With the end of this year’s flu campaign drawing nigh, it is vital to ensure we maximise our coverage and profit and use up all our stock. This year’s campaign has been plagued by worries that fewer people are being vaccinated than before and that pharmacists are directing patients away from GP appointments. Here are six tips to help you make the most of the remaining few months of the campaign.
1. Hit the QOF targets
Our first priority is to hit the QOF targets. Instruct the staff to search the computer system for any patients in the target groups (diabetes, COPD, CHD and stroke) who have not been vaccinated and phone them to offer an appointment. If the patients decline the offer then record ‘seasonal flu vaccine declined’, with a read code of 9OX5 in their records. This takes them out of the denominator for QOF. The maximum achievement in these domains is 95% so it is worth targeting every patient.
2. Focus on all other national target areas
The next priority is to focus on all other national target areas (over 65s, neurological disease, asthma on inhaled steroids, immunosuppressed, chronic kidney disease and any other patient in which it is considered clinically indicated) with the same process. Don’t forget the expectant mums. Any woman who is pregnant during the flu season qualifies. If the practice does not have a register it might be necessary to ask the community midwifery team for an up to date list.
Ask the practice staff to ask any housebound patients requesting a visit if they would like a flu jab and take one with you when you go. The cold chain is preserved as long as you are reasonably swift with your visits or carry a small cold bag.
Patients in residential facilities such as care and nursing homes are in the target group. If they haven’t been covered by the community team is it worth sending a nurse or healthcare assistant out to vaccinate them. To be economically viable there probably needs to be at least two maybe three patients in each location.
3. Have a range of appointments available
Make sure you have a range of appointments available for vaccinations. Could some extended hours appointments with a nurse or HCA be set aside for this? Some hard to reach ‘at risk’ patients have jobs.
4. Find out has been vaccinated by the pharmacy
Pharmacies immunising at risk patients are required to inform their GP practice ‘the same day or the next working day’ by ‘post, fax , hand delivery or secure e-mail’. If this is consistently not happening then Public Health England should be informed. Your local LMC will have the contacts and be able to advise how best to act.
Patients immunised at pharmacies can be coded as ‘seasonal influenza given by pharmacist’, read code 65EDO.
5. Order more vaccine if it looks like you’ll run out
If it looks like you are running out of vaccine without hitting targets it is worth ordering some additional stock from your supplier. Most early bulk orders will be on sale or return so it is worth putting the old stock at the back of the fridge in case some isn’t used, that you can later return.
6. Liaise with neighbouring practices
In many areas practices are collaborating and it may be easier to liaise with neighbouring practices by sharing vaccines to ensure maximum community coverage with minimum waste.
Dr John Allingham is medical secretary at Kent LMC
