NHS England wrote to commissioners last week to inform them of two separate issues relating to the seasonal flu and childhood flu extractions, which may affect payments to practices. The communication outlines steps practices need to take, which vary based on their clinical system provider.
Issue 1 – seasonal flu Injectable vaccines pharmacy reference sets
One of the seasonal flu injectable vaccines pharmacy reference sets had not been updated to reflect changes to the list of seasonal flu vaccines for 2022/23 (as per the annual flu letter). Practices using only prescription codes to record flu vaccination (rather than an administration code or both together) will have lower than expected figures from the GPES extraction for September flu activity. This will also impact the childhood flu service for non-intranasal vaccines given to children aged 2-3 years.
Individual clinical system suppliers have told NHS England that practices using their systems should:
- Cegedim: Practices on Cegedim may now declare their September flu achievement and commissioners can approve the declarations.
- EMIS: EMIS will re-extract September’s activity where data has not been approved for payment in CQRS National. Once this re-extract is complete (anticipated by the end of Wednesday 19 October), EMIS practices that had not already declared their September achievement will be able to do so and commissioners may approve the declarations. Where EMIS practices had already declared and had their achievement approved by the commissioner, further clarity on action to take will be provided shortly
- TPP: The planned fixed should be in place for the October extract which will take place in November and be paid in December. This will cover both September and October activity. See annex for actions TPP practices and commissioners should take.
Issue 2 – TPP issue with Seasonal Flu reports
TPP identified an issue with the Seasonal Flu 2022/23 reports which meant the practice data extracted could be lower than the level of activity completed in September. TPP have told NHS England that a fix has now been put in place and a re-extract taking place to resolve this issue now. Please note, this re-extraction will not resolve the issue with the pharmacy reference set detailed above.
Detail and actions for practices and commissioners
The coding changes are:
- 3 codes that were in the 2021/22 pharmacy reference set are still on the list of approved vaccines for 2022/23 so remain in the pharmacy reference set.
- 3 codes used in the 2021/22 which are not on the 2022/23 list of approved vaccines so need to be removed from the pharmacy reference set and should not be used by GP practices.
- 2 new vaccines are on the list of approved vaccines, the codes have yet to be added.
| SNOMED code | Description | 21/22 service | 22/23 service | Status |
| 34680411000001107 | Quadrivalent vaccine (split virion inactivated) suspension for injection 0.5ml pre-filled syringes (sanofi pasteur MSD Ltd) (product) | Yes | Yes | Correct |
| 35727111000001109 | Influvac sub-unit Tetra vaccine suspension for injection 0.5ml pre-filled syringes (Viatris UK Healthcare Ltd) (product) | Yes | Yes | Correct |
| 39566211000001103 | Supemtek Quadrivalent vaccine (recombinant) solution for injection 0.5ml pre-filled syringes (Sanofi Pasteur) (product) | Yes | Yes | Correct |
| 40085311000001103 | Adjuvanted quadrivalent influenza vaccine (surface antigen inactivated) suspension for injection 0.5ml pre-filled syringes (Seqirus UK Ltd) (product) | No | Yes | Missing |
| 40085011000001101 | Cell-based quadrivalent influenza vaccine (surface antigen inactivated) suspension for injection 0.5ml pre-filled syringes (Seqirus UK Ltd) (product) | No | Yes | Missing |
| 35726811000001104 | Influenza Tetra MYL vaccine suspension for injection 0.5ml pre-filled syringes (Viatris UK Healthcare Ltd) (product) | Yes | No | Needs removing |
| 36509011000001106 | Flucelvax Tetra vaccine suspension for injection 0.5ml pre-filled syringes (Seqirus UK Ltd) (product) | Yes | No | Needs removing |
| 38973211000001108 | Fluad Tetra vaccine suspension for injection 0.5ml pre-filled syringes (Seqirus UK Ltd) (product) | Yes | No | Needs removing |
Actions for practices:
- EMIS practices should check CQRS from Thursday 20 October and follow the usual declaration process.
- Before the end of October TPP practices should compare expected September achievement, with the achievement on CQRS National. They should also check the table above for any incorrect codes that may have been used and amend accordingly. Where a generic vaccination administration code such as “Administration of first inactivated seasonal influenza vaccination” has been used on its own, or with a drug specific code, this will not affect achievement as the generic code will trigger payment. However, practices should ensure they have not used any of the 3 codes to be removed (see table).
- Once the September and October extracts have completed, if you are satisfied that your September flu achievement is accurate, ‘declare your achievement’ in CQRS National. Do not do this unless you are sure as once achievement is accepted by your commissioner, adjustments cannot be made within CQRS National and if a re-extraction of data takes place, the systems will not be able to overwrite the approved data in CQRS National.OR
- If a discrepancy is identified, confirm with your commissioner in the first instance that there is an issue. Ensure that you have checked your coding is in line with the table below. The commissioner and the practice will then need to agree the most suitable course of action. If payment is a priority, the commissioner can make a manual adjustment to ensure prompt payment.
Pinnacle changes requested for co-administered flu and Covid vaccinations
We are aware of concerns that Pinnacle (the recording system for administering vaccines) does not currently have a “Covid + Flu” option. This means that practice teams have to complete two sets of information for Covid and for flu. The BMA has raised this with the NHS England team who deal with Pinnacle and they are aware of the time issues during vaccinations but we understand that there is not expected to be any ‘combined’ co-administration template for this season.