What is your name What is your job How much do you know about child imms Why have you come here today What is your burning question Introductions I did not understand what you said ID: 920470
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August 2019Ana Gutierrez – CEG Senior Primary Care Facilitator
Slide2What is your name? What is your job?How much do you know about child
imms?Why have you come here today? What is your burning question?Introductions
Slide3‘I did not understand what you said’ ‘I think you got that wrong’
‘Yes, but what about if?’ Questions as we go along?
Slide4Global antivax sentimentsSpecific local cultural rejection40% population born outside UKHigh rates of population mobility
High birth ratesConfusing reporting systemsStaff shortagesWork overloadYou have a very difficult job
Slide5Slide6Slide7Herd immunity is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, thereby providing a measure of protection for individuals who are not immune. The more infectious the disease, the higher the coverage needed
Example- Measles:90% to stop a disease spreading95% to get rid of the diseaseHerd Immunity
Slide8e.g.: declined, did not attendPopulation coverage is incompatible with exception reporting
Therefore not accepted in any kind of national data reportingIt does not stop protocol alerts in clinical systemException reporting
Slide9PHE COVERGP ContractCH local Contracts
Vaccination Additional and Enhanced ServicesDifferent perspectives
Slide10GP Contract (lower target 70%, higher 90%):Cohort aged 2 but not 3:
DTaP Pol HibMMRMen CCohort aged 5 but not 6:DTaP Pol boosterDetails: pages 38-50 SFE
GP Contract
Slide11GP Contract
Slide12Cohort becoming 1 in the quarter:DTaP IPV Hib Hep B (6in1)PCV
RotavirusMen BCohort becoming 2 in the quarter:DTaP IPV Hib Hep B (6in1) or DTaP IPV Hib (5in1)MMRHib/Men CPCV boosterMen B booster
Cohort becoming 5 in the quarter:DTaP IPV Hib (5in1) or DTaP IPV Hib Hep B (6in1)DTaP IPV boosterMMR 1st doseMMR boosterHib/Men C
PHE COVER
Slide13IS:A proxy measure of UK protectionA standard by which all areas are judged
From PID data collected by QMS/Health Intelligence and sent to CHIS hubsBased on current populationIS NOT:A recall systemUp to date immunisation dataA count of activity done (number of vaccinations given)Designed as a tool to improve uptake
It will not show the impact of very recent interventionPHE COVER is/is not
Slide14Is run monthly rather than quarterly (interim reports)Is does not contribute to the national dataIt follows PHE definitions. E.g.: if pre-school booster given before 3y 4m, child will appear unvaccinated
Is commissioned by CCGs/PH to keep an eye (trends) and try to drive improvement (shows number left to vaccinate to reach target) after success project in THPHE COVER –CEG Dashboard
Slide15KPIs reported in 2018/19:Uptake of 5in1or 6in1at 12 monthsUptake of 5in1or 6in1at 24 months
Uptake of MMR at 24 months2019/20:Added uptake of DTaP/IPV at 5 Years95% coverage targetFocus on NE improvement
CH GPC
Slide16COVER:Becoming 1 (during the quarter)Becoming 2
Becoming 5 e.g. 1st Apr 2014-30th June 2014CH GPC KPIs:
Aged 1 but not 2 (at the end of the quarter)Aged 2 but not 3Aged 5 but not 6 e.g. 1st Jul 2013-30th Jun 2014
GP Contract:Aged 2 but not 3
Aged 5 but not 6
Different cohorts
Slide17Third 6in1Third 5in1 + Hep B
Third 4in1 + Hib + Hep BThird 3in1 + pol + Hib + Hep BDashboard searches
Slide18Designed by EMIS – CEG cannot edit them. Any concerns, report to EMIS
QOF-like alerts
Slide19Check and record vaccinations at registration pointRecord vacs given by other providersEnsure dates entered are correctGive out personalised vaccination schedule at first opportunity
Follow up DNAs promptlyUse a recall systemWhat you can do
Slide20EMIS provides a system based on diary entriesCEG lists: you need to check each patient record to see what is missingCEG line reports: check for gaps. You still need to check each patient record but start with a better idea of where you are at. Useful to keep spreadsheet with notes on actions and outcomes
Recall systems
Slide21MMR Catch up for 10-11 year oldsMMR (aged 16+)RotavirusHPV completing dose (age 14-24)
Hep B at risk babiesMen ACWY completing dose (age 14-24)Men ACWY freshersMen B infantsPPV (pneum) at risk
Flu (at risk)Childhood seasonal influenzaPCV/HibMenC completing dose (under consultation)
Enhanced and Additional Services
Slide22https://www.bma.org.uk/advice/employment/gp-practices/service-provision/prescribing/vaccinationPages 48 – 69:
https://www.england.nhs.uk/wp-content/uploads/2019/07/technical-requirements-for-201920-GMS-contract.pdfMore details at:
Slide23CQRS manual submissions:
Slide24Have we answered the initial questions?Are there any questions left?
Slide25Any questions you forgot to ask?
l.o.rivastaquias@qmul.ac.uk
020 7882 2533http://www.qmul.ac.uk/blizard/ceg/