001 CQRS: RSV for older adults

001 CQRS: RSV for older adults

Notes
This article assumes the reader has access to CQRS, and can interpret the descriptions of payment indicators.
The RSV vaccination programme 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.
Info
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)
RSV003
Monthly count of registered patients aged 56 years or over who have received an RSV vaccination administered by the GP practice during the reporting period
56 years
none

PCIT authored reports


Payment Reports

Primary Care IT has built a set of searches to support the RSV (older adults) 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 RSVx. 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 RSV, this is grouped between over 75s, and younger patients (aged at least 56) who may have been vaccinated as care home residents.

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.
  1. 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. 
  2. Patient was too young. Patients under the age of 56 living in a care home may have been vaccinated, but this 
  3. The patient has previously received a dose. Eligible patients only require one dose in their lifetime. The Green Book has clarified that patients receiving dose(s) whilst they were pregnant will not require a further dose at the age of 75.
  4. 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.

Patients under the age of 56 who were vaccinated due to living in a care home will not be picked up by either the payment search or the missed activity search. Female patients of childbearing potential may be flagged in the other RSV service for pregnant women (search RSVPx).
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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