Cache programme status in database

app/components/app_outcome_banner_component.rb

@@ -54,7 +54,7 @@ def rows
   end
 
   def vaccination_record
-    @vaccination_record ||= patient.programme_outcome.all[programme].last
+    @vaccination_record ||= patient.latest_vaccination_records(programme:).last
   end
 
   def triage

app/components/app_patient_page_component.html.erb

@@ -96,7 +96,7 @@
   <% end %>
 <% end %>
 
-<% patient.programme_outcome.all[programme].each do |vaccination_record| %>
+<% patient.latest_vaccination_records(programme:).each do |vaccination_record| %>
   <%= render AppCardComponent.new do |c| %>
     <% c.with_heading { "Vaccination details" } %>
     <%= render AppVaccinationRecordSummaryComponent.new(vaccination_record, current_user:) %>

app/components/app_patient_search_result_card_component.rb

@@ -68,7 +68,7 @@ def call
   private
 
   def programme_outcome_tag
-    status = @patient.programme_outcome.status[@programme]
+    status = @patient.vaccination_status(programme: @programme).status
     render AppProgrammeStatusTagsComponent.new(
              { @programme => status },
              outcome: :programme

app/components/app_patient_session_search_result_card_component.rb

@@ -73,7 +73,7 @@ def action_required
     tag.ul(class: "nhsuk-list nhsuk-list--bullet") do
       safe_join(
         patient_session.programmes.map do |programme|
-          status = patient_session.patient.next_activity.status[programme]
+          status = patient_session.next_activity(programme:)
           tag.li("#{I18n.t(status, scope: :activity)} for #{programme.name}")
         end
       )

app/components/app_simple_status_banner_component.rb

@@ -95,7 +95,10 @@ def who_refused
   def nurse
     (
       patient.triages.includes(:performed_by).where(programme:) +
-        patient.programme_outcome.all[programme]
+        patient
+          .vaccination_records
+          .includes(:performed_by_user)
+          .where(programme:)
     ).max_by(&:updated_at)&.performed_by&.full_name
   end
 

app/controllers/draft_vaccination_records_controller.rb

@@ -112,6 +112,8 @@ def handle_confirm
 
     @vaccination_record.save!
 
+    StatusUpdater.call(patient: @patient)
+
     send_vaccination_confirmation(@vaccination_record) if should_notify_parents
 
     @vaccination_record.triage_patient_as_do_not_vaccinate!

app/controllers/programmes_controller.rb

@@ -47,22 +47,14 @@ def sessions
   end
 
   def patients
-    @statuses = Patient::ProgrammeOutcome::STATUSES
-
     scope =
-      policy_scope(Patient).in_programmes([@programme]).preload(
-        :triages,
-        :vaccination_records,
-        consents: :parent
+      policy_scope(Patient).includes(:vaccination_statuses).in_programmes(
+        [@programme]
       )
 
     patients = @form.apply(scope, programme: @programme)
 
-    if patients.is_a?(Array)
-      @pagy, @patients = pagy_array(patients)
-    else
-      @pagy, @patients = pagy(patients)
-    end
+    @pagy, @patients = pagy(patients)
   end
 
   def consent_form

app/controllers/triages_controller.rb

@@ -54,7 +54,12 @@ def set_patient
     @patient =
       @session
         .patients
-        .includes(:consents, :school, parent_relationships: :parent)
+        .includes(
+          :consents,
+          :school,
+          :vaccination_records,
+          parent_relationships: :parent
+        )
         .find_by(id: params[:patient_id])
   end
 

app/controllers/vaccination_records_controller.rb

@@ -39,6 +39,8 @@ def destroy
       send_vaccination_deletion(@vaccination_record)
     end
 
+    StatusUpdater.call(patient: @vaccination_record.patient)
+
     redirect_to @return_to, flash: { success: "Vaccination record deleted" }
   end
 

app/forms/search_form.rb

@@ -49,7 +49,7 @@ def apply(scope, programme: nil)
     end
 
     if (status = programme_status&.to_sym).present?
-      scope = scope.select { it.programme_outcome.status[programme] == status }
+      scope = scope.has_vaccination_status(status, programme:)
     end
 
     if (status = session_status&.to_sym).present?

app/jobs/concerns/send_clinic_invitations_concern.rb

@@ -25,7 +25,7 @@ def should_send_notification?(patient_session:, programmes:, session_date:)
 
     all_vaccinated =
       eligible_programmes.all? do |programme|
-        patient.programme_outcome.vaccinated?(programme)
+        patient.vaccination_status(programme:).vaccinated?
       end
 
     return false if all_vaccinated

app/jobs/school_consent_reminders_job.rb

@@ -56,7 +56,7 @@ def should_send_notification?(patient_session:, programmes:)
     has_consent_or_vaccinated =
       programmes.all? do |programme|
         patient.consents.any? { it.programme_id == programme.id } ||
-          patient.programme_outcome.all[programme].any?
+          patient.vaccination_records.any? { it.programme_id == programme.id }
       end
 
     return false if has_consent_or_vaccinated

app/jobs/school_consent_requests_job.rb

@@ -49,7 +49,7 @@ def should_send_notification?(patient:, programmes:)
     has_consent_or_vaccinated =
       programmes.all? do |programme|
         patient.consents.any? { it.programme_id == programme.id } ||
-          patient.programme_outcome.all[programme].any?
+          patient.vaccination_records.any? { it.programme_id == programme.id }
       end
 
     return false if has_consent_or_vaccinated

app/jobs/school_session_reminders_job.rb

@@ -44,7 +44,7 @@ def should_send_notification?(patient_session:)
 
     all_vaccinated =
       programmes.all? do |programme|
-        patient.programme_outcome.vaccinated?(programme)
+        patient.vaccination_status(programme:).vaccinated?
       end
 
     return false if all_vaccinated

app/lib/reports/offline_session_exporter.rb

@@ -160,7 +160,7 @@ def rows(patient_session:)
         }
       }
 
-      vaccination_records = patient.programme_outcome.all[programme]
+      vaccination_records = patient.vaccination_records
 
       if vaccination_records.any?
         vaccination_records.map do |vaccination_record|

app/lib/status_updater.rb

@@ -13,6 +13,7 @@ def initialize(patient: nil, session: nil)
   def call
     update_consent_statuses!
     update_triage_statuses!
+    update_vaccination_statuses!
   end
 
   def self.call(...) = new(...).call
@@ -69,6 +70,29 @@ def update_triage_statuses!
       end
   end
 
+  def update_vaccination_statuses!
+    Patient::VaccinationStatus.import!(
+      %i[patient_id programme_id],
+      patient_statuses_to_import,
+      on_duplicate_key_ignore: true
+    )
+
+    Patient::VaccinationStatus
+      .where(patient: patient_sessions.select(:patient_id))
+      .includes(:patient, :programme, :consents, :triages, :vaccination_records)
+      .find_in_batches(batch_size: 10_000) do |batch|
+        batch.each(&:assign_status)
+
+        Patient::VaccinationStatus.import!(
+          batch.select(&:changed?),
+          on_duplicate_key_update: {
+            conflict_target: [:id],
+            columns: %i[status]
+          }
+        )
+      end
+  end
+
   def patient_statuses_to_import
     @patient_statuses_to_import ||=
       patient_sessions

app/lib/vaccinated_criteria.rb

@@ -1,20 +1,20 @@
 # frozen_string_literal: true
 
 class VaccinatedCriteria
-  def initialize(programme, patient:, vaccination_records:)
+  def initialize(programme:, patient:, vaccination_records:)
     @programme = programme
     @patient = patient
     @vaccination_records = vaccination_records
   end
 
   def call
-    if vaccination_records.any? { it.programme_id != programme.id }
-      raise "Vaccination records provided for different programme."
-    end
+    vaccination_records_for_programme =
+      vaccination_records.select { it.programme_id == programme.id }
 
-    return true if vaccination_records.any?(&:already_had?)
+    return true if vaccination_records_for_programme.any?(&:already_had?)
 
-    administered_records = vaccination_records.select(&:administered?)
+    administered_records =
+      vaccination_records_for_programme.select(&:administered?)
 
     if programme.menacwy?
       administered_records.any? { patient.age(now: it.performed_at) >= 10 }
@@ -30,9 +30,7 @@ def call
     end
   end
 
-  def self.call(*args, **kwargs)
-    new(*args, **kwargs).call
-  end
+  def self.call(...) = new(...).call
 
   private_class_method :new
 

app/models/concerns/patient_session_status_concern.rb

@@ -22,9 +22,9 @@ def self.available_statuses
     def status(programme:)
       @status_by_programme ||= {}
 
-      @status_by_programme[
-        programme
-      ] ||= if patient.programme_outcome.vaccinated?(programme)
+      @status_by_programme[programme] ||= if patient.vaccination_status(
+           programme:
+         ).vaccinated?
         "vaccinated"
       elsif patient.triage_status(programme:).delay_vaccination?
         "delay_vaccination"

app/models/immunisation_import.rb

@@ -125,6 +125,6 @@ def count_column(vaccination_record)
   end
 
   def postprocess_rows!
-    # Nothing to do.
+    StatusUpdater.call(patient: patients)
   end
 end

app/models/patient.rb

@@ -75,6 +75,7 @@ class Patient < ApplicationRecord
   has_many :triage_statuses
   has_many :triages, -> { order(:created_at) }
   has_many :vaccination_records, -> { kept.order(:performed_at) }
+  has_many :vaccination_statuses
 
   has_many :parents, through: :parent_relationships
   has_many :gillick_assessments,
@@ -158,6 +159,17 @@ class Patient < ApplicationRecord
 
   scope :search_by_nhs_number, ->(nhs_number) { where(nhs_number:) }
 
+  scope :has_vaccination_status,
+        ->(status, programme:) do
+          where(
+            Patient::VaccinationStatus
+              .where("patient_id = patients.id")
+              .where(status:, programme:)
+              .arel
+              .exists
+          )
+        end
+
   validates :given_name, :family_name, :date_of_birth, presence: true
 
   validates :birth_academic_year, comparison: { greater_than_or_equal_to: 1990 }
@@ -264,14 +276,6 @@ def year_group_changed?
     birth_academic_year_changed?
   end
 
-  def programme_outcome
-    @programme_outcome ||= Patient::ProgrammeOutcome.new(self)
-  end
-
-  def next_activity
-    @next_activity ||= Patient::NextActivity.new(self)
-  end
-
   def consent_status(programme:)
     # Use `find` to allow for preloading.
     consent_statuses.find { it.programme_id == programme.id } ||
@@ -295,14 +299,20 @@ def latest_triage(programme:)
       .max_by(&:created_at)
   end
 
+  def vaccination_status(programme:)
+    # Use `find` to allow for preloading.
+    vaccination_statuses.find { it.programme_id == programme.id } ||
+      vaccination_statuses.build(programme:)
+  end
+
   def latest_vaccination_records(programme:)
     vaccination_records
       .select { it.programme_id == programme.id }
       .reject(&:discarded?)
   end
 
   def consent_given_and_safe_to_vaccinate?(programme:)
-    return false if programme_outcome.vaccinated?(programme)
+    return false if vaccination_status(programme:).vaccinated?
 
     consent_status(programme:).given? &&
       (