001 CQRS: HPV completing dose (booster)
This article assumes the reader has access to CQRS, and can interpret the descriptions of payment indicators.
The HPV completing dose vaccination indicators are a manual submission to CQRS following the end of the monthly reporting period. Unlike other vaccination indicators found on CQRS, there are no established business rules. Instead NHS Digital suggests Practices "decide the best mechanism for reporting the figures, either by developing their own template or by working with their system to create a template." In other words, Practices can theoretically report based on any searches they choose to write. The caveat is that the bulk of HPV jabs are expected to be done in the schools programme so the activity in general practice should be small.
The searches are built in a way which means it is not possible to review data in historic months. Practices may consider storing results for future reference.
Service Indicators
Indicator | Description | Lower age limit | Upper age limit (inclusive) |
HPV006 | Monthly count of the number of patients who achieved 14 years of age and who have not achieved the age of 25 years who have received a first dose of HPV at the GP practice as a result of missing the provision by the Schools programme for school aged patients. | 14 years (14th birthday) | Day before 25th birthday |
HPV007 | Monthly count of the number of immunosuppressed patients who achieved 14 years of age and who have not attained the age of 25 years who have received a second dose of HPV at the GP practice as a result of missing the provision by the Schools programme for school aged patients. | 14 years (14th birthday) Previous dose must have been given at least 31 days prior | Day before 25th birthday |
HPV008 | Monthly count of the number of immunosuppressed patients who achieved 14 years of age and who have not yet attained 25 years who have received a third dose of HPV, at the GP practice as a result of missing the provision by the Schools programme for school aged patients; and who had their first dose aged 15 years and above. | 14 years (14th birthday) Previous dose must have been given at least 31 days prior | Day before 25th birthday |
PCIT authored reports
Payment Reports
Primary Care IT has built a set of searches to support the 6in1 extraction. The main searches closely mirror the business rules, and it is expected that these will forecast the volume of activity recognised for payment by the CQRS count.
HPV007 and HPV008 will only report on patients with an immunocompromised condition. In the absence of defined business rules for these indicators, the immunocompromised rules were adopted from the PPV cohort for PNEU005.
Missed Activity
Additional "Missed Activity" searches are provided to highlight additional patients who have not already been counted by the CQRS counts. They are identified by the prefix HPVBx. Missed Activity searches are NOT built to return a specific service indicator but to capture likely activity based on vaccinations recorded during the month, grouped by a certain characteristic. In the case of 6IN1, this is grouped between under 10s and over 10s.
There are several reasons why a patient may appear in a "Missed Activity" report instead of a "Payment" report, and these all need to be considered.
- The vaccination was recorded without the GMS qualifier. The business rules require that vaccinations given under GMS should be recorded correctly. Failure to select GMS may lead to the vaccination not being recognised for payment.
- The wrong vaccination or part was added. Ensure the correct type of HPV vaccination has been recorded.
- Patient was too old or too young. Patients must be at least 14 but younger than 25 when they received the dose.
- The code was added too early. A second dose must have been administered at least 31 days after the first dose, and a third dose at least 93 days after the second dose.
- Patients who have received a stem cell transplant. Following a stem cell transplant a patient's immune system is wiped, and an accelerated individualised schedule of childhood type vaccinations is planned. Practices are likely to be asked to deliver these vaccinations, but CQRS is often not designed to accommodate these additional doses.
The Missed Activity searches have been built around vaccinations, while the business rules allow for codes OR medication issues. Using vaccinations in SystmOne helps to offer a more precise vaccination history, but some patients may present with a mixed code and vaccination history especially if they were previously registered with a GP surgery using EMIS Web or Vision.
Review the CQRS article for points to consider when using these searches.
The business rules and code cluster lists for enhanced services can be found on the NHS Digital website.
While the main searches have been built to closely mirror the business rules, there is a creative element to the Missed Activity searches. Where patients appear in the Missed Activity searches, don't discount that there are other factors which erroneously brought the patient into the search. PCIT is always happy to hear about problems, but is unable to assist with every query why a specific patient is/isn't included.
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