001 CQRS: Pertussis in pregnant women
This article assumes the reader has access to CQRS, and can interpret the descriptions of payment indicators.
The pertussis in pregnant women 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) |
PT001 | Monthly count of the number of pregnant women who have received a pertussis vaccination by the GP practice within the reporting period. | n/a | n/a |
PCIT authored reports
Payment Reports
Primary Care IT has built a set of searches to support the pertussis in pregnant women 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 PTx. 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 Pertussis in pregnancy, this is grouped between female patients aged 10-15 given Adacel last month with recent pregnancy codes and those without.
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 code 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 patient has already received a dose in the past 6 months. The business rules exclude payment any expectant mother who has already received a dose in the 6 months prior to the claiming month.
- The vaccine was recorded for what it is. The pertussis dose is delivered as part of a 3-in-1 Tdap vaccine. A claim can only be made where 'Pertussis vaccination in pregnancy' is coded. Practices can decide whether to code the 3-in-1 as well as the pertussis vaccination in pregnancy code, and bear in mind that both codes will appear on the Vaccinations screen in Care History.
- 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.
Missed activity data offers some opportunities for learning. Hopefully most entries highlighted by the Missed Activity reports are due to coding which can easily be fixed. Whilst it isn't possible to 'fix' where a vaccination has been given to an ineligible patient, there is an opportunity for reflection and learning to ensure the same scenario is not repeated.
The business rules cannot determine the gestational period (or even whether a patient is pregnant) for when the vaccination was given, so patients vaccinated early will be recognised for payment.
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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