CQRS: PCV HIB MenC programme searches

CQRS: PCV HIB MenC programme searches

The current version of CQRS: PCV HIB MenC is v1
The PCV HIB MenC programme service indicators are extracted automatically from your system approximately 10 days after the end of the monthly reporting period. Practices have a short opportunity to check their data prior to extraction and maximise their income potential. For reviewing data in historic months, the relative run date may be any date in the month following the achievement period (eg: for the achievement period of April, any date in May can be selected).

This article assumes the reader has access to CQRS, and can interpret the descriptions of payment indicators; only payment indicator codes are used below.

Indicator
Description
Lower age limit
Upper age limit (inclusive)
PCVHIB001
Monthly count of the number of patients who received a first dose of PCV13 vaccine whilst aged at least 12 weeks and under 1 year, administered by the GP practice within the reporting period.
84 days
Day before 1st birthday
PCVHIB002
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 PCV13 vaccine whilst aged at least 6 weeks and under 1 year, administered by the GP practice within the reporting period.
42 days
Day before 1st birthday
PCVHIB003
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 PCV13 vaccine whilst aged at least 14 weeks and under 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
PCVHIB004
Monthly count of the number of patients who received a booster dose of PCV13 vaccine whilst aged at least 1 year (on or after their first birthday) and under 2 years, administered by the GP practice 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
PCVHIB005
Monthly count of the number of unimmunised or partially immunised patients at clinical risk (including those with asplenia, splenic dysfunction, complement disorder or severely immunocompromised) who received one dose of PCV13 whilst aged at least 2 years (on or after their second birthday) and under 10 years, administered by the GP practice within the reporting period.
2 years (2nd birthday)
Day before 10th birthday
PCVHIB006
Monthly count of the number of patients aged at least 1 year (on or after their first birthday) and are under 2 years, who received a booster dose of Hib/MenC vaccine, administered by the GP practice within the reporting period.
1 year (1st birthday)
Day before 2nd birthday
PCVHIB007
Monthly count of the number of patients aged 2 years or over and under 10 years who have an incomplete or uncertain vaccine history who have received a dose of Hib/MenC vaccine, administered by the GP practice within the reporting period.
2 years (2nd birthday)
Day before 10th birthday

The main searches closely mirror the business rules to properly reflect the CQRS count, but each search is also based on a denominator (dependency) search designed by PCIT to include patients who may not be picked up by the extraction. These are similarly named, but with square brackets (eg: [PCVHIB002] ). When reviewing the figures prior to CQRS extraction, Practices are looking for the searches to show 100%. When the search is not 100%, Practices can use the Check Patient feature to try to understand why a patient has been picked up in the denominator search but not for CQRS. There are several reasons why a patient may not be included in an indicator, and these all need to be considered.
  1. The wrong code was added. The business rules are accommodating if the vaccine dose code (eg 1st pneumococcal conjugated vaccination) has been used to record a subsequent dose. There are a number of similarly named legacy EMIS codes which do not count. 'Adult' pneumo codes (used in PPV searches) also do not count. We recommend using a template to minimise the chances of invalid codes being used. 
  2. Patient was too old or too young. The specification for most babies require that they are at least 84 days old (12 weeks) for their first pneumococcal vaccination. The HIB/MenC vaccine should be given on or after the child's first birthday.
  3. The code was added too early. The second dose of pneumococcal vaccination (PCVHIB004) 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 PCVHIB003, the interval must be at least 56 days. 
  4. The patient's historical record is incomplete. Where codes are missing patients won't be picked up, so adding certain pneumococcal conjugated vaccination codes when the first code isn't present may include the patient in the first dose indicators instead of the second dose.
Always check the 0% searches to ensure that single patients from the denominator are not missed!
The Full Hierarchy button on the ribbon can make checking the parent searches of 0% searches easier.

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 denominator searches. Where the main search isn't 100%, don't discount that there are other factors which erroneously brought the patient into the denominator 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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