QMS - NHS Questionnaire Processing System

QMS was Inflecto’s first major project — and the work that led to Inflecto being formed to meet a clear, urgent need at Quality Health.

Quality Health is a Care Quality Commission approved national contractor, working across the NHS on National Patient and Staff Surveys. Their programmes span the full breadth of the NHS, including Foundation Trusts, Acute and Specialist hospitals, PCTs, Mental Health Trusts, Ambulance Trusts, and SHAs.

In 2006, Inflecto took over management of Quality Health’s systems. Over the following years, the scale and complexity of survey programmes increased dramatically. Existing tools began to struggle with higher volumes, more complex questionnaire designs, and the operational demands of processing national programmes reliably.

As Quality Health prepared to process PROMs end-to-end (with the existing system already under major strain), Inflecto recommended a complete redesign — replacing the questionnaire processing estate with a modular, scalable system built for long-term evolution.

In October 2020, Quality Health was acquired by IQVIA, reflecting the strength and maturity of the organisation and its role within large-scale healthcare data and services.

The challenge

Quality Health needed a platform capable of supporting national-scale survey processing while adapting to changing requirements:

Very high questionnaire volumes with year-on-year growth
Increasingly complex survey formats and processing rules
The need for automated scanning recognition and data extraction
Strong governance and security for sensitive patient data
Integrations with key NHS/government systems
Flexibility to support multiple survey programmes with different workflows
A platform that could scale out as processing demands increased

Alongside this, Inflecto was also contracted by Northgate to supply software for the initial PROMs pilot — a programme Quality Health later supported as a direct supplier of PROMs services — increasing the need for robust end-to-end processing.

What we delivered

Early scanning automation (EMC Captiva OMR integration)

Soon after taking over system management in 2006, Inflecto developed integrations with an EMC Captiva Optical Mark Recognition (OMR) system. This enabled automatic recognition of scanned questionnaires, reducing manual effort and improving throughput.

Ongoing support and continuous improvement

For years, Inflecto provided day-to-day support plus regular weekly improvements and upgrades to Quality Health’s Extranet — keeping mission-critical operations stable while demands increased.

Full redesign: a modular system built for change

To meet the next stage of growth, Inflecto designed QMS as a modular system so it could flex to support both current and future survey programmes.

Core capabilities could be:

Enhanced
Combined
Extended by end users through workflows and code extensions

Workflow designer + plug-in architecture (Visual Studio Add-In)

A key feature was a Visual Studio Add-In enabling end users to build workflows using a drag-and-drop approach and develop custom code plug-ins to change system behaviour at key points.

This meant the same platform could process very different survey programmes without requiring a complete rebuild each time requirements changed.

Service Oriented Architecture and scalable subsystems

QMS consists of 10+ sub-systems, built using a Service Oriented Architecture (SOA). The components work together as a coordinated processing pipeline, with key parts designed to scale out by adding additional processing nodes as volume increased.

NHS and government integrations

The system integrates with key NHS systems including:

Demographics Batch Service (DBS)
Health and Social Care Information Centre (HSCIC)

This enabled Quality Health to:

Automatically detect deceased patients
Identify patients who had changed address
Upload PROMs data directly to government systems

Security by separation

The platform is designed with a clear separation between internal and client-facing areas. Communication occurs through a restricted channel, and sensitive data flows only from the less secure to the more secure sections of the system — strengthening overall security posture and reducing risk.

Outcome

Over the years, Inflecto’s systems have processed millions upon millions of NHS questionnaires, supporting Quality Health in delivering national programmes and, ultimately, helping NHS organisations improve services based on patient and staff feedback.

Following the redesign, the new processing systems collected feedback from approximately 2 million questionnaires within the first year.

Just as importantly, the long-running partnership demonstrated the platform’s ability to perform under real-world pressure: high volumes, tight deadlines, and requirements that can change suddenly.