CQRS: RSV for older adults vaccination programme
The current version of CQRS: RSV for older adults is v2.0
Overview
The RSV vaccination programme 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). 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 |
RSV003 | Monthly count of registered patients aged 56 years
or over, who have received an RSV vaccination administered by the GP practice
within the reporting period. | 56 years | none |
The main search closely mirrors the business rules to properly reflect the CQRS count, but the 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: [RSV003] ).
When reviewing the figures prior to CQRS extraction, practices are looking for the searches in the top folder 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 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.
- The wrong code was added. Administration of RSV (respiratory syncytial virus) vaccine and the identically named legacy EMIS code does not count. We recommend using an up-to-date template to minimise the chances of this occurring.
- Patient was too young. The RSV Older Adults vaccination programme was updated in Spring 2026 with the removal of the upper age limit and a simplified age criteria plus the addition of a new cohort - patients living in a care home for older adults. As the care home cohort is based on the CQC registration category of the care home rather than the age of the individual patient, it is possible that a patient who is younger than 56 may be living in a care home registered for older adults, especially as some care homes cater for a wider age group (for example nursing homes may be registered for adults under 65 and over 65).
The mismatch between the 'patient living in a care home for older adults' in the specification and the 'aged 56 or older' in the business rules mean that potentially a practice may have a patient younger than 56 vaccinated due to living in a care home registered for older adults. These vaccinations may need to be submitted on a manual adjustment request as there is no way for them to be included in the CQRS extract. Primary Care IT cannot advise on any judgements made by the Commissioner about whether to pay for these vaccinations.
Since October 2024, EMIS has introduced an auto-filing feature for certain vaccinations which may include RSV. 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. Since 2025 the GMS flag has been used to designate vaccinations administered in a practice under the GMS contract so it is important to make sure the GMS flag is used on all practice vaccinations to separate them from vaccinations given by a 3rd party provider.
RSV Coding
It is important to make sure the correct SNOMED code is used for RSV vaccination to ensure it is recognised for payment.
PCIT recommends using the following code which users can find in templates and in the optional RSV vaccination clinic protocol.
Administration of RSV (respiratory syncytial virus) vaccine [1303503001]
Missed Activity
Having run the top folder, check that the report RSV00X - medication issued but no codes is empty; all of the claiming searches have been built 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.
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.
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.
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
v2.0 - updated to reflect changes in RSV Older Adults programme in Spring 2026 - removal of upper age limit and addition of care home cohort
v1.2 - reduced lower age range of cohort from 75 to 65 to capture patients outside of eligible age range (under 65s picked up in RSV for pregnant women service).
v1.1 - added criteria to ignore autofiled reports
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