Patients with cancer are not automatically eligible for a flu jab based on the Green Book and CQRS business rules. Patients with a history of a blood cancer will always be eligible, but patients being managed for other types of cancer will only be eligible if they have had specific codes added (or drugs issued) in the last 12 months:
- Chemotherapy
- Radiotherapy (if it has an immunosuppressing effect)
- Biologic/biosimilar therapy
The absence of such coding will mean patients are not picked up by the invitation reports, and if they are vaccinated the activity may not be recognised for payment unless another code such as 'Needs influenza immunisation' is added around the time of the vaccination.
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SIV-Q00: Three searches identify patients who have been vaccinated by the surgery using one of the 4 primary vaccination codes. This search has been improved for 25/26 by ignoring patients who had a vaccination at a previous surgery before registering with the current surgery. The search and its children, which subdivide activity into injection and nasal spray, may be used as a rough guide as to how many vaccinations of each type have been administered.
If vaccine manufacturer information has been correctly recorded against the codes (possible when using a protocol), data the report SIV-D00 can be manipulated in Excel to establish a breakdown of each type of vaccine.
Patients who have deregistered during the flu vaccination season are NOT included in these searches.
SIV-Q01: Counts the patients who were not originally eligible, but has been flagged following clinical review as being eligible to receive a vaccination. This code is essential on non-eligible patients (by the definition of the business rules) to ensure payment. Consider clinical review and coding "Long term indication for seasonal influenza vaccination" to save having to add a code every year.
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SIV-Q04: Identifies patients who have had an invalid flu vaccination code added this season, and the activity would not be counted in CQRS. Patients who also have a valid vaccination code are not included. Ideally this search should return 0 patients, but in the event of a number look at the report to check the code used as well as which staff member added it. If staff administering the vaccines adhere to using a protocol for coding, this search should remain empty!
SIV-Q05: Coding vaccinations as problems clogs up the problem page with unnecessary information. If the Practice is also using a protocol to code vaccinations it would highlight where it is not being used. Any patients listed can be a learning exercise for staff to know how to manage coding.
SIV-Q06: Another data quality search to root out coding issues. This can be used in two ways; one to pick up where staff double code during the same encounter, and when using the report it is also possible to pick out codes added on separate dates, perhaps as a result of other healthcare providers sending data twice.
SIV-Q07: Patients who have a medication issue for a flu jab but the episode is not coded are still counted for a CQRS claim, but nothing will appear on the patient's vaccination summary. If a patient were to request a vaccination history, a complete summary would need to show every jab which means the event must be coded.
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SIV-Q10: Immunocompromised patients and the rest of their household can be easily identified for review. If a household member is not already eligible by some other means, the code 'Lives with immunocompromised person' may be added to their record.
SIV-Q11: In conjunction with working through SIV-Q10, this is able to list the patients who have had the code added in the past few years, but these patients will need the code re-adding on an annual basis in order to maintain eligibility to receive a flu vaccination.
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SIV-Q12 and SIV-Q13: These two searches highlight patients who were coded as healthcare workers or needing influenza vaccination in the previous 3 years (but not this year). Patients would require repeat coding in order to maintain eligibility to receive a flu vaccination. Patients appearing in these searches may also appear in SIV-D99 as the relevant code has not been added this year.
SIV-Q13 provides a report containing all 'Needs influenza vaccination' from the past 3.5 years along with associated text to identify in advance which patients could definitely need a flu jab. Following clinical review it may be appropriate to code 'Long term indication for seasonal influenza vaccination' to save annual coding.
SIV-Q15: The EMIS red box utilises Primis code lists to highlight eligible patients for vaccination. This list differs slightly from the eligible codes used by CQRS, meaning that patients identified here will not be picked up by CQRS for payment unless coding for an at-risk clinical condition is refined or "Needs influenza vaccination" is added.
SIV-Q16: This is less relevant for 25-26 since the flu indicators in IIF were removed, but the rule logic for invitations has been retained since data for the retired indicators are still extracted. Remember the flu programme only officially starts on 1st September.
SIV-Q17: Useful for later in the season, and again a legacy of the IIF indicators, this search identifies patients who haven't been vaccinated and have only received 1 invitation. In the absence of vaccination declined codes they could be invited again.
This folder contains separate elements which are linked, and may be used as the final step in converting a list of patients for recall into a mass communication. It includes influenza invitation searches which can be added to recall searches if practices wish to identify only those patients who have not had an invitation or who have had a specific number of invitations. These may also help if you are doing combined flu and covid recalls - see our support article for further details.
SIV-U001:
So far the flu searches have not covered care home residents in much detail. This search helps to separate out care home residents for whom there might be special local arrangements to run a planned vaccination session for the entire home.