001 CQRS: Meningococcal ACWY vaccination
This article assumes the reader has access to CQRS, and can interpret the descriptions of payment indicators.
The Meningitis ACWY indicator is extracted automatically from your system approximately 10 days after the end of the monthly reporting period. The searches will return data for the claim month from the 25th of the month, until the 24th of the following month (eg: for activity performed in the month of April, use the searches between 25th April and 24th May). This is intended to provide sufficient time for Practices to check and update their data prior to extraction, and review activity once figures are available to declare on CQRS.
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) |
MACWY05 | Monthly count of the number of patients aged at least 14 who have yet to attain 25 years of age who have been given a MenACWY vaccine by the GP practice in the reporting period. | 14 years | Day before 25th birthday |
PCIT authored reports
Payment Reports
Primary Care IT has built a set of searches to support the Men ACWY 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.
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 MACWYx. 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 Men ACWY, this is grouped between 14-24 year olds and over 25s at the time of vaccination.
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. The business rules simply require a MenACWY code or vaccination coded. Coding staff should ensure the vaccination or code is correctly recorded as being given elsewhere, and consider the that the payment indicator MACWY05 may show higher than it should and the Practice is at risk of clawback.
- Patient was too old or too young. The Men ACWY service payment is only for patients aged at least 14 and less than 25 when they receive the vaccine. Payment cannot be claimed if the patient was even a few days short of their 14th birthday, or they had already had their 25th birthday.
- The patient has received a second dose. The service only awards payment for the first Men ACWY vaccination as long as it has been given by the GP.
- 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.
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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