CQRS: RSV for older adults vaccination programme
The current version of CQRS: RSV for older adults is v1.1The 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.
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 (inclusive) |
RSV001 | Monthly count of the number of registered patients who turn 75 years on or after 1 September 2024 and who have a record of receiving a dose of RSV carried out by the practice within the reporting period whilst aged at least 75 but aged less than 80. | 75 years (75th birthday) | 79 years (day before 80th birthday) Born after 01/09/1949 |
RSV002 | Monthly count of the number of registered patients aged 75 to 79 years (inclusive) on 31 August 2024 who have a record of receiving a dose of RSV carried out by the practice during the reporting period whilst the patient was aged 75 to 79 inclusive. Patients remain eligible up to and including the day before they attain 80 years. | 75 years Born before 01/09/1949 | 79 years (day before 80th birthday) Born before 01/09/1949 |
Manual claim | This search provides a count of the number of registered patients aged 79 years on 31 August 2024 who have a record of receiving a dose of RSV carried out by the practice during the previous month when the patient was aged 80. | 80 years Born before 01/09/1945 | 80 years Born after 01/09/1944 |
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: [RSV001] ). 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 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 old or too young. Patients will be allocated to either the main cohort or the catch up cohort, defined by a date of birth range. Patients must be at least 75 years of age to receive their RSV vaccination and before their 80th birthday.
There is an exception for the first year of the programme until 31st August 2025 (highlighted in yellow on the table) where 80 year olds will be eligible for the vaccination, so the upper age limit to receive a dose will be the day before their 81st birthday.
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 codes
Administration of RSV (respiratory syncytial virus) vaccine [1303503001]
Manual claim during first year of programme
Displayed in yellow on the table above is an unofficial wording for patients who are eligible for the first year of the RSV vaccination programme but there is no mechanism for automatic payment on CQRS. NHS England has advised PCIT that Practices must manually claim for these patients who technically are part of the same eligible cohort as those in RSV002.
The date of birth range for these patients is between 02/09/1944 and 31/08/1945.
In response to this information, PCIT has produced a separate search for manual reporting, where otherwise those patients would have appeared in RSV002X Missed activity.
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.
Missed activity data offers some opportunities for learning. Hopefully most entries highlighted by the Missed Activity reports are due to coding which can easily be fixed. Whilst it isn't possible to 'fix' where a Zostavax dose has been given where the programme calls for Shingrix (such as in immunocompetent patients aged 65), there is an opportunity for reflection, as would be second doses given too early (SHROU07X and SHROU10X prior to 8 weeks; SHROU13X and SHROU16X prior to 6 months).
Version History
v1.1 - added criteria to ignore autofiled reports
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