001 CQRS: Pneumococcal Child At Risk programme
This article assumes the reader has access to CQRS, and can interpret the descriptions of payment indicators.
The pneumococcal child indicators are 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) |
PCV001 | Monthly count of the number of patients who received a first dose of pneumococcal vaccine whilst aged at least 16 weeks and who have not attained 1 year, administered by the GP practice within the reporting period. | 112 days | Day before 1st birthday |
PCV002 | Monthly count of the number of patients with asplenia, splenic dysfunction, complement disorder or who are severely immunocompromised, who have received a first dose of pneumococcal vaccine whilst aged at least 6 weeks and who have not attained the age of 1 year, administered by the GP practice within the reporting period. | 42 days | Day before 1st birthday |
PCV003 | Monthly count of the number of patients with asplenia, splenic dysfunction, complement disorder or who are severely immunocompromised who have received a second dose of pneumococcal vaccine whilst aged at least 14 weeks and who have not attained the age of 1 year, administered by the GP practice within the reporting period, a minimum of 8 weeks after the first dose. | 98 days Previous dose must have been at least 56 days prior | Day before 1st birthday |
PCV004 | Monthly count of the number of patients who received a booster dose of pneumococcal vaccine, administered by the GP practice, whilst aged at least 1 year (on or after their first birthday) and under 2 years, within the reporting period, a minimum of 4 weeks after the initial dose. | 1 year (1st birthday) Previous dose must have been at least 28 days prior | Day before 2nd birthday |
PCV005 | Monthly count of the number of unimmunised or partially immunised patients with at least one clinical code or "requires a pneumococcal vaccination" in the patient's record, who received one dose of pneumococcal vaccine whilst aged at least 2 years (on or after their second birthday) and who have not attained the age of 10 years, administered by the GP practice within the reporting period. | 2 years (2nd birthday) | Day before 10th birthday |
PCIT authored reports
Payment Reports
Primary Care IT has built a set of searches to support the Pneumococcal child 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 PCVx. 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 Pneumococcal child, these only report on under 10s, grouped between those with a clinical at risk code and those without such codes.
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 are accommodating if 2nd part has been recorded twice. We recommend using a template to minimise the chances of this occurring.
- Patient was too old or too young. The specification for most babies require that they are at least 112 days old (16 weeks) for their first pneumococcal vaccination.
- The code was added too early. The second dose of pneumococcal vaccination (PCV004) must not be given until at least 28 days after the first dose. Since the schedule changed for children born on or after 1st January 2020 this won't often have caused an issue where before there had to be at least 8 weeks between the 1st and 3rd set of primary vaccinations. Payment won't be given if the 2nd dose was administered at a 27 day interval.
For immunocompromised babies picked up by PCV003, the interval must be at least 56 days. - The patient's historical record is incomplete. Where codes are missing, patients may fall into the wrong denominator.
- 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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