CQRS: RSV for pregnant women

The current version of CQRS: RSV for pregnant women is v1.0. This search folder is available in 001 CQRS v5.4 and above

Introduction:

Unlike most other indicators on CQRS which are extracted automatically from your system approximately 10 days after the end of the monthly reporting period, this RSV for pregnant women service is a manual claim. Practices should 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).
For more information on identifying eligible patients, refer to this article.

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
RSVP001	Monthly count of the number of registered patients from 28 weeks of pregnancy who have a record of receiving a dose of RSV carried out by the GP practice within the reporting period.	10 years (PCIT defined age)	Day before 55th birthday (PCIT defined age)

To date (December 2024), there are no business rules to properly reflect the CQRS count which is probably due to the complex nature of validating how far along a pregnancy a patient is, and why this particular service requires Practices to submit a manual submission. Primary Care IT has built a set of searches along the same lines as all other CQRS searches which a particular emphasis on checking coding and where the vaccination was given. A denominator (dependency) search designed by PCIT includes patients who may not qualify a claim under the indicator. These are similarly named, but with square brackets (eg: [RSVP001] ). 

Primary Care IT has defined a minimum and maximum age for this service of 10 years and 55 years which is intended to include any patient of likely childbearing age. The lower limit of 10 years should ensure that young patients who are vaccinated are not inadvertently picked up, while the upper limit of 55 years appears in several PCIT searches as an upper age of childbearing potential. 

A key feature of the searches is that they will only pick up activity which has been recorded by Practice staff; coded vaccinations received electronically from a third party system will not be counted, reducing the burden of reviewing each record to verify where a vaccination was given (eg: elsewhere by the maternity services team).

Actions:

Primary Care IT recommends that all patient records returned by the manual claim search RSVP001 are reviewed to confirm that the vaccination was given on or after 28 weeks of pregnancy.

There are several reasons why a patient may not be included in an indicator, and these all need to be considered.

1. A RSV vaccination has been given in the previous 6 months. The recommendation is for pregnant patients to be vaccinated once for each pregnancy, so double vaccinations or double coding across consecutive months will not be counted in the main RSVP001 claim search. 
2. Patient was too old or too young. PCIT has defined an expected age range of 10 years to 55 years, but patients between 55 and 64 years old may be picked up if they have been vaccinated.
   

The main claim search will only identify patients registered as female on their registration page. Patients recorded as male who have been vaccinated will be found in [RSVP001] but not appear in RSVP001, and Practices should review individual records to confirm pregnancy. If a pregnant male or FTM transgender patient is found, add them to the total number to be submitted on CQRS.

Valid codes

Administration of RSV (respiratory syncytial virus) vaccine            [1303503001]

Review the CQRS article for points to consider when using these searches.

Version History

v1.0.0 - new release

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