Patient Support Portal
A secure wellbeing management platform enabling clinicians to monitor quality of life, pain and mental health for end-of-life cancer patients - deployed across NHS trusts with full data encryption and multi-tenant isolation.
Overview
Built as sole developer and architect for Open Health, this platform gave clinicians across NHS trusts a data-driven tool for monitoring end-of-life cancer patients. Monthly wellbeing questionnaires generated quantified scores tracking pain, mental health and quality of life over time - informing treatment adjustments and palliative care decisions. The architecture prioritised security above all else: field-level AES-256 encryption, per-tenant database isolation, scoped sessions and automated deployment through Ansible.
The Challenge
Open Health needed a platform that could track the wellbeing of end-of-life cancer patients across multiple NHS trusts. Clinicians required a way to monitor quality of life, pain levels and mental health over time - using structured data to inform medication adjustments and treatment plans. The system had to meet NHS data security standards, with patient records fully encrypted and no possibility of data leakage between trusts. Key requirements included:
- Monthly lifestyle questionnaires generating quantified wellbeing scores over time
- Clinician dashboards showing patient trends, alerts and reporting
- Full NHS data security compliance with field-level encryption of all patient data
- Multi-tenant architecture with complete data isolation between NHS trusts
- Automated deployment and provisioning across trust environments
Wellbeing Tracking & Questionnaires
The core of the platform was a structured monthly questionnaire system designed in collaboration with clinical teams. Patients completed questionnaires covering pain levels, mental health, mobility, appetite and overall quality of life. Each response generated a quantified wellbeing score that was tracked longitudinally - giving clinicians a clear, data-driven view of how a patient's condition was changing over time. Clinicians could drill into individual responses, compare scores across periods, and use the trends to inform decisions about medication adjustments, palliative care intensity and support interventions.
Data Security & Encryption
Given the sensitivity of patient health data and NHS compliance requirements, security was the primary architectural concern. All patient and staff data was encrypted at the field level using AES-256 encryption - not just at rest, but within the database itself, meaning even direct database access would yield only encrypted values. Custom tooling was built to enable querying and managing encrypted records without exposing plaintext data in logs, caches or intermediate storage. Encryption keys were cycled per tenant, ensuring that a compromised key in one trust could never expose data from another.
Multi-Tenancy & Isolation
Each NHS trust operated as a fully isolated tenant with its own dedicated database. Tenant resolution was handled at the session level, with scoped sessions ensuring that every query, every view and every report was locked to the authenticated trust context. Combined with per-tenant encryption key cycling and separate database instances, this created a defence-in-depth isolation model that satisfied NHS information governance requirements. New trusts could be onboarded through automated provisioning without affecting existing deployments.
Infrastructure & Deployment
Deployment and server provisioning were automated through Ansible playbooks, enabling consistent, repeatable deployments across trust environments. This was critical for a healthcare platform where manual configuration errors could introduce security gaps or data integrity issues. The automation covered server setup, application deployment, database provisioning, encryption key generation and environment configuration - reducing the operational overhead of managing multiple isolated trust instances.
Technology Stack
Technical Challenges
Field-Level Encryption With Queryable Records
Implemented AES-256 encryption at the database field level for all patient and staff data, with custom tooling to query and manage encrypted records without exposing plaintext in logs or intermediate storage. This exceeded standard at-rest encryption by protecting data even from direct database access.
Multi-Tenant Isolation Across NHS Trusts
Built a multi-tenant architecture with dedicated databases per trust, scoped session isolation and per-tenant encryption key cycling. Defence-in-depth ensured no data leakage between trusts, satisfying NHS information governance requirements.
Clinical Data Modelling for Longitudinal Tracking
Worked with clinical teams to design questionnaire structures that generated meaningful, quantifiable wellbeing scores. The data model supported longitudinal tracking across months, enabling clinicians to visualise trends and make evidence-based treatment decisions.