CQRS: Pertussis in pregnant women searches
The current version of CQRS: Pertussis in pregnant women is v4.1
The pertussis in pregnant women service indicator is 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) |
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 |
The main search closely mirrors the business rules to properly reflect the CQRS count, but it is also based on a denominator (dependency) search designed by PCIT to include patients who may not be picked up by the extraction. This is similarly named, but with square brackets ( [PT001] ). 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 refer to the corresponding report in the Missed Activity folder. It is also possible to 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.
- 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 coded 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.
Since October 2024, EMIS has introduced an auto-filing feature for certain vaccinations. Pertussis in pregnant women is affected. Vaccinations administered elsewhere come into the system electronically with the same coding that would be used in general practice. The searches have been adapted to ignore any vaccinations given by external users. In October 2024 it is likely that Practices will encounter discrepancies between these PCIT searches and what CQRS reports. Until EMIS amend the CQRS extract searches, PCIT results will be lower but will ignore vaccinations that should not be claimed for.
Valid Code
956951000000104 - Pertussis vaccination in pregnancy
Missed Activity
Having run the top folder, check that the report PT000X - medication issued but no codes is empty; all of the claiming searches have been built primarily around codes rather than medication issues, and this search/report will identify any patients who had a medication issue last month but there was no corresponding clinical code in the same period. The reason for this is to support good practice of coding vaccinations; not only does this make future reporting easier, it ensures whenever the patient requests their vaccination history that everything is included from the vaccination filter in Care History.
Reports to help review potential data can be found in the Missed Activity folder, named with the indicator code followed by an X. If the searches have run, highlight the report and press View Results from the ribbon or right click for the quick menu.
The missed activity reports for CQRS have been designed in a standard fashion for ease of understanding.
CHECK - data in the CHECK column means that the codes used are correct, but the patient was either too old or young, or a subsequent dose was given too early or too late. It may be necessary to refer to
INVALID - data in the INVALID column means that activity has been found but with a different code that may indicate claimable activity. This column only focuses on the code and not on the age or the interval, meaning the report may need to be re-run or work out the time criteria yourself offline.
There may be a few scenarios where data appears in both CHECK and INVALID columns due to the way missed activity reports have been configured; prioritise CHECK before considering wither INVALID contains claimable activity.
For some indicators there are additional columns denoting first dose or qualifying conditions for eligibility. First dose is always shown on the left hand side of the report; qualifying conditions are shown on right hand side of the report.
The report has also been designed to pick up women of childbearing age who received a pertussis containing vaccine, so PT001X may show women who are not pregnant. In these cases it is always worth checking the record for current pregnancy.
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.
Version History
v4.1 - added criteria to ignore auto-filed reports
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