Vaccinations by other healthcare provider
A recent change to SNOMED is the removal of vaccinations 'given by other healthcare provider'. The expectation is that the code used for administration in Practice should also be used to record vaccinations given elsewhere. Some Practices have reported spikes in their CQRS returns where teenage boosters done at school have been picked up.
Retired codes
The below list is a summary, as child derivatives such as "Second meningitis B vaccination given by other healthcare provider" have also been retired.
Meningitis B vaccination given by other healthcare provider
Meningitis C vaccination given by other healthcare provider
Meningitis ACW and Y given by other healthcare provider
Rotavirus vaccination given by other healthcare provider
Human papillomavirus vaccination given by other healthcare provider
Measles mumps and rubella vaccination given by other healthcare provider
Hepatitis B vaccination given by other healthcare provider
Pertussis vaccination given by other healthcare provider
Influenza vaccination given by other healthcare provider
Pneumococcal vaccination given by other healthcare provider
Herpes zoster vaccination given by other healthcare provider
Other procedures relating to contraception services are also affected:
Hormone releasing intrauterine contraceptive device fitted by other healthcare provider
Intrauterine contraceptive device fitted by other general practitioner practice
Insertion of subcutaneous contraceptive implant by other healthcare provider
Removal of subcutaneous contraceptive implant by other healthcare provider
Intrauterine contraceptive device fitted by other healthcare provider
Intrauterine contraceptive device checked by other healthcare provider
Intrauterine contraceptive device removed by other healthcare provider
Intrauterine contraceptive device fitted by other general practitioner practice
Insertion of subcutaneous contraceptive implant by other healthcare provider
Removal of subcutaneous contraceptive implant by other healthcare provider
Intrauterine contraceptive device fitted by other healthcare provider
Intrauterine contraceptive device checked by other healthcare provider
Intrauterine contraceptive device removed by other healthcare provider
Impact
The removal of the other healthcare provider codes will initially present an operational obstacle when users cannot find the codes they are used to using for recording activity done elsewhere. Using another code and simply typing the name or type of provider in the associated/descriptive test is not sufficient and the vaccination may be incorrectly included in your monthly CQRS return. The next section advises of the correct approach to recording.
Where Practices have built searches using a clinical code search criteria, the 'other healthcare provider' code may have originally been a child of a higher code. When the code is deactivated it disappears from the SNOMED hierarchy. If that code is important to the integrity of a search, it would have to be manually added back into the criteria. This is a good example of why lists of clinical codes in searches should be specified individually rather than relying on a high level code and including all children.
Taking the screenshots above, Seasonal influenza vaccination given by other healthcare provider was originally a child of Influenza vaccination given. Once deactivated the code has become orphaned, is no longer part of the 'tree', and now shows as a standalone inactive concept.
Recording activity done elsewhere
Last month Optum published a small article on the Support Centre (KB5004523) explaining the impact of the codes being removed, and how to record vaccinations done elsewhere.
All staff involved in coding vaccinations should be aware of the importance of using the GMS qualifier. When given in Practice, always select 'GMS', while any vaccinations given elsewhere (or private vaccinations at the surgery) must select 'Not GMS'.
The descriptive text - if enabled for that vaccination on a template - can provide more detail in the record for where the vaccination was actually given.
The CQRS searches are directly affected by the GMS qualifier, especially where vaccinations might be given elsewhere. The most likely programmes are:
- 6IN1005 - 6IN1009 - includes the Td/IPV teenage booster
- HPV - may pick up vaccinations given in school but coded manually.
- Men ACWY - may pick up vaccinations given in school but coded manually.
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