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+++ b/.idea/.gitignore
@@ -0,0 +1,10 @@
+# Default ignored files
+/shelf/
+/workspace.xml
+# Editor-based HTTP Client requests
+/httpRequests/
+# Ignored default folder with query files
+/queries/
+# Datasource local storage ignored files
+/dataSources/
+/dataSources.local.xml
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diff --git a/app/age-related-messaging/2025/11/introduction-to-age-related-messaging/index.md b/app/age-related-messaging/2025/11/introduction-to-age-related-messaging/index.md
index cd6a30351..0ccd50996 100644
--- a/app/age-related-messaging/2025/11/introduction-to-age-related-messaging/index.md
+++ b/app/age-related-messaging/2025/11/introduction-to-age-related-messaging/index.md
@@ -1,15 +1,15 @@
---
-title: Introduction to age‑related messaging
+title: Introduction to age-based messaging
description: A new way of providing timely advice and guidance to parents and carers of infants
date: 2025-11-17
tags:
- - age‑related messaging
+ - age-based messaging
- Digital Child Health
- Digital Best Start
- infants
---
-Age‑related messaging is a project to send messages via the NHS App (and SMS) to parents of newborns.
+Age-based messaging is a project to send messages via the NHS App (and SMS) to parents of newborns.
## Background
@@ -19,19 +19,33 @@ This was under the umbrella of “Digital Child Health”, which has since been
A discovery was carried out in late 2024, from which a series of use cases were formed. One of these use cases involves sending out age‑based, standardised communications to parents of newborns and infants.
-## Getting reliable information to parents
+---
+## Getting Reliable Information to Parents
Parents currently access information through NHS sources, health professionals, or peers and social media. However, searching online requires parents to be proactive and to know what to look for and when. Support from professionals is often tied to the timing of routine appointments and may not always be available when needed.
-## Extending the reach
+---
+## Extending the Reach
-Services such as [Best Start in Life](https://www.nhs.uk/best-start-in-life/) show how timely guidance can be delivered directly to families, but current reach is just 1 to 2 percent of parents.
+Services such as [Best Start in Life](https://www.nhs.uk/best-start-in-life/) demonstrate how timely information and guidance can be delivered directly to parents and carers. Through an opt-in email newsletter, Best Start in Life provides frequent support, delivered weekly until 12 weeks, fortnightly until 40 weeks, and monthly thereafter. Content covers a broad range of topics including vaccinations, sleep, mental health, financial support and signposting. The service also offers tailored content for fathers and same-sex couples.
-As a result, many rely instead on informal or unverified sources. While often well‑intentioned, this advice can leave parents without the right knowledge, confidence, or timing to make evidence‑based decisions about their child’s care.
+However, Best Start in Life is only one part of a much wider information ecosystem. Research has highlighted that parents and carers receive information from multiple sources, delivered through a combination of verbal conversations, printed materials and digital channels. This includes information from health visitors, GPs, midwives, NHS services, local authorities, charities and community organisations.
-There are also wider benefits to improving early health engagement for both families and services. For example, encouraging parents to register with a GP online saves around nine minutes of administrative time per registration compared with in‑person sign‑ups.
-## Messages based on the infant’s age
+### The Information Landscape
+
+Parents often receive information through leaflets, letters, text messages, apps and resources added to the Red Book during appointments and reviews. Local areas have developed their own approaches to parent communication through services such as Just One Norfolk, Growing Healthy North Yorkshire, Essential Parent and up to 40% of health visiting services use ChatHealth, a two-way messaging platform that allows parents to communicate directly with health visitors.
+
+The result is a complex and fragmented information landscape. Information can be duplicated across services, delivered at different times, and sometimes appear inconsistent or contradictory. This can contribute to information overload, particularly during the first few weeks and months after birth when parents are receiving large amounts of advice and support.
+
+
+### Challenges Within the Current Information Landscape
+Parents receive information from many different services and channels, making it difficult to understand what information is being shared, where duplication exists, and which communications are driving meaningful outcomes. As a result, parents may rely on informal or unverified sources when trusted information is difficult to find, understand or access at the right time.
+
+As Age-Based Messaging develops, it should complement existing communications, reduce duplication, deliver measurable value, and support outcomes that matter to parents, the NHS and public health.
+
+---
+## Messages Based on the Infant’s Age
To tackle this, a series of universal prompts will be sent to parents and carers at key stages, that signpost them to key jobs to be done and services relevant to their child. These include but are not limited to:
@@ -43,4 +57,20 @@ To tackle this, a series of universal prompts will be sent to parents and carers
These notifications would be delivered at specific intervals in the neonatal and infancy stages of a child’s life, with the intention being to provide reminders to parents and carers at key stages, and signpost them to NHS services.
-The team is currently preparing a pilot of age‑related messaging.
+### Public Health-Focused
+
+There are also wider benefits to improving early health engagement for both families and services. For example, encouraging parents to register with a GP online saves around nine minutes of administrative time per registration compared with in‑person sign‑ups.
+
+Some key statistics that have already been collected that we have used to determine the content of our messages include:
+
+- 9% of parents are currently reached by the DHSC Best Start in Life email programme — leaving the vast majority without proactive support
+
+- 75% of parents are not using digital GP registration, limiting early access to services and increasing admin burden
+
+- 46% of parents believe weaning should start at 5 months or earlier (national guidance: 6 months)
+
+- 10% of parents introduce solids before 4 months
+
+- 19% of Healthy Start–eligible parents give their child recommended vitamins
+
+The team is currently preparing a pilot of age-based messaging.
diff --git a/app/age-related-messaging/2026/08/our-opt-out-journey/index.md b/app/age-related-messaging/2026/08/our-opt-out-journey/index.md
new file mode 100644
index 000000000..673f92b18
--- /dev/null
+++ b/app/age-related-messaging/2026/08/our-opt-out-journey/index.md
@@ -0,0 +1,157 @@
+---
+title: Our Opt-Out Journey
+description: Exploration of how parents understand, manage and control their participation in Age-Based Messaging, including opting out, resubscribing and managing preferences.
+date: 2026-08-14
+tags:
+ - consensual design
+ - unsubscribe
+ - user flow
+ - identity validation
+author:
+ - Ash Finnegan
+
+
+---
+
+The opt-out journey has been a significant area of design work within the Age-Based Messaging (ABM) programme.
+
+While current cohorts are enrolled through a consensual model where participants explicitly agree to receive messages, the long-term ambition is to move towards a national service where eligible parents and carers are automatically enrolled. This reflects the anticipated public health value of delivering timely, evidence-based information throughout a child's early years.
+
+As automatic enrolment increases, to adhere to the principles of consensual design, users must be able to easily stop receiving messages if the service no longer meets their needs. For this reason, the opt-out journey forms a critical part of the service experience, ensuring participants remain in control of their communications.
+
+This work is particularly important because ABM is not delivering traditional appointment reminders or transactional communications. Instead, it provides developmental information, advice and support over a five-year period, creating unique considerations around consent, relevance, engagement and user control.
+
+---
+## User Needs
+
+Through design workshops and research, we identified the following user needs for the opt-out journey:
+
+- As a parent, I want to easily stop receiving messages when they are no longer useful to me.
+
+- As a parent, I want to be able to restart messages if my circumstances or needs change.
+
+- As a parent, I want to understand what I am opting out of and what will happen when I unsubscribe.
+
+- As the NHS, we need to accurately record user preferences and ensure users no longer receive messages once they have opted out.
+
+---
+## Design Constraints
+
+Several constraints influenced the design of the opt-out journey.
+
+### Digital Exclusion
+
+The current journey requires internet access. Users must leave the NHS App message and navigate through a web-based flow before they can manage their subscription preferences.
+
+### Identity Verification
+
+To protect user preferences and prevent accidental changes, users are required to verify their identity before completing the unsubscribe journey. This adds friction to the journey but is currently a necessary security requirement.
+
+### Re-subscription
+
+At present there is no defined route for users to opt back into the service once they have unsubscribed. This presents a challenge given that ABM spans five years and users' information needs are likely to change over time.
+
+### NHS App Constraints
+
+ABM messages are delivered within existing NHS App patterns and components. This limits the extent to which message presentation and preference management can be customised.
+
+### Preference Management
+
+The NHS App previously explored a broader "manage your preferences" capability. However, this work did not progress due to insufficient evidence of user value at the time, limiting available infrastructure for ABM preference management within the apps interface.
+
+---
+## Content Considerations
+
+One of the key design questions centred around language and user expectations.
+
+We explored a number of different approaches, including:
+
+- Opt out - can imply a user previously opted in
+
+- Unsubscribe - suggests a permanent decision
+
+- Manage preferences - implies a greater level of control and ongoing management of communications
+
+Understanding users' mental models and expectations became a key focus of the research.
+
+---
+## Research Approach
+
+Participants were shown ABM messages within the NHS App before being asked to:
+
+- Explain their understanding of the service.
+- Locate and complete the unsubscribe journey.
+- Explain their expectations of an "unsubscribe" journey and how they would expect to rejoin the service if they changed their mind.
+
+The research explored both usability and users' expectations around message preferences.
+
+
+
+---
+## What We Learned
+
+### Relevance Is the Biggest Driver of Opt-Out
+
+Participants were generally comfortable with receiving messages automatically. The primary reason users said they would opt out was not automatic enrolment itself, but a lack of relevance. Messages perceived as generic, repetitive or not applicable to their circumstances were more likely to result in disengagement or opt-out behaviour.
+
+### Users Expect Preference Management Rather Than a Final Opt-Out
+
+Users expected a greater degree of control and often separated messages into two categories:
+
+- Important NHS information, such as vaccinations, appointments and health-related actions.
+
+- Advice, support and developmental guidance.
+
+- Several participants expressed a desire to receive essential health information while opting out of less relevant content. This suggests that users think in terms of managing preferences rather than simply leaving the service altogether.
+
+### Users Were Unclear About the ABM Service
+
+Many participants believed messages were being sent by health visitors, midwives or GPs. Others associated the messages with Best Start in Life and viewed these as the same service.
+
+As a result, participants often struggled to understand:
+
+- Who owned the service.
+
+- Why they were receiving messages.
+
+- How they would rejoin the service in future.
+
+This lack of service identity created confusion throughout the unsubscribe and re-subscription experience. Users viewed subscription management as reversible and expected they would be able to change their decision as their circumstances evolved.
+
+---
+## Design Decisions
+
+Based on the research, we have prioritised the following areas for further exploration:
+
+As a result, we will:
+
+- Strengthen the ABM service identity and clarify its relationship with Best Start in Life/other communications.
+
+- Improve message content to better communicate the value and purpose of messages.
+
+- Explore preference management options rather than a simple unsubscribe model.
+
+- Investigate pause and resubscription journeys.
+
+- Assess whether message categories/tiers could provide users with greater control.
+
+---
+## Next Steps
+
+We will continue testing service iterations throughout the remaining cohort period.
+
+Alongside this, we will:
+
+- Refine the ABM service proposition and identity.
+
+- Review the relationship between ABM and existing parent-facing communications.
+
+- Develop the content strategy to ensure messaging remains relevant and valuable over time.
+
+- Explore opportunities for preference management and re-subscription.
+
+- Validate whether message categorisation provides meaningful user value without adding complexity.
+
+The long-term goal is to create an experience that balances public health benefits with user autonomy, ensuring users remain informed, engaged and in control throughout their child's journey.
+
+
diff --git a/app/age-related-messaging/2026/08/our-opt-out-journey/opt-out-screen.png b/app/age-related-messaging/2026/08/our-opt-out-journey/opt-out-screen.png
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diff --git a/app/age-related-messaging/2026/08/pilot-service-overview-and-current-delivery/index.md b/app/age-related-messaging/2026/08/pilot-service-overview-and-current-delivery/index.md
new file mode 100644
index 000000000..ba16bd58c
--- /dev/null
+++ b/app/age-related-messaging/2026/08/pilot-service-overview-and-current-delivery/index.md
@@ -0,0 +1,148 @@
+---
+title: Pilot, Service Overview and Current Delivery
+description: Some updates now that the service is live.
+date: 2026-08-12
+tags:
+ - age-based messaging
+ - Pilot
+ - Digital Best Start
+author:
+ - Ash Finnegan
+opengraphImage:
+ src: /your-service/2025/12/post-title/image-name.png
+ alt: Alternative text for the lead image
+---
+
+Age-Based Messaging (ABM) is currently being piloted in Essex. The service sends timely information, guidance and reminders to parents and carers to support their child's health and development.
+
+The pilot officially launched in July 2026. For this phase, birth mothers are being asked for consent before receiving messages. While this approach helps us understand user attitudes towards the service, it has resulted in a slower rollout than initially anticipated as parents are being approached individually.
+
+The current pilot cohort is expected to conclude between October and November 2026. Subject to outcomes and learning, we hope to expand the service to five additional areas. Findings from the pilot will be used to inform future iterations, wider rollout plans and longer-term service strategy.
+
+Following the pilot, we plan to conduct surveys and user research with participants to understand:
+
+- Their experience of receiving the messages
+
+- Whether the messages influenced behaviour
+
+- Areas for improvement
+
+- The overall value of the service
+
+---
+## Our Approach
+
+The Essex pilot provides an opportunity to test the service with a smaller user group before wider rollout.
+
+Alongside live delivery, we have started a re-discovery phase to understand how Age-Based Messaging could develop and scale in future. This work looks beyond the initial seven messages and explores how the service could create value for parents, public health and the wider NHS.
+
+Our activities include:
+
+- Reviewing existing research and evidence
+
+- Mapping the current information landscape for parents
+
+- Understanding user needs and behaviours
+
+- Aligning with public health priorities
+
+- Exploring future content, service models and outcomes
+
+- Engaging with stakeholders across healthcare and public health
+
+We know that many health visitors, GPs and local services already communicate with parents. However, much of this communication is manual, resource-intensive and varies considerably by location. Age-Based Messaging provides an opportunity to deliver some information more consistently and at scale.
+
+---
+## How the Service Works
+The service consists of two key components:
+### Content
+The messages parents receive, including advice, reminders, signposting and guidance.
+### Cohorting and Delivery
+The technical process used to identify eligible recipients and deliver messages at the appropriate time.
+
+
+This approach helps ensure information reaches both NHS App users and those who rely on SMS communications.
+
+
+
+---
+
+## Multi-Channel Delivery
+
+As part of the current service journey, information about the birth mother is made available through PDS(Personal Demographics Service) following the birth of a child. The first Age-Based Message is sent 7 days after birth.
+
+Messages are delivered through NHS Notify using a multi-channel approach. The NHS App is the primary delivery channel. If a message remains unread after 3 days, an SMS version is automatically sent as a fallback. This helps ensure messages can reach both NHS App users and those who may not regularly access the app.
+
+Message content has been adapted for each channel, with separate versions designed for NHS App messaging and SMS delivery.
+
+### Eligibility and Safety Checks
+We use PDS records to help identify eligible recipients and ensure messages are not sent where they should not be.
+
+Examples include:
+
+- Baby deceased
+- Parent or Carer deceased
+- Sensitive record flagged
+- Parent opted out
+These checks form an important part of the service's safeguarding and governance approach.
+---
+
+## Our Happy Path User Journey
+Our current happy path assumes:
+
+1. Parent is identified through PDS.
+
+2. Introductory message is received.
+
+3. Parent recognises who the message is from.
+
+4. Parent understands the value of the service.
+
+5. Parent engages with the content.
+
+6. Parent acts on relevant calls to action.
+
+7. Parent continues engaging.
+
+8. Parent feels informed and supported.
+
+
+
+---
+
+### Behaviour States
+Within this, the research has suggested that users may respond in one or more of the followings ways:
+- Act immediately - Completes the call to action right away (e.g., clicks link, books check).
+
+- Save for later - Flags or bookmarks the notification to review when convenient.
+
+- Act later - Intends to take action but delays completion.
+
+- Forget - Reads the message but fails to follow through without reminders.
+
+- Ignore or disengage - Ignores or actively opts out of future communications.
+
+A particular risk is silent disengagement, where users remain enrolled but stop opening, reading or acting on messages.
+
+---
+## Current Relationship with Best Start in Life
+The current sender name for ABM messages is Best Start in Life (BSIL).
+
+Messages frequently signpost to BSIL content and other trusted NHS resources. Users can also choose to sign up for the BSIL email newsletter if they would like more detailed guidance and support.
+
+As we continue to develop the service, further work is needed to understand:
+
+- Where ABM and BSIL overlap
+
+- How the two services complement one another
+
+- How to avoid duplication
+
+- Whether the service name should evolve to better reflect the purpose of Age-Based Messaging
+
+The relationship between Age-Based Messaging and Best Start in Life continues to be an important area of exploration. While the current messages signpost to Best Start in Life content and are sent under the Best Start in Life sender name, it has become clear that further work is needed to clarify where the two services overlap and where they are distinct.
+
+Research has also shown that the term "Age-Based Messaging" is not always intuitive or user-friendly. As the service develops, we will explore alternative naming options and clearer ways of describing the service, helping users understand what it is, why they are receiving messages and what value it provides.
+
+The content strategy is currently under review as part of the scaling and discovery work.
+
diff --git a/app/age-related-messaging/2026/08/pilot-service-overview-and-current-delivery/messagebreakdown.png b/app/age-related-messaging/2026/08/pilot-service-overview-and-current-delivery/messagebreakdown.png
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diff --git a/app/age-related-messaging/2026/08/re-discover-phase/index.md b/app/age-related-messaging/2026/08/re-discover-phase/index.md
new file mode 100644
index 000000000..3b6d8b90d
--- /dev/null
+++ b/app/age-related-messaging/2026/08/re-discover-phase/index.md
@@ -0,0 +1,157 @@
+---
+title: Re-discovery for Scaling Up
+description: Why we started a re-discovery phase post pilo release.
+date: 2026-08-13
+tags:
+ - discovery
+ - problem-solving
+ - users
+ - age-based messaging
+author:
+ - Ash Finnegan
+
+---
+
+As the pilot developed, it became clear that Age-Based Messaging could evolve in a number of different directions. There was a need to establish a clearer strategic direction and align on where the service could create meaningful value for parents, public health and the wider NHS.
+
+The re-discovery phase started with identifying assumptions about the service and understanding where evidence already existed to support or challenge them. This evolved into a programme of workshops, stakeholder engagement and evidence reviews designed to better understand user needs, public health priorities and future opportunities for the service.
+
+This work resulted in the creation of a vision statement and two problem statements, allowing us to consider the challenge from both a parent and NHS perspective.
+
+## What We Are Exploring
+As part of the re-discovery phase, we are defining what a future Age-Based Messaging service could look like and how it could scale beyond the current pilot. Workshops have been used to align stakeholders around key questions relating to content, outcomes, user needs and public health priorities.
+
+A significant focus has been understanding what information should be delivered between birth and five years of age, how frequently it should be sent, and what action users should take after receiving a message. We are also examining what success looks like, both from a parental perspective and in terms of wider NHS and public health outcomes.
+
+In parallel, we are investigating clinical feasibility and safety considerations alongside the technical constraints and opportunities involved in delivering messages through services such as the NHS App. This includes understanding how data is used for cohorting, how messages are delivered, and where future personalisation may or may not be possible.
+
+The work is intended to identify opportunities, uncover gaps and support the development of a future evaluation framework that will help measure value and impact.
+
+
+## Our Vision Statement
+To set a clear direction and avoid scope creep, we established this vision:
+*A future where every parent and carer has clear, credible and relevant information throughout their child's early years, empowering them to make informed decisions and take the right action at the right time.*
+
+## Our Problem Statement(s)
+### Parent Perspective
+*Parents and carers lack clear, timely information about their child's health and development, leaving them unsure how to support them and turning to less reliable sources.*
+
+### NHS Perspective
+*Key public health indicators show that opportunities to improve children's health and development are frequently missed. Limited routine contact and traditional health promotion approaches mean parents and carers do not always receive timely, relevant information. This reduces opportunities to improve outcomes, prevent illness and reduce health inequalities.*
+
+## Stakeholder Workshops
+We have already conducted a series of stakeholder workshops including a content strategy workshp and a clinical hazard workshop to identify key stakeholders and their needs. We are continuing to facilitate workshops to continue information gathering to identify how best we can bring value to the NHS, public health and parents.
+
+Workshop participants include:
+
+- Health Visitors
+
+- Midwives
+
+- GPs and nurses
+
+- Best Start in Life representatives
+
+- 0-19 teams
+
+- Representatives from potential future rollout areas
+
+These workshops are helping shape future strategy and priorities.
+
+### Clinical and Public Health Considerations
+We are working with healthcare professionals, public health representatives and NHS stakeholders to understand:
+
+- Clinical safety considerations
+
+- Public health priorities
+
+- Feasibility of proposed topics
+
+- Potential risks
+
+This includes work completed through a dedicated Clinical Hazard Workshop.
+
+## Outcomes We Are Exploring
+
+As part of discovery, we are defining which outcomes Age-Based Messaging is best placed to influence. These include:
+
+- Awareness of important health interventions and services
+- Understanding of child health and development
+- Taking action at the right time
+- Confidence and reassurance for parents and carers
+- Navigation to appropriate services and support
+- Public health outcomes such as improved uptake of vaccinations, checks and preventative interventions
+
+This work will help determine future content, success measures and evaluation criteria.
+
+## User Archetypes
+The archetypes were developed using findings from Red Book, Growth Chart and Age-Based Messaging research. Rather than fixed personas, they represent common needs, behaviours and barriers that may affect engagement with child health information and services.
+
+At a high level, users sit within two broad groups: first-time parents and multi-child parents. Within these groups, we identified four broad subgroup categories of circumstances that may create barriers to engagement:
+
+- Parents facing personal and wellbeing challenges
+
+- Parents facing access and engagement barriers
+
+- Parents navigating complex child health journeys
+
+- Secondary carers and parents with diverse family, cultural and caregiving contexts
+
+These categories are not mutually exclusive and many parents may experience barriers across multiple groups at different points in their journey.
+Personal circumstances may influence how they interact with the service, including parents experiencing digital exclusion, language barriers, low confidence, financial pressures, complex family circumstances, caring responsibilities, or additional child health needs. We also included Health Visitors as important groups within the wider service ecosystem.
+
+The archetypes are intended to help teams consider how different circumstances can affect trust, accessibility, confidence, engagement and the ability to act on information. They should be used as a reference point when making content, design, product and strategic decisions to ensure the service works for a broad range of parents and carers, not just those with the fewest barriers to engagement.
+
+
+
+### What We Learned About Parent Pain Points
+
+Across archetypes, several themes emerged:
+
+- Information is difficult to find and not well surfaced
+
+- Information is fragmented across different services and resources
+
+- Content can feel unclear, overly clinical or lacking context
+
+- Parents are not always supported to understand what is normal
+
+- Guidance is not always timely, relevant or actionable
+
+- Parents are expected to connect information themselves across services and channels
+
+### Worst Case Scenarios
+The archetypes also helped us explore worst-case scenarios if user needs are not met, helping identify risks and inform prioritisation decisions.
+
+Across the archetypes, common risks included:
+
+- Parents disengaging from the service.
+
+- Loss of trust in NHS communications.
+
+- Important information, support or interventions being missed.
+
+- Increased reliance on informal or unreliable sources of information.
+
+- Secondary caregivers becoming excluded from the child's health journey.
+
+- Families with additional needs receiving information that feels inappropriate or irrelevant.
+
+These scenarios helped us identify areas of risk and ensure the service remains focused on delivering meaningful value to parents, carers and healthcare professionals.
+Next Steps
+
+## Next Steps Include:
+
+Completing the current workshop programme
+
+- Aligning on a long-term ABM strategy
+
+- Reviewing pilot outcomes and analytics
+
+- Conducting user interviews with pilot participants
+
+- Understanding value to parents, public health and the NHS
+
+- Identifying opportunities for future rollout and scaling
+
+The pilot findings will play an important role in determining how Age-Based Messaging evolves and where it can create the greatest meaningful impact.
diff --git a/app/record-a-vaccination/2024/07/pilot-designs/index.md b/app/record-a-vaccination/2024/07/pilot-designs/index.md
index 060e83201..e35bf4124 100644
--- a/app/record-a-vaccination/2024/07/pilot-designs/index.md
+++ b/app/record-a-vaccination/2024/07/pilot-designs/index.md
@@ -2,7 +2,7 @@
title: Designs used in the pilot
date: 2024-07-12
tags:
- - pilot
+ - Pilot
---
We ran an initial pilot of the service with 3 NHS Trusts in June 2024.