxy detection) | ⚠ Must run |
| 035 | Coding recovery queue table | ⚠ Must run |
> supabase/RUN_ALL_SETUP.sql now contains ALL migrations in one file. For new environments, run this single file.
Summary: What Makes CareFlow Different
Purpose-built for NHS PTL — not a generic project management tool adapted for healthcare
Multi-organisation platform — one secure instance serves multiple trusts, each fully isolated
Validation workflow — structured clinical validation with QA review layer
Real-time RAG — automatic breach risk calculation for every pathway
AI-assisted validation — Advisory suggestions to support clinical review decisions
Full audit trail — every action traceable for CQC/NHSE compliance
PII protection — patient data masked by default, revealed on click
Contract management — automatic access expiry when contracts end
Working hours control — restrict access to approved hours
Session monitoring — know who's logged in, from where, for how long
IP Geolocation + VPN Detection — every login enriched with country, city, ISP, VPN/proxy risk flag
Coding Recovery ROI Engine — identifies un-coded clinical activity, maps it to NHS tariff brackets, manages T21 recovery workflow with full audit trail
Financial & Coding Integrity reporting — Board Assurance Report and Weekly Pack show un-coded volume, T21 resolution rate, and estimated uncaptured tariff value
Professional platform — custom domain, email invites, role-based access, multi-organisation management