Track consent status on programme status

This adds a new column to the programme status model which will store
the consent status of the patient for that programme and academic year.
This is needed as a replacement for the individual consent status model
which we'd like to get rid of to simplify the code.

There are some parts of the service (notably the offline spreadsheet and
the reporting API) that relies on being able to display a list of
consent statuses and therefore replacing the `Patient::ConsentStatus`
with dynamically calculated values would not be performant. Instead we
will add the consent status as a column on the programme status model,
allowing us to simplify the `StatusUpdater` class and likely cut down
how long it takes to run by approximately half.

Jira-Issue: MAV-2660

Author: thomasleese

app/lib/status_generator/programme.rb

@@ -78,7 +78,7 @@ def without_gelatine
     if vaccination_generator.status == :not_eligible ||
          triage_generator.status.in?(
            %i[required invite_to_clinic do_not_vaccinate]
-         ) || consent_generator.status.in?(%i[no_response conflicts refused])
+         ) || consent_status.in?(%i[no_response conflicts refused])
       return nil
     end
 
@@ -89,14 +89,14 @@ def vaccine_methods
     if vaccination_generator.status == :not_eligible ||
          triage_generator.status.in?(
            %i[required invite_to_clinic do_not_vaccinate]
-         ) || consent_generator.status.in?(%i[no_response conflicts refused])
+         ) || consent_status.in?(%i[no_response conflicts refused])
       return nil
     end
 
     if triage_generator.vaccine_method
       [triage_generator.vaccine_method]
     else
-      consent_generator.vaccine_methods
+      consent_vaccine_methods
     end
   end
 
@@ -105,7 +105,7 @@ def disease_types
 
     if vaccination_generator.disease_types
       vaccination_generator.disease_types
-    elsif consent_generator.status.in?(%i[given refused conflicts])
+    elsif consent_status.in?(%i[given refused conflicts])
       consent_generator.disease_types
     end
   end
@@ -119,6 +119,14 @@ def location_id
     vaccination_generator.latest_location_id
   end
 
+  def consent_status
+    consent_generator.status
+  end
+
+  def consent_vaccine_methods
+    consent_generator.vaccine_methods
+  end
+
   private
 
   attr_reader :programme_type,
@@ -182,20 +190,19 @@ def should_be_needs_triage?
   end
 
   def should_be_has_refusal_consent_conflicts?
-    consent_generator.status == :conflicts
+    consent_status == :conflicts
   end
 
   def should_be_has_refusal_consent_refused?
-    consent_generator.status == :refused
+    consent_status == :refused
   end
 
   def should_be_needs_consent_follow_up_requested?
     false # TODO: Implement this status.
   end
 
   def should_be_needs_consent_no_response?
-    vaccination_generator.status == :eligible &&
-      consent_generator.status == :no_response
+    vaccination_generator.status == :eligible && consent_status == :no_response
   end
 
   def should_be_needs_consent_request_failed?

app/lib/status_updater.rb

@@ -70,6 +70,8 @@ def update_programme_statuses!
           on_duplicate_key_update: {
             conflict_target: [:id],
             columns: %i[
+              consent_status
+              consent_vaccine_methods
               date
               disease_types
               dose_sequence

app/models/patient/programme_status.rb

@@ -4,17 +4,19 @@
 #
 # Table name: patient_programme_statuses
 #
-#  id               :bigint           not null, primary key
-#  academic_year    :integer          not null
-#  date             :date
-#  disease_types    :enum             is an Array
-#  dose_sequence    :integer
-#  programme_type   :enum             not null
-#  status           :integer          default("not_eligible"), not null
-#  vaccine_methods  :integer          is an Array
-#  without_gelatine :boolean
-#  location_id      :bigint
-#  patient_id       :bigint           not null
+#  id                      :bigint           not null, primary key
+#  academic_year           :integer          not null
+#  consent_status          :integer          default("no_response")
+#  consent_vaccine_methods :integer          default([]), is an Array
+#  date                    :date
+#  disease_types           :enum             is an Array
+#  dose_sequence           :integer
+#  programme_type          :enum             not null
+#  status                  :integer          default("not_eligible"), not null
+#  vaccine_methods         :integer          is an Array
+#  without_gelatine        :boolean
+#  location_id             :bigint
+#  patient_id              :bigint           not null
 #
 # Indexes
 #
@@ -117,6 +119,16 @@ class Patient::ProgrammeStatus < ApplicationRecord
        default: :not_eligible,
        validate: true
 
+  enum :consent_status,
+       { no_response: 0, given: 1, refused: 2, conflicts: 3, not_required: 4 },
+       default: :no_response,
+       prefix: :consent,
+       validate: true
+
+  array_enum consent_vaccine_methods: vaccine_methods
+
+  validates :consent_vaccine_methods, subset: consent_vaccine_methods.keys
+
   scope :needs_consent, -> { where(status: NEEDS_CONSENT_STATUSES.keys) }
 
   scope :has_refusal, -> { where(status: HAS_REFUSAL_STATUSES.keys) }
@@ -136,6 +148,8 @@ def vaccinated? = status.in?(VACCINATED_STATUSES.keys)
   def group = GROUPS.find { status.starts_with?(it) }
 
   def assign
+    self.consent_status = generator.consent_status
+    self.consent_vaccine_methods = generator.consent_vaccine_methods
     self.date = generator.date
     self.disease_types = generator.disease_types
     self.dose_sequence = generator.dose_sequence

db/migrate/20260122080105_add_consent_status_to_patient_programme_statuses.rb

@@ -0,0 +1,10 @@
+# frozen_string_literal: true
+
+class AddConsentStatusToPatientProgrammeStatuses < ActiveRecord::Migration[8.1]
+  def change
+    change_table :patient_programme_statuses, bulk: true do |t|
+      t.integer :consent_status, default: 0
+      t.integer :consent_vaccine_methods, array: true, default: []
+    end
+  end
+end

db/schema.rb

@@ -618,6 +618,8 @@
 
   create_table "patient_programme_statuses", force: :cascade do |t|
     t.integer "academic_year", null: false
+    t.integer "consent_status", default: 0
+    t.integer "consent_vaccine_methods", default: [], array: true
     t.date "date"
     t.enum "disease_types", array: true, enum_type: "disease_type"
     t.integer "dose_sequence"

spec/factories/patient_programme_statuses.rb

@@ -4,17 +4,19 @@
 #
 # Table name: patient_programme_statuses
 #
-#  id               :bigint           not null, primary key
-#  academic_year    :integer          not null
-#  date             :date
-#  disease_types    :enum             is an Array
-#  dose_sequence    :integer
-#  programme_type   :enum             not null
-#  status           :integer          default("not_eligible"), not null
-#  vaccine_methods  :integer          is an Array
-#  without_gelatine :boolean
-#  location_id      :bigint
-#  patient_id       :bigint           not null
+#  id                      :bigint           not null, primary key
+#  academic_year           :integer          not null
+#  consent_status          :integer          default("no_response")
+#  consent_vaccine_methods :integer          default([]), is an Array
+#  date                    :date
+#  disease_types           :enum             is an Array
+#  dose_sequence           :integer
+#  programme_type          :enum             not null
+#  status                  :integer          default("not_eligible"), not null
+#  vaccine_methods         :integer          is an Array
+#  without_gelatine        :boolean
+#  location_id             :bigint
+#  patient_id              :bigint           not null
 #
 # Indexes
 #

spec/lib/status_generator/programme_spec.rb

@@ -30,6 +30,8 @@
       create(:vaccination_record, :already_had, patient:, programme:, location:)
     end
 
+    its(:consent_status) { should be(:not_required) }
+    its(:consent_vaccine_methods) { should be_empty }
     its(:date) { should eq(vaccination_record.performed_at.to_date) }
     its(:disease_types) { should eq(%w[human_papillomavirus]) }
     its(:dose_sequence) { should be_nil }
@@ -46,6 +48,8 @@
       create(:vaccination_record, patient:, programme:, location:)
     end
 
+    its(:consent_status) { should be(:not_required) }
+    its(:consent_vaccine_methods) { should be_empty }
     its(:date) { should eq(vaccination_record.performed_at.to_date) }
     its(:disease_types) { should eq(%w[human_papillomavirus]) }
     its(:dose_sequence) { should be_nil }
@@ -62,6 +66,8 @@
       create(:vaccination_record, patient:, programme:, location:)
     end
 
+    its(:consent_status) { should be(:no_response) }
+    its(:consent_vaccine_methods) { should be_empty }
     its(:date) { should eq(vaccination_record.performed_at.to_date) }
     its(:disease_types) { should be_nil }
     its(:dose_sequence) { should eq(2) }
@@ -73,6 +79,8 @@
     context "with consent for the next dose" do
       before { create(:consent, :given, patient:, programme:) }
 
+      its(:consent_status) { should be(:given) }
+      its(:consent_vaccine_methods) { should contain_exactly("injection") }
       its(:status) { should be(:due) }
       its(:date) { should eq(vaccination_record.performed_at.to_date) }
       its(:disease_types) { should be_empty }
@@ -88,6 +96,8 @@
       create(:vaccination_record, :unwell, patient:, programme:, location:)
     end
 
+    its(:consent_status) { should be(:given) }
+    its(:consent_vaccine_methods) { should contain_exactly("injection") }
     its(:date) { should eq(vaccination_record.performed_at.to_date) }
     its(:disease_types) { should eq(programme.disease_types) }
     its(:location_id) { should be_nil }
@@ -120,6 +130,8 @@
       create(:vaccination_record, :refused, patient:, programme:, location:)
     end
 
+    its(:consent_status) { should be(:given) }
+    its(:consent_vaccine_methods) { should contain_exactly("injection") }
     its(:date) { should eq(vaccination_record.performed_at.to_date) }
     its(:disease_types) { should eq(programme.disease_types) }
     its(:location_id) { should be_nil }
@@ -151,6 +163,8 @@
       )
     end
 
+    its(:consent_status) { should be(:given) }
+    its(:consent_vaccine_methods) { should contain_exactly("injection") }
     its(:date) { should eq(vaccination_record.performed_at.to_date) }
     its(:disease_types) { should eq(programme.disease_types) }
     its(:location_id) { should be_nil }
@@ -176,6 +190,8 @@
       create(:attendance_record, :absent, patient:, session:)
     end
 
+    its(:consent_status) { should be(:given) }
+    its(:consent_vaccine_methods) { should contain_exactly("injection") }
     its(:date) { should eq(attendance_record.date) }
     its(:disease_types) { should eq(programme.disease_types) }
     its(:location_id) { should be_nil }
@@ -207,6 +223,8 @@
       )
     end
 
+    its(:consent_status) { should be(:given) }
+    its(:consent_vaccine_methods) { should contain_exactly("injection") }
     its(:date) { should eq(Date.tomorrow) }
     its(:disease_types) { should eq(programme.disease_types) }
     its(:dose_sequence) { should be_nil }
@@ -224,6 +242,8 @@
       create(:triage, :invite_to_clinic, patient:, programme:)
     end
 
+    its(:consent_status) { should be(:given) }
+    its(:consent_vaccine_methods) { should contain_exactly("injection") }
     its(:date) { should be_nil }
     its(:disease_types) { should eq(programme.disease_types) }
     its(:dose_sequence) { should be_nil }
@@ -241,6 +261,8 @@
       create(:triage, :do_not_vaccinate, patient:, programme:)
     end
 
+    its(:consent_status) { should be(:given) }
+    its(:consent_vaccine_methods) { should contain_exactly("injection") }
     its(:date) { should be_nil }
     its(:disease_types) { should eq(programme.disease_types) }
     its(:dose_sequence) { should be_nil }
@@ -255,6 +277,8 @@
 
     before { create(:consent, :given, :needing_triage, patient:, programme:) }
 
+    its(:consent_status) { should be(:given) }
+    its(:consent_vaccine_methods) { should contain_exactly("injection") }
     its(:date) { should be_nil }
     its(:disease_types) { should eq(programme.disease_types) }
     its(:dose_sequence) { should be_nil }
@@ -269,6 +293,8 @@
 
     before { create(:consent, :refused, patient:, programme:) }
 
+    its(:consent_status) { should be(:refused) }
+    its(:consent_vaccine_methods) { should be_empty }
     its(:date) { should be_nil }
     its(:disease_types) { should be_empty }
     its(:dose_sequence) { should eq(1) }
@@ -286,6 +312,8 @@
       create(:consent, :given, patient:, programme:, parent: create(:parent))
     end
 
+    its(:consent_status) { should be(:conflicts) }
+    its(:consent_vaccine_methods) { should be_empty }
     its(:date) { should be_nil }
     its(:disease_types) { should be_empty }
     its(:dose_sequence) { should be(1) }
@@ -298,6 +326,8 @@
   context "when consent is needed" do
     let(:programme) { Programme.menacwy }
 
+    its(:consent_status) { should be(:no_response) }
+    its(:consent_vaccine_methods) { should be_empty }
     its(:date) { should be_nil }
     its(:disease_types) { should be_nil }
     its(:dose_sequence) { should be_nil }
@@ -316,6 +346,8 @@
   context "when not eligible" do
     let(:patient) { create(:patient, year_group: 20) }
 
+    its(:consent_status) { should be(:no_response) }
+    its(:consent_vaccine_methods) { should be_empty }
     its(:date) { should be_nil }
     its(:disease_types) { should be_nil }
     its(:dose_sequence) { should be_nil }

spec/models/patient/programme_status_spec.rb

@@ -4,17 +4,19 @@
 #
 # Table name: patient_programme_statuses
 #
-#  id               :bigint           not null, primary key
-#  academic_year    :integer          not null
-#  date             :date
-#  disease_types    :enum             is an Array
-#  dose_sequence    :integer
-#  programme_type   :enum             not null
-#  status           :integer          default("not_eligible"), not null
-#  vaccine_methods  :integer          is an Array
-#  without_gelatine :boolean
-#  location_id      :bigint
-#  patient_id       :bigint           not null
+#  id                      :bigint           not null, primary key
+#  academic_year           :integer          not null
+#  consent_status          :integer          default("no_response")
+#  consent_vaccine_methods :integer          default([]), is an Array
+#  date                    :date
+#  disease_types           :enum             is an Array
+#  dose_sequence           :integer
+#  programme_type          :enum             not null
+#  status                  :integer          default("not_eligible"), not null
+#  vaccine_methods         :integer          is an Array
+#  without_gelatine        :boolean
+#  location_id             :bigint
+#  patient_id              :bigint           not null
 #
 # Indexes
 #
@@ -45,11 +47,13 @@
         programme_generator
       )
       allow(programme_generator).to receive_messages(
+        consent_status: :given,
+        consent_vaccine_methods: %w[injection],
         date: Date.new(2020, 1, 1),
         disease_types: %w[influenza],
         dose_sequence: 1,
         location_id: 1,
-        status: "vaccinated",
+        status: :vaccinated_fully,
         vaccine_methods: %w[injection],
         without_gelatine: true
       )
@@ -58,11 +62,15 @@
     it "calls the status generator" do
       assign
 
+      expect(patient_programme_status.consent_status).to eq("given")
+      expect(patient_programme_status.consent_vaccine_methods).to eq(
+        %w[injection]
+      )
       expect(patient_programme_status.date).to eq(Date.new(2020, 1, 1))
       expect(patient_programme_status.disease_types).to eq(%w[influenza])
       expect(patient_programme_status.dose_sequence).to eq(1)
       expect(patient_programme_status.location_id).to eq(1)
-      expect(patient_programme_status.status).to eq("vaccinated")
+      expect(patient_programme_status.status).to eq("vaccinated_fully")
       expect(patient_programme_status.vaccine_methods).to eq(%w[injection])
       expect(patient_programme_status.without_gelatine).to be(true)
     end