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Vaccines and Immunisations - Guidance for Practices

Page Contents

Vaccinations and Immunisation Programme

Vaccs & Imms Indicators in QOF

GP Collections Timetable

Immunisation Schedules

Public Health Contacts for Imms and Screening

SCID, BCG and Rotavirus

Patient Group Directions

HPV Vaccination Guidance for Healthcare Practitioners

Travel Vaccinations

Childhood Immunisation Resources

Information for Immunisation Professionals

MMR For Practice Staff

The Green Book

BMA ‘Focus On’ Guidance

Cold Chain - CQC

Vaccine Incident Guidance Responding to errors in vaccine storage, handling and administration

Guy's and St Thomas' NHS Foundation Trust - Overcoming your needle phobia (fear of needles)

Vaccinating people with a learning disability and autistic people - Podcast

Refugees and Asylum Seekers

Vaccinations and Immunisation Programme

The national arrangements for providing vaccines and immunisations are set out in the Statement of Financial Entitlements (SFE).

2022/23 Programme

There are minimal changes to some vaccinations and immunisations this year:

2021/22 Programme

Further details on arrangements can be seen in the Update to GP Contract 20/21 - 23/24

Contract changes from 1st April 2021 will see the provision of vaccination and immunisation services become an essential service for all routine NHS-funded vaccinations with two exceptions:

There will be five core contractual standards will be introduced to underpin the delivery of immunisation services. These are described in more detail in Annex A of the NHSE letter.

  1. A named lead for vaccination services
  2. Provision of appointments
  3. Call/recall and opportunistic offer standards
  4. Participation in national agreed catch-up campaigns
  5. Standards for record keeping and reporting

A single item of service fee (IOS) will be fully implemented for all doses delivered in vaccination programmes funded through the GMS contract - More detail in Annex B (of above letter).

There are 3 tables within Annex B that detail the schedules of the current programs with full details of age eligibility etc, and can be seen in the NHSE letter above. It is stronlgly recommended that you check the details in full for each immunisation.

 In summary they include the following :-

Childhood Imms

Adult routine immunisations

Selective immunisations

Essentially there is an IOS payment of £10.06 available for each dose, however, there is a requirement to reach certain targets to achieve payment in full or a part thereof. The following table helps to demonstrate how this works.

Practice Index have also published this table above within their guidance on the new IOS reimbursements arrangements. The LMC also assisted with the table and think you may find it helpful. Full details can be seen here.

Useful resource:

     https://www.healthpublications.gov.uk/Home.html

 

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Vaccs & Imms Indicators in QOF

A new vaccination and immunisation domain in the Quality and Outcomes Framework was introduced for 2021/22. The vaccination and immunisation indicators in this domain were also referenced in the letter of 21 January 2021. With only minimal changes to vaccination and immunisations 22/23, these indicators remain as below and can be seen in the 22/23 QoF Guidance (pg 83)

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GP Collections Timetable

NHS Digital publish the GP collections timetable on a monthly basis and can be seen at: - https://digital.nhs.uk/services/general-practice-gp-collections/gp-collections-schedule

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Immunisation Schedules

A Visual Guide to Vaccines
Complete routine immunisation schedule - GOV.UK (www.gov.uk)
Routine childhood immunisation schedule - GOV.UK (www.gov.uk)
Vaccination of individuals with uncertain or incomplete immunisation status - GOV.UK (www.gov.uk)

UK and international immunisation schedules comparison tool - GOV.UK (www.gov.uk)

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Public Health Contacts for Imms and Screening

NHS England Thames Valley, Hampshire and IoW Public Health Commissioning

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SCID, BCG and Rotavirus

UKHSA 1st September 2021 - Changing the timing of the neonatal BCG immunisation programme to a 28-day immunisation programme. Although the BCG is not routinely given in practices, it is helpful to be aware of the process and the SCID screening.

UKHSA have also published a patient pathway flowchart for BCG and SCID which maybe useful.

However, SCID screening does need to be checked before babies have the Rotovirus vaccine. UKHSA have also published a handy guide and a flowchart for practices on how to manage Rotovirus immunisations with regard to SCID.

Further information on these changes can be found in the UKHSA Vaccine update: issue 327, May 2022, SCID, TB and BCG special edition.

        https://www.healthpublications.gov.uk/Home.html

 

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Patient Group Directions

PGDs in Dorset, Hampshire and the Isle of Wight (Wessex)

PGDs in Bath, Dorset, Swindon and Wiltshire

For more advice and guidance on PGDs and PSDs go to: https://www.wessexlmcs.com/patientspecificdirectionspsdsandpatientgroupdirect

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HPV Vaccination Guidance for Healthcare Practitioners

This guidance provides information for healthcare practitioners about the human papillomavirus (HPV) universal programme for adolescents and the HPV for men who have sex with men (MSM) programme. It includes information on eligibility, scheduling and vaccine administration.

Responding to Private HPV Self-sample Tests

The purchase of Human Papillomavirus (HPV) self-sampling home testing kits is increasing. Results of these private tests will not be acted on by the NHS Cervical Screening Programme (NHS CSP) and cannot be recorded in an individual’s NHS screening record.

If a private test result is positive, the person should be advised that having HPV does not mean they have or will get cervical cancer.

HPV is common; over 80% of the population will get it at some point during their lives.

Individuals eligible for the NHS CSP remain so, even if they have had a private test. Most HPV infections clear themselves without causing problems. If someone has persistent HPV infection, it will be identified when they accept their next NHS CSP invitation.

Cervical cancer usually develops slowly over 10 years in three stages:

1.Infection with HPV

2.Development of abnormal cells if the immune system does not rid the HPV infection

3.Development of cancer if abnormal cells are not treated.

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Travel Vaccinations

For advice on travel vaccinations, go to: https://www.wessexlmcs.com/travelvaccinations

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Childhood Immunisation Resources

The RCN have produced a really useful document on best guidelines in Managing Childhood Immunisation Clinics.

It covers

 RCN - Managing Childhood Immunisation Clinics

 

 

Nursing Standard -  Childhood immunisation: best-practice guide for nurses published

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Information for Immunisation Professionals

For further information/links to the national immunisation schedule, incomplete immunisation algorithm and e-learning resources, go to:

https://www.gov.uk/government/collections/immunisation

UK and international immunisation schedules comparison tool - GOV.UK (www.gov.uk)

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MMR For Practice Staff

The Green Book Chapter 12 details infromation for the Immunisation of healthcare and laboratory staff.

Gov.uk also has a webpage entitled MMR for all: general leaflet. This leaflet explains the measles mumps rubella (MMR) vaccine for all ages.

We would advise that for any staff member over the age of 16 who has not received 2 doses of MMR they are eligible to receive the vaccine which can be given by the patient’s own GP who is able to claim the fee for this. It should be noted that people born before 1970 are likely to have immunity from exposure or single vaccine but this doesn’t preclude them from having an MMR if in doubt.

On the following weblink you can download an algorithm that provides information on what to do if the vaccination status of an individual is uncertain or incomplete. https://www.gov.uk/government/publications/vaccination-of-individuals-with-uncertain-or-incomplete-immunisation-status Please also refer to the relevant pages in the Green Book.

     https://www.healthpublications.gov.uk/Home.html

 

 

Older adults

Adults born in the UK before 1970 are likely to have had measles, mumps and rubella as a child or to have had single measles or rubella vaccines which were used before MMR was introduced in 1988.

If you are unsure whether or not you have had these infections or the vaccines to protect against them, you can ask your GP to vaccinate you. You will need two doses, one month apart. Even if you have had the vaccines before, you will not come to any harm from having extra doses as your immune system will recognize and quickly destroy the vaccine viruses.

For other vaccinations which are not part of a national programme then please see below a really useful link to one of the CQC myth busters relating to the immunisation of healthcare staff:

https://www.cqc.org.uk/guidance-providers/gps/gp-mythbuster-37-immunisation-healthcare-staff

Practices have a responsibility to ensure they have logged for each employee (clinical and non-clinical) their immunisation history or a risk assessment as to why this is not required. The list of vaccinations this applies to can be found via the attached web link.

When new members of staff join the practice you may ask for a health questionnaire to be completed. At this stage you can ask for the immunisation history and a clinician should then assess if any immunisations may be required, these can either be given by the practice (which is what happens in most practices) or by an occupational health service. If there was anything else identified on the questionnaire which you feel requires an occupational health assessment you may wish to identify a service and refer them at this point.

Practices can’t register staff as Temporary Residents as they are not actually resident in your area for more than 24 hours nor should you use supplied stock.

There is no longer an occupational health service for practice staff (only for GPs) other than for needle stick injuries and so you would need to find a service to commission or staff can request their own GP to provide the vaccination.

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The Green Book

The Green Book has the latest information on vaccines and vaccination procedures, for vaccine preventable infectious diseases in the UK.  To download a version click here: https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book

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BMA ‘Focus On’ Guidance

Focus on travel immunisation
This guidance explains which travel immunisations are available on the NHS and which can be charged for privately.

Focus on hepatitis B immunisations
The Focus on hepatitis B immunisations aims to clarify the circumstances where charges can be made and where active attempts to encourage immunisation ought to be made.

 

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Cold Chain - CQC

CQC's definition of Cold Chain is: "This term describes the cold temperature conditions in which certain products need to be kept" 

Further details and up dates can be found on the CQC Guidance page  GP Mythbuster 17: Vaccine storage and fridges in GP practices 

Wessex LMCs also has information on our page Cold Chain

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Vaccine Incident Guidance Responding to errors in vaccine storage, handling and administration

https://www.gov.uk/government/publications/vaccine-incident-guidance-responding-to-vaccine-errors

 

 

 

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Guy's and St Thomas' NHS Foundation Trust - Overcoming your needle phobia (fear of needles)

Reviewed in October 2020, please click HERE to access their leaflet about needle phobia.

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Vaccinating people with a learning disability and autistic people - Podcast

NHS England and NHS Improvement, Learning Disability and Autism, National Clinical Director is in conversation with Fazilla Amide, whose 17 year old son has complex health needs, learning disability and autism. Please click HERE to access the conversation.

 

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Refugees and Asylum Seekers

Wessex LMCs: Refugees and Asylum Seekers

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Updated on Friday, 8 July 2022 14428 views