It has come to our attention that there are some patients who have been vaccinated in GP practices but are not being identified by your monthly CQRS payment searches. This means that practices will not receive payment for this activity. This will be due to one of three reasons.
1. Coding Anomalies affecting CQRS Claims
"Carers", "care home residents" and "shielding patients" are not included in the Flu CQRS Business Rules. Household contacts of shielding patients may also not have been correctly coded. Additionally there are also some patients included in the Ardens "at-risk" flu search suite who are not included in the Flu CQRS business rules (please read this support article for more information about this).
We have produced a suite of searches that identifies patients that have been vaccinated by the GP practice and not apparently included in your monthly CQRS extraction. These patient records should be reviewed and the "Needs Influenza Immunisation" (9OX4) code added where appropriate. In order to exclude patients included in the CQRS auto-extraction we have had to use the recently published EMIS Library "Enhanced Service" Flu search and we know this is not 100% accurate - but it is the only search available at this time.
These searches can be found in "Ardens Flu Search Suite v19.2 -> 7. Monthly Flu CQRS Discrepancies" (download from the Ardens Portal if needed). For all of these searches remember to set the relative run date as the 1st day of the month AFTER the month you wish to review (so if you wish to review September's data, set the relative run date as 1st October).
2. Registration Anomalies affecting CQRS Claims
Regular patients that are not correctly registered will not be included in the CQRS auto-extraction (e.g. registration status stuck at "FP1 submitted").
We have produced a search to identify patients registered incorrectly. Please run the search "3. Not properly registered or left/died and vaccinated by practice last month" and review the registration status of the patients identified. This search is in the the Ardens Flu Search Suite (v19.2).
If the patient is a regular patient but incorrectly registered then this will affect more than just your CQRS claims and needs fixing (please note that Ardens cannot assist practices in correcting the registration status of any patients identified.)
3. Left and Deceased Anomalies affecting CQRS Claims
The CQRS auto-extraction does not always include patients who have left the practice or died after having received a vaccine.
The search in (2) above will also identify these patients. If the patient has left or died please submit a "manual adjustment" (see below).
Deadline to complete this work by
Coding and registration anomalies should be fixed and the "9OX4" code appropriately added to records each month before the CQRS extraction to avoid having to do a "manual adjustment" (with the date of the code added to be between 1 Sep 2020 and on or before the date of flu vaccine). If you miss the deadline you will have to submit a "Manual Adjustment".
Please note that NHS Digital has not confirmed the exact extraction date but they have advised that the data will available to view by the 15th of each month, and we suspect that data is extracted about 2-3 days beforehand.
A "Manual Adjustment" is where a practice can make an additional manual submission after the CQRS auto-extraction. Practices should only submit a manual adjustment where the number of patients vaccinated according to CQRS does not match practice activity. If practices miss the monthly deadline then this is the only way to submit a retrospective claim for payment.
Please contact our support team via firstname.lastname@example.org should you have any questions.