Locally Commissioned Service Clinical Lead Commissioner Reporting Mechanism/Frequency Payment Frequency Payment Contact Childhood Immunisation Dr Oliver Anglin Camden Clinical Commissioning Group Partially Manual & Electronic / Quarterly Quarterly in arrears Camdenlcs@nhs.net This Version Childhood Immunisation LCS Specification 2015-2016 v.1.0 Date 2 September 2015 Original Version, dated July 2012 (revised August 2015) Review date March 2016 Childhood Immunisation Locally Commissioned Service 2015-16 This LCS is NOT an alternative to the Directed Enhanced Service (DES). It is in addition and to support the catch up to ensure that the highest possible percentage of children from age 5 to young people aged less than 19 years receive the appropriate immunisations. This LCS is available to Providers until further notice. 1. Service aims 1.1. NHS Camden Clinical Commissioning Group s Locally Commissioned Service (LCS) for Childhood Immunisation aims to ensure that the highest possible percentage of children from age 5 to the age below 19 years receive the appropriate immunisations as this represents the most effective means of ensuring that individual children and the wider community (especially those for whom immunisation is contra-indicated) are protected from these serious diseases and from the complications associated with those diseases. 1.2. The LCS provides local GP practices with a framework for immunising, recording, maintaining and transferring accurate information on the vaccination status of children and young people. Furthermore it seeks to ensure health professionals who deliver vaccinations have received training that complies with the National minimum standard for immunisation training. 1 1.3. The LCS has been developed with reference to the NICE guidance, Reducing differences in the uptake of immunisations (including targeted vaccines) among children and young people aged less than 19 years, issued September 2009. It enhances the existing Directed Enhanced Service (DES) specification by providing a payment 1 Health Protection Agency et al. (2005a) National minimum standard for immunisation training [online]. Available from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/362171/national_immun_train_sta nd1.pdf http://www.nhsemployers.org/~/media/employers/documents/primary%20care%20contracts/v%20 and%20i/v%20and%20i%20home%20page/2015%2016%20vi%20guidance.pdf Childhood Immunisatons LCS Specification 2015-2016 v20 1
framework for the immunisation of children falling outside the target cohorts. 1.4. The overall focus of the LCS is on monitoring vaccination status as part of a wider assessment of health of children and young people over the age of five and under the age of 19 and immunising those who have not been immunised or have only been partially immunised. 2. Duration 2.1. This LCS is NOT an alternative to the Directed Enhanced Service (DES). It is in addition and to support the catch up to ensure that the highest possible percentage of children from age 5 to the age less than 19 years receive the appropriate immunisations. This LCS is available to Providers until further notice. 3. Eligibility Criteria 3.1. In order to be eligible to provide the LCS for Childhood Immunisations, providers will need to: 3.1.1. be fully compliant with all requirements of core contracts (General Medical Services, Personal Medical Services or Alternative Personal Medical Services) and the requirements of the additional services; 3.1.2. be commissioned to provide the Vaccinations and Immunisations additional service; 3.1.3. be signed up to the Childhood Immunisations DES with NHS England; 3.1.4. have a named lead clinician for the service; and 3.1.5. ensure all staff involved in immunisation services are appropriately trained and updated (see 4.4). 4. Service to be provided under the LCS 4.1. The contractor shall deliver the following for the LCS, alongside the requirements of the NHS England DES: 4.1.1. Develop and maintain a register ( Childhood Immunisation Scheme Register which may comprise electronically tagged entries in a wider computer database) of all the children for whom the contractor has a contractual duty to provide childhood immunisation and pre-school booster services (who may already have been immunised, by the contractor or otherwise, or to whom the contractor has offered or needs to offer immunisations); 4.1.2. Undertake to offer the recommended immunisations referred to in https://www.gov.uk/government/uploads/system/uploads/attachment_data /file/315489/phe-routine-childhood-imm-july-2014-03.pdf to the children on its Childhood Immunisation Scheme Register (with the aim of maximising uptake the interests of patients, both individually and collectively); 4.1.3. Undertake to record the information that it has in Childhood Immunisation Scheme Register using the following READ Codes: Childhood Immunisatons LCS Specification 2015-2016 v22 2
Name of Vaccination Booster diphth tet ac pertus, haem influb, inac polio vaccn READ Code 65MP Booster diph tet ac pertussis, haem influ b, inacc polio vac 65MQ Fourth DTP polio and Hib vaccination 65MK Booster (single) haemophilus B vaccination 657D Booster diphth tet ac pertus, haem influ b, inac polio vac 65a3 Booster diphtheria tetanus pertussis (DTaP) + polio vaccintn 65I4 Low dose diphth, tet, acellular pert, inactive polio vac 65I8 Booster diphth, tetanus, acellular pert, inactive polio vac 65I9 Booster diphtheria tetanus pertussis (DTaP) vaccination 65H4 Booster DT(double)+polio vac 65K4 Low dose diphtheria, tetanus and inactivated polio vaccination 65K5 First booster low dos diphtheria, tet and inactive polio vacc 65K9 Second booster low dos diphtheria, tet and inactive polio vac 65KA and 4.1.4. Submit data on registered patients and immunisation status, including refusals, to the Child Health Records Department on a regular (at least fortnightly) basis using the Record of Immunisations Given/Refused form provided. This information will be entered on RIO and used to audit payments against achievement. 4.2. The contractor shall: 4.2.1. Develop a strategy for liaising with and informing parents or guardians of children on its Childhood Immunisation Scheme Register about its immunisation programme with the aim of improving uptake; and 4.2.2. Provide information on request to those parents or guardians about Childhood Immunisatons LCS Specification 2015-2016 v22 3
immunisation. 4.3. The contractor is required to take all reasonable steps to ensure that the lifelong medical records held by a child s general practitioner are kept up-to-date with regard to the child s immunisation status, and shall include the following: 4.3.1. Any refusal of an offer of vaccination; 4.3.2. All information and advice given to the parent or guardian involved, including discussion about any special needs the child may have or any concerns regarding the vaccination expressed by the child, parent or guardian; and 4.3.3. Where an offer of vaccination was accepted: Details of the consent to the vaccination or immunisation (where a person has consented on a child s behalf, that person s relationship to the child must also be recorded); The batch number, expiry date and title of the vaccine; The date of administration of the vaccine; Where two vaccines are administered in close succession, the route of administration and any injection site of each vaccine; Any contraindications to the vaccination or immunisation; and Any adverse reactions to the vaccination or immunisation. 4.3.4. Vaccination information should also be entered into the personal child health record (PCHR, also known as the Red book ). The relevant red book flimsy or, if not available, a fax back form (Records of immunisations given or refused) must be forwarded to the relevant NHSE Immunisation Team within two weeks of immunisation taking place. 4.3.5. To ensure standardisation of Read coding, practices should use nationally or locally recommended Childhood Immunisation templates for recording purposes. 4.3.6. If the patient is not registered with the practice providing the LCS, then the practice must send this information to the patient s registered practice for inclusion in the patient record within five working days. 4.3.7. All childhood immunisations given must be reported to the Child Health Department either by returning the relevant copy of the immunisation page of the child s Red Book or using the attached Record of Immunisation Given or Refused within two weeks of the immunisation being given. 4.4. The contractor is required to ensure that any health care professional who is involved in administering a vaccine has: 4.4.1. Any necessary experience, skills and training with regard to the administration of the vaccine; and 4.4.2. Training with regard to the recognition and initial treatment of anaphylaxis. 4.5. The contractor is required to ensure that: 4.5.1. All vaccines are stored in accordance with the manufacturer s instructions; 4.5.2. All refrigerators in which vaccines are stored have a maximum/minimum thermometer and that readings are taken from that thermometer on all working days; and 4.5.3. The contractor is required to supply its CCG/NHSE with such information as it Childhood Immunisatons LCS Specification 2015-2016 v22 4
may reasonably request for the purposes of monitoring the contractor s performance of its obligations under the plan. 4.6. Monitoring vaccination status and immunisation of children and young people over the age of five and below the age of 19: Services to be provided include monitoring the vaccination status as part of a wider assessment of health of children and young people over the age of five and below the age of 19 and immunising those who have not been immunised or have only been partially immunised. This includes immunisations that form part of the National Immunisation Schedule. http://www.hpa.org.uk/web/hpawebfile/hpaweb_c/1194947406156 5. Quality and safety 5.1. Practices making claims will be required to complete and submit EMIS web searches and reports in accordance with the quarterly submission schedule. A help file has been created to support practices in reporting. 5.2. Camden Clinical Commissioning Group is responsible for obtaining assurance that all the services it commissions are safe and are of good quality. All practices delivering the Childhood Immunisations LCS must provide assurance that they are compliant with all stipulations outlined in Section 3, Eligibility, above as well as the following: 5.2.1. The practice is registered with the Care Quality Commission (CQC). 5.2.2. The practice meets requirements of NHS England for the provision of Core, Additional services and any related Directed Enhanced Service (DES) or National Enhanced Service (NES) that the practice are commissioned to deliver. 5.3. Practices are to report any incidents (including near misses, significant events, incidents and Serious Incidents (SIs), complaints and patient feedback relating to this locally commissioned service to Camden CCG Quality & Safety Team via secure email: qands.camdenccg@nhs.net. SIs must be reported within 24 hours following identification. 6. Criteria, pricing and monitoring arrangements 6.1. All payments for this LCS will be made quarterly in arrears subject to the submission of the requisite monitoring information. 6.2. Payment is made only for completed courses of vaccinations for children and young people over the age of five and below the age of 19. Participating practices will be paid 15.28 per completed course. 7. Exit and suspension arrangements 7.1. The Contractor can terminate the scheme by providing one month written notice to the CCG Primary Care Team. The CCG may terminate the scheme within 28 days if, following suspension of payments the contractor fails to re-establish services according to the service specification or take appropriate action to address deficiencies within eligibility criteria. Before issuing an exit notice, the parties will meet to discuss the reason for termination. If after this meeting the reason for terminating is not resolved then the relevant partly will issue an exit notice. 7.2. Either primary care providers or the CCG can exit this agreement by providing a minimum of six months written notice. Childhood Immunisatons LCS Specification 2015-2016 v22 5
7.3. Either party can appeal against a suspension or termination notice to the CCG s Director of Commissioning. Childhood Immunisatons LCS Specification 2015-2016 v22 6