The Ardens Flu Search Suite is a comprehensive suite of searches to support practices with the work associated with Flu season. As 2020-21 criteria are not yet available, we have based these on EMIS's 2019-20 SNOMED searches with significant edits to improve accuracy, in line with guidance. These edits include, e.g. addition of Learning Disability cohort, improvement of accuracy of pregnancy rule, corrected obesity rule and others. However, they may not match business rules but these had not yet been published for 2020-21. These searches are intended for recall of patients. Most notably, based on practice feedback, we have included the COVID shielding patients as eligible, even if they do not have a flu eligibility code on their record.


Note - we recommend reading this whole support article before using the searches, so that you are clear about the resources available.


The suite contains 6 folders of searches:



These can be found in the Population Reporting module of EMIS in Ardens searches > 5. Ardens Immunisation searches > Ardens Flu Search Suite folder.


Please note - the latest flu searches will be available to download from the Ardens Portal


1. Seasonal Flu Vaccine Ordering Guide

This suite is designed to help you to work out how many vaccines of which type to order. Based on everyone who was eligible last year, it is designed to be a 'catch all' and is likely to be an over estimate, if anything, of eligible patients. Please note this SHOULD NOT be used for call/recall.


There are 3 groups of searches within this folder:


They all give slightly different numbers to enable you to best assess the number of vaccines to order.


The top group, 'All Patients at risk 2020/21.....' is every patient who is likely to be potentially at risk this year. This group is broken down by the different age groups to enable ordering of the different vaccines.


The next group 'Patients vaccinated by anyone.....LAST season' gives you an indication of the total number of patients who were vaccinated altogether, again broken down by age.


The final group 'Patients vaccinated with correct GP code....' indicates the update at practice level last year.


2. Seasonal Flu Call & Recall Searches 2020-21

To aid the invitation process, these searches are firstly broken down into those who are 50-64 years old and not otherwise eligible, then the at-risk cohorts are broken into those in the COVID 'shielding ' category (COVID High Risk) and others (Not COVID High Risk) and Housebound or care home residents.



NOTE - the COVID High Risk may not be the same number as your EMIS library COVID high risk search. There are a couple of reasons for this:

1. Some practices may not have input the 'High Risk of COVID Complications' code on all patients and this is the only one we are searching on.

2. We have excluded patients who are contraindicated or who have declined flu.


Bear in mind that there are some patients with COVID shielding codes on their record who do not have a code which otherwise indicated flu eligibility. We have now (in v18.5) auto-included these as eligible but 9OX4 may be needed to ensure payment for these patients. 


Each of these folders contains searches  broken down into those due 1st invitation, those due 2nd invitation and those who have had 2 invitation and not yet been vaccinated. They all have the same layout within them, breaking the groups into manageable age-groups for recall:



Each of the invitation groups is further broken down as shown below.


1. Send 1st Invitations: SMS - these are patients who have a mobile number and have not declined text messaging

2. Send 1st Invitation: Email - patients who did not fall into the SMS group but who do have a valid email address 

3. Send 1st Invitation: Post - those who have neither mobile number nor email address

4. All of the above - this includes everyone and may be useful if you want to send a letter to all eligible patients



NOTE - we have separated out the healthy 2 & 3 year olds from the other under 18s on request from several practices. This enables you to focus on those who are eligible due to a code on their record, not just by virtue of their age.



3. Seasonal Flu done and still to do 2020-21

These searches are designed to help practices to assess the uptake of flu vaccine among their patients, whether vaccinated by the practice or elsewhere (NOTE - these are not searches to be used for claims).


These searches are broken down by age group and then by who gave the vaccination, with separate searches to indicate those who have declined / are contraindicated and also those who have not had, declined or contraindicated.


4. 'Seasonal Flu - Other Searches (for review)'  folder contains 5 sub-folders:




'Pregnancy - for review (check still pregnant)' should be reviewed before you start inviting anyone, as these are the patients who are included in the 'at risk' cohort due to having code on their record within a time frame which indicates that they are still pregnant. As it depends on accurate coding, it is possible that some of these patients may no longer be pregnant.



The report shows you the most recent pregnancy code recorded on their record - we recommend reviewing the records of each patient to check the accuracy of this coding.


The 'Check coding for payment' folder is a very useful suite of searches:





These help you to identify:


  • Not on 'at risk' list or 50-64 who have been vaccinated with GP code or drug (need to consider adding '9OX4 (Needs flu immunisation) code in order to ensure payment if appropriate.
  • Patients who were coded with 9OX4 (Needs flu immunisation) LAST year, not on 'at risk' list - consider whether it is appropriate to vaccinate these patients this year and if so, add the code 9OX4 to ensure recall and payment. 
  • Patients vaccinated by practice last season, not at risk or 9OX4 - these patients were vaccinated by their GP practice last year - consider whether they should be included this year. Note - the report in this search highlights patients who were pregnant last year.
  • Patients vaccinated elsewhere last season, not at risk or 9OX4 - these patients were vaccinated elsewhere last year - it may be because they paid for a private vaccine but it may be worth considering whether they are actually eligible for vaccination by the practice. 
  • Patients vaccinated with the wrong GP code, without correct code - this is a list of patients who have been vaccinated by the practice but who do not have the correct vaccine code on their record, meaning that you will not get paid for them.
  • Vaccination recorded more than once - these patients appear to have more than one flu vaccine code on their record, which may need checking.


COVID High risk code anomalies - will highlight patients who were coded by EMIS (in the original round of auto-coding of high risk patients) but who do not have the 'High risk category of developing complications from COVID-19' code. We recommend that you review these patients and add this code if they ought to be included in the 'shielded' list/


Egg Allergy- this folder identifies patients with egg allergy, broken down by age group, in order that you can work with them differently if required.


Specific Eligible Populations - these have been provided further to requests and help you to identify additional populations of patients:


Also eligible according to QOF - these are the patients on a QOF register which has a domain for flu (Diabetes, COPD, Stroke and CHD).


At risk children - these are the children at risk of flu, broken down into age under 18 and age 2& 3, both just for info. It also includes those aged 6m-under 9 years who are at risk anf had had their first flu vaccine this year, who are therefore due a second vaccine.

 

5. Seasonal Flu Denominators

These are the denominator searches upon which the others are based:





The sub-folders can be ignored, but the searches shown in the screenshot above may prove useful to obtain an overview of the numbers who have been / have not been vaccinated so far this year.


6. Searches for PPA flu claim (FP34D appendix)

This folder gives you the report you need to claim your vaccine costs. There is no need to issue a prescription for each flu vaccine administered. Indeed, this slows the process hugely. Flu vaccine (along with some others) is a 'high volume vaccine' - see NHSBSA here. This report will give you all vaccines administered, by GP, manufacturer and month.


For further support please email our support desk - support-emis@ardens.org.uk