Ensure PSDs are created after verbal consent

When a prescriber records verbal consent, we also ask the user if they
would like to add a PSD to the patient. This wasn't working correctly,
and instead a PSD wasn't being added to the patient. This is because the
logic related to creating PSDs was specific to the triage journey that
occurs outside of the verbal consent journey. Instead I've moved the
logic in to the `TriageForm` ensuring that both triage journeys will
have the same logic.

Jira-Issue: MAV-1905

Author: thomasleese

app/components/app_patient_session_triage_component.rb

@@ -1,9 +1,10 @@
 # frozen_string_literal: true
 
 class AppPatientSessionTriageComponent < ViewComponent::Base
-  def initialize(patient_session, programme:, triage_form: nil)
+  def initialize(patient_session, programme:, current_user:, triage_form: nil)
     @patient_session = patient_session
     @programme = programme
+    @current_user = current_user
     @triage_form = triage_form || default_triage_form
   end
 
@@ -13,7 +14,7 @@ def render?
 
   private
 
-  attr_reader :patient_session, :programme, :triage_form
+  attr_reader :patient_session, :programme, :current_user, :triage_form
 
   delegate :govuk_button_link_to, to: :helpers
   delegate :patient, :session, to: :patient_session
@@ -50,5 +51,7 @@ def latest_triage
       )
   end
 
-  def default_triage_form = TriageForm.new(patient_session:, programme:)
+  def default_triage_form
+    TriageForm.new(patient_session:, programme:, current_user:)
+  end
 end

app/components/app_triage_form_component.html.erb

@@ -4,11 +4,11 @@
     <%= f.govuk_radio_buttons_fieldset :status_and_vaccine_method, **fieldset_options do %>
       <% form.safe_to_vaccinate_options.each do |option| %>
         <%= f.govuk_radio_button :status_and_vaccine_method, option do %>
-        <% if show_psd_options?(option) %>
-          <%= f.govuk_radio_buttons_fieldset :psd_action,
+        <% if form.show_add_patient_specific_direction?(option) %>
+          <%= f.govuk_radio_buttons_fieldset :add_patient_specific_direction,
                                              legend: { text: "Do you want to add a PSD?", size: "s" } do %>
-            <%= f.govuk_radio_button :add_psd, "true", label: { text: "Yes" } %>
-            <%= f.govuk_radio_button :add_psd, "false", label: { text: "No" } %>
+            <%= f.govuk_radio_button :add_patient_specific_direction, "true", label: { text: "Yes" } %>
+            <%= f.govuk_radio_button :add_patient_specific_direction, "false", label: { text: "No" } %>
           <% end %>
         <% end %>
       <% end %>

app/components/app_triage_form_component.rb

@@ -19,12 +19,6 @@ def initialize(form, url:, method: :post, heading: true, continue: false)
 
   def builder = GOVUKDesignSystemFormBuilder::FormBuilder
 
-  def show_psd_options?(option)
-    patient_session.session.psd_enabled? &&
-      option == "safe_to_vaccinate_nasal" &&
-      policy(PatientSpecificDirection).create?
-  end
-
   def fieldset_options
     text = "Is it safe to vaccinate #{patient.given_name}?"
     hint =

app/controllers/draft_consents_controller.rb

@@ -106,6 +106,8 @@ def handle_triage
     @triage_form.assign_attributes(triage_form_params)
 
     @draft_consent.assign_attributes(
+      triage_add_patient_specific_direction:
+        @triage_form.add_patient_specific_direction,
       triage_form_valid: @triage_form.valid?,
       triage_notes: @triage_form.notes,
       triage_status_and_vaccine_method: @triage_form.status_and_vaccine_method,
@@ -145,7 +147,13 @@ def update_params
   end
 
   def triage_form_params
-    params.expect(triage_form: %i[status_and_vaccine_method notes])
+    params.expect(
+      triage_form: %i[
+        status_and_vaccine_method
+        notes
+        add_patient_specific_direction
+      ]
+    )
   end
 
   def set_draft_consent
@@ -184,6 +192,9 @@ def set_triage_form
     @triage_form =
       if policy(Triage).new?
         TriageForm.new(
+          add_patient_specific_direction:
+            @draft_consent.triage_add_patient_specific_direction,
+          current_user:,
           notes: @draft_consent.triage_notes,
           vaccine_methods: @draft_consent.vaccine_methods,
           patient_session: @patient_session,

app/controllers/patient_sessions/triages_controller.rb

@@ -18,6 +18,7 @@ def new
 
     @triage_form =
       TriageForm.new(
+        current_user:,
         patient_session: @patient_session,
         programme: @programme,
         triage: previous_triage
@@ -46,8 +47,6 @@ def create
         )
         .each { send_triage_confirmation(@patient_session, @programme, it) }
 
-      @triage_form.add_psd? ? ensure_psd_exists : remove_existing_psd
-
       redirect_to redirect_path, flash: { success: "Triage outcome updated" }
     else
       render "patient_sessions/programmes/show",
@@ -59,7 +58,13 @@ def create
   private
 
   def triage_form_params
-    params.expect(triage_form: %i[status_and_vaccine_method notes add_psd])
+    params.expect(
+      triage_form: %i[
+        status_and_vaccine_method
+        notes
+        add_patient_specific_direction
+      ]
+    )
   end
 
   def redirect_path
@@ -70,34 +75,4 @@ def redirect_path
       return_to: "triage"
     )
   end
-
-  def ensure_psd_exists
-    # TODO: Handle programmes with multiple nasal vaccines.
-    vaccine = @programme.vaccines.nasal.first
-
-    psd_attributes = {
-      academic_year: @academic_year,
-      delivery_site: "nose",
-      patient: @patient,
-      programme: @programme,
-      vaccine:,
-      vaccine_method: "nasal"
-    }
-
-    return if PatientSpecificDirection.exists?(**psd_attributes)
-
-    PatientSpecificDirection.create!(
-      psd_attributes.merge(created_by: current_user)
-    )
-  end
-
-  def remove_existing_psd
-    PatientSpecificDirection.find_by(
-      {
-        academic_year: @academic_year,
-        patient: @patient,
-        programme: @programme
-      }
-    )&.destroy!
-  end
 end

app/forms/triage_form.rb

@@ -6,23 +6,21 @@ class TriageForm
 
   attr_accessor :patient_session, :programme, :current_user
 
-  attribute :status_and_vaccine_method, :string
-  attribute :add_psd, :boolean
+  attribute :add_patient_specific_direction, :boolean
   attribute :notes, :string
+  attribute :status_and_vaccine_method, :string
   attribute :vaccine_methods, array: true, default: []
 
+  validates :add_patient_specific_direction,
+            inclusion: {
+              in: [true, false]
+            },
+            if: :requires_add_patient_specific_direction?
   validates :status_and_vaccine_method,
             inclusion: {
               in: :status_and_vaccine_method_options
             }
   validates :notes, length: { maximum: 1000 }
-  validates :add_psd,
-            inclusion: {
-              in: [true, false]
-            },
-            if: -> { add_psd.present? }
-
-  def add_psd? = add_psd
 
   def triage=(triage)
     self.status_and_vaccine_method =
@@ -40,11 +38,14 @@ def triage=(triage)
   end
 
   def save
-    Triage.create!(triage_attributes) if valid?
+    save! if valid?
   end
 
   def save!
-    Triage.create!(triage_attributes)
+    ActiveRecord::Base.transaction do
+      handle_patient_specific_direction
+      Triage.create!(triage_attributes)
+    end
   end
 
   def safe_to_vaccinate_options
@@ -67,6 +68,11 @@ def consented_to_injection? = consented_vaccine_methods.include?("injection")
 
   def consented_to_injection_only? = consented_vaccine_methods == ["injection"]
 
+  def show_add_patient_specific_direction?(option)
+    session.psd_enabled? && option == "safe_to_vaccinate_nasal" &&
+      can_create_patient_specific_directions?
+  end
+
   private
 
   delegate :team, :patient, :session, to: :patient_session
@@ -87,7 +93,7 @@ def triage_attributes
       programme:,
       status:,
       vaccine_method:,
-      academic_year: session.academic_year
+      academic_year:
     }
   end
 
@@ -113,4 +119,53 @@ def vaccine_method
       "nasal"
     end
   end
+
+  def requires_add_patient_specific_direction?
+    show_add_patient_specific_direction?(status_and_vaccine_method)
+  end
+
+  def can_create_patient_specific_directions?
+    PatientSpecificDirectionPolicy.new(
+      current_user,
+      PatientSpecificDirection
+    ).create?
+  end
+
+  def handle_patient_specific_direction
+    if add_patient_specific_direction
+      create_patient_specific_direction!
+    elsif add_patient_specific_direction == false
+      destroy_patient_specific_directions!
+    end
+  end
+
+  def create_patient_specific_direction!
+    vaccine_method = "nasal"
+
+    # TODO: Handle programmes with multiple nasal vaccines.
+    vaccine = programme.vaccines.find_by(method: vaccine_method)
+
+    attributes = {
+      academic_year:,
+      delivery_site: "nose",
+      patient:,
+      programme:,
+      vaccine:,
+      vaccine_method:
+    }
+
+    return if patient.patient_specific_directions.exists?(attributes)
+
+    patient.patient_specific_directions.create!(
+      created_by: current_user,
+      **attributes
+    )
+  end
+
+  def destroy_patient_specific_directions!
+    patient
+      .patient_specific_directions
+      .where(academic_year:, programme:)
+      .destroy_all
+  end
 end

app/models/draft_consent.rb

@@ -32,6 +32,7 @@ class DraftConsent
   attribute :recorded_by_user_id, :integer
   attribute :response, :string
   attribute :route, :string
+  attribute :triage_add_patient_specific_direction, :boolean
   attribute :triage_notes, :string
   attribute :triage_status_and_vaccine_method, :string
   attribute :vaccine_methods, array: true, default: []
@@ -309,6 +310,8 @@ def write_to!(consent, triage_form:)
     consent.academic_year = academic_year if academic_year.present?
 
     if triage_allowed? && response_given?
+      triage_form.add_patient_specific_direction =
+        triage_add_patient_specific_direction
       triage_form.notes = triage_notes || ""
       triage_form.current_user = recorded_by
       triage_form.status_and_vaccine_method = triage_status_and_vaccine_method

app/views/patient_sessions/programmes/show.html.erb

@@ -8,7 +8,7 @@
   <div class="app-grid-column-patient-session">
     <%= render AppPatientSessionConsentComponent.new(@patient_session, programme: @programme) %>
 
-    <%= render AppPatientSessionTriageComponent.new(@patient_session, programme: @programme, triage_form: @triage_form) %>
+    <%= render AppPatientSessionTriageComponent.new(@patient_session, programme: @programme, current_user:, triage_form: @triage_form) %>
 
     <%= render AppPatientSessionRecordComponent.new(@patient_session, programme: @programme, current_user:, vaccinate_form: @vaccinate_form) %>
 

config/locales/en.yml

@@ -146,7 +146,7 @@ en:
             status_and_vaccine_method:
               blank: Choose a status
               inclusion: Choose a status
-            add_psd:
+            add_patient_specific_direction:
               blank: Select yes or no
               inclusion: Select yes or no
         vaccinate_form:

db/seeds.rb

@@ -261,6 +261,7 @@ def create_team_sessions(user, team)
   create_user(:medical_secretary, team:, email: "admin.hope@example.com")
   create_user(:superuser, team:, email: "superuser@example.com")
   create_user(:healthcare_assistant, team:, email: "hca@example.com")
+  create_user(:prescriber, team:, email: "prescriber@example.com")
 
   attach_sample_of_schools_to(team)