Contents Page
1. Introduction

Brief explanation of the scope of the vaccination eligible “risk” groups,
highlighting the areas that differ to QOF etc.
2. Case Finding




Location and Use of clinical system case finding (recall searches)
Read Codes
Overview of the PRIMIS Seasonal Influenza case finding tool
Hints & Tips from local practices to maximise patient uptake
3. Data Recording

Overview of patient groups for 2015/16 seasonal Influenza recording,
highlighting those recognised by Immform.
4. Reporting
 System seasonal Influenza reports (that mirror the data being extracted
by Immform (Location of and use including screen shots)
 System seasonal influenza payment reports (link to screen shots)
 Understanding the Immform Data report (link to screenshots and
explanations)
Acknowledgements:Guidance developed by: Midlands & East Area Team, Imms & Vacs Flu QOF Sub Group
Written by: Vaughan Farrer – Primary Care IT Support Facilitator –Herts Valleys CCG
Designed by: Donna Holding – Primary Care Development Team – Luton CCG
1. Introduction
There are a number of differing seasonal influenza data streams within primary care.
The key ones are:



CQRS data used for payment purposes
Immform data that is used for uptake monitoring.
Some QOF areas include a seasonal influenza uptake attainment indicator
and all patients in each of the QOF areas form part of the overall seasonal
influenza cohort.
Background to the Monitoring Data Set

Each year Public Health England provides details of that year’s seasonal
influenza specification to PRIMIS. PRIMIS then translate this higher level
subjective clinical guidance into the language of the two Clinical Coding
Terminologies currently used in Primary Care, to give a very specific
specification that is practical to implement by all GP IT clinical system
suppliers in a consistent, standardised way and quality assured nationally.

Of the roughly 42,000 diagnostic terms within Read v2, approximately 2,000
of them would explicitly warrant the administration of the influenza vaccine. A
further 2,000 are clinically ambiguous in terms of whether or not an influenza
vaccine should be administered (e.g. "Congenital malformation of circulatory
system, unspecified"). There are two clinical groups in particular (Neurology
& Cardiology), that contain large numbers of rarer diagnoses or conceptually
ambiguous terms. Both of these areas are affected by the presence of clinical
conditions of variable severity that are congenital in origin and coded as such.

The concept of Immune Suppression is also a technically difficult one to
represent. For many patients, especially those undergoing chemotherapy or
significant radiotherapy, the indication for seasonal influenza vaccination may
be temporary. Within the medication hierarchies, especially immune
suppressant drugs there are particular problems. The concept of "immune
suppression by a daily dose of 20mg prednisolone" cannot be meaningfully
represented by the current system suppliers. This, of course, is further
complicated by the use of two clinical terminologies and attempting to ensure
they are aligned.

It should be noted that whilst the vaccination window associated with the
Quality and Outcomes Framework programme runs from 1st August, the
Vaccine Uptake Monitoring set window starts at the 1st September 2015.
PRIMIS state that the data set is a Vaccine Uptake Monitoring set and not a
patient Recall or Payment set as there are subtle differences, not least in the
tolerances.

Immform reports now include data on the number of patients to have declined
a seasonal influenza vaccination, so it important the correct declined Read
codes are recorded on your clinical system. However these patients will not
be deducted from the relevant group denominator because they haven’t
received the vaccination and therefore cannot count towards your
achievement.

For the 2015-16 season, children aged 5 years or 6 years on the 01/9/2015
will also be vaccinated and they will appear in a numerator / denominator
group whether they are in a clinical risk group or not. It should be noted that it
is expected that these children will be vaccinated in schools and that Public
Health England are requesting information on the numbers of children
vaccinated in school. There are currently no READ codes available to directly
support this information so an inference will be made that all vaccinations
recorded on practice computer systems for children in these birth cohorts,
where the vaccination is recorded as having been given by ‘Other health
professional’, have in fact been given in school.
2. Case Finding
For detailed “step by step2 instructions for case finding within your clinical system
accessing flu reports and templates (item 2a-2d), please select the appropriate
option below:
SystmOne
Screenshots.docx
EMISWeb
Screenshots.docx
Vision
Screenshots.docx
A detailed list of Seasonal Influenza vaccination read codes can be found below:
Seasonal Influenza
Vaccination Read codes.docx
As an alternative to practice clinical system PRIMIS provide a “free” audit tool as part
of their suite of searches available to General Practice details of which can be found
at:
https://www.primis.nottingham.ac.uk/registration
PRIMIS Flu Uptake Survey audit tool – Free
The PRIMIS ‘Flu Uptake’ Survey audit tool supports practices monitor their Seasonal
Influenza Immunisation Vaccine Uptake during each flu season. It is available free of
charge to all members of the PRIMIS Hub (including those signed up for free basic
membership). PRIMIS has developed the original specification for this year’s ‘flu
monitoring programme on behalf of ImmForm at Public Health England, on which all
tools including those released by PRIMIS or GP IT suppliers are based.
Practice Hints & Tips
Information on practical hints and tips that can be applied in practice can be found
below:-
Hints & Tips From
Practices To Maximise Uptake.docx
3. Data Recording
The survey and dataset include 2, 3 and 4 year olds, including “At Risk” groups who
are eligible for the nasal flu vaccine. In addition that scheme has been extended to
children in school years 1&2.
Cumulative data on influenza vaccinations in the GP registered population in
England between 1 September 2015 and 31 January 2016 (inclusive) is collected for
eligible cohorts.
Details relating to the eligible groups for the seasonal flu vaccination for 2015/16 can
be found here:-
Overview of Groups
Eligible For Flu Vaccination.docx
4. Reporting
Detailed information including set up instructions and screen shorts relating to
Seasonal Flu Achievement & Payment Reports can be found (under item 7
Reporting) for each of the clinical systems below:-
SystmOne
Screenshots.docx
EMISWeb
Screenshots.docx
Vision
Screenshots.docx
Immform Data Set & Reporting
The data groups collected by Immform mirror the groups that were outlined in
section 3 of this guidance. However there are some additional factors to be taken
into consideration such as:



Denominators
Refusals
“All Patients” (As shown on Immform)
A full and comprehensive explanation of these points can be found below together
with screen shots of the Immform reporting system:-
Understanding Key
Immform Data
Aspects of Immform Data.docx
Elements (inc screenshots).docx