Ardens has developed a suite of searches to support practices with the COVID19 vaccination enhanced service. The searches do the following:

  • Identifies patients to be invited for the COVID Vaccine, based on cohort.
  • Allows practices to risk stratify each cohort based on ethnicity and co-morbidities.
  • Splits out patients with 'Housebound' codes.
  • Identifies patients coded as having had a severe allergic reactions/auto injectors.
  • Includes HSC workers coded with an Ardens recognised HSC worker "occupation" code and splits out patients with all other HSC worker codes into a separate search for manual checking. 
  • Identifies patients that have been coded as having had only one vaccination should you need to contact these patients.
  • Shows an overview of the practice COVID vaccination activity. 


To access the Ardens COVID19 Vaccination searches, navigate to the Population Reporting module > Ardens Searches > 1.7 Ardens COVID19 Searches > Ardens COVID19 Vaccination Searches folder.



It's important to note that these searches may change, depending on the latest advice. Please see further guidance released by NHS England here. The searches are based on the following guidance from the JCVI dated 30th December 2020. 

These have been updated on 20th July 2021 to include the eligible 12-15 year olds as per the JCVI guidance issued on 19th July 2021. The new search folder is in v7.4 onwards.


*Practices can download the most recent version of the Ardens COVID19 Vaccination searches from the Ardens Portal*


COVID19 Vaccination Searches 


00. Overview of Achievement

This search folder (broken down by phase 1 and phase 2) offers an audit of those patients fully vaccinated, partially vaccinated, not vaccinated and declined. The searches have been broken down by eligible cohorts.



Fully vaccinated patients have been defined as those patients who have had 2 or more doses recorded, partially vaccinated is patients that have only had 1 dose recorded. 


00.Second Vaccination Recall

This search folder supports practices in identifying patients to be called in for a second vaccine. The searches excludes patients already invited for a second vaccine.



To run the searches, right click on the search folder, select Run and click Yes. This will open the Run Parameters screen which allows practices to choose the timeframe since the first vaccination e.g. 9 weeks or more ago. 


When selecting a timeframe, please ensure you select 'before or on' for the 'time since 1st vaccine is' option, followed by the desired time frame (example below shows more than 9 weeks ago).



Always pay attention to the description at the bottom of the screen as this will let you know the date it will use if run today.


Click OK to run the searches.


To support practices with planning and managing patients to be called in for the second vaccine, the 'AccuBook ready report' will show details of the date the patient received the 1st vaccination, along with details of the type given and the vaccine centre the patient received this at. This report can be exported to Excel to be able to further filter and sort data to recall patients in. For further information on how to do this, please see the following 5-min training video.



The 'REVIEW - Had 1st vacc dose...' search identifies patients with a unclear vaccine type. Practices may wish to review these patients before inviting them in.



00. Vaccination Status

This search folder includes searches to identify all currently registered regular patients that have had 1 or 2 or more COVID19 vaccination doses. Please note the patients will appear in only one of these searches.



The 'No invitation and Invitation coded more than....' searches will identify those patients invited more than 14 days ago (or between 7-10 days) and have had no vaccinations.



For practices to be able to recall those patients in cohort 1-9 that have still not be invited, the following search is available:


The following search is available for patients coded with 'vaccine hesitant'.



01. Residential Care Home Patients (over 65s)

This search folder will show eligible Residential Care Home patients over the age 65s, with a break down of those not vaccinated (contraindicated and declined). If practices would like to view a list of those care home patients that have a contraindication or not indicated code, declined or have a severe allergy, separate searches are available for this.



Please note - the Ardens searches above are based on EMIS's Residential home search. If a practice is unsure why the patient is appearing as a Care Home Patient, this can be checked by accessing the Denominator Searches folder (still within the COVID19 Vaccination Searches folder), selecting the 'All residential home patients' search and clicking on the Check Patient feature on the EMIS ribbon. This will let you know which code is being picked up. It's important that practices code patients with a 'No longer lives in residential home' code if this is no longer the case for the patient.


02. Age 80y + and HSC Workers (excl cohort 1)

This search folder identifies patients aged over 80 and eligible HSC workers to be invited in for the vaccination. The searches will exclude cohort 1 patients.


To support practices in identify HSC Workers, the COVID Vaccination Template now includes a 'Occupation coding' page to record that a patient is a HSC worker. The template includes specific codes that are unlikely to have been used accidentally in the past.


The searches to identify HSC workers can be found in the '02. Age 80y+ and HSC workers' folder:



For practices that would like to review patients with occupation codes (not used by the Ardens searches) for data quality purposes, access the Data Quality searches folder:



You may wish to review these patients and apply the Ardens recognised HSC worker codes.


03. Age 75-70y (excl patients in cohorts 1 and 2)

This search folder identifies patients aged between 75-70 to be invited in for the vaccination and will exclude anyone included in cohort 1 and 2.


04. Age 70-74 OR COVID high risk (excl cohort 1&2)

This search folder identifies patients aged 70 - 74 AND any patients over the age of 16 that have a COVID high risk code entered in their record, to be invited for the vaccine. It will exclude any patients that are included in cohort 1 and 2.


If you would like more information on how to split the non 70-74 year olds from the CEV patients and further filter the reports, please see following 6-min training video.


If you do not understand why a particular patient is displaying as a CEV patient, please see the following support article on how to check this information.


05. Age 65-69 (excl patients in cohort 1, 2, 4)

This search folder identifies patients aged between 65-69 to be invited in for the vaccination and will exclude anyone included in cohort 1, 2 and 4.

 

06. Age 16-64 + Underlying Health Conditions (UHC)

This search folder identifies patients aged 16-64 with an underlying health condition to be invited in for the vaccination. It will exclude anyone in cohort 1, 2, 4 and 5).


The JCVI guidance includes those patients with underlying health conditions (UHC) within eligibility group 6. The Green Book (COVID-19: The Green Book Chapter 14a) identifies the relevant conditions and we have interpreted this into a suite of searches:




These have been used to compile the patients included in this cohort:


If you are unsure as to why a patient appears in a group, please click on the search at the top (COVID-19 Vaccination - Age 16-64 with underlying health conditions) and choose 'check patient' on the ribbon at the top of the screen. You will then see a window like this:



The highlights show which searches from the Underlying Health Conditions denominators the patient appears in. By navigating to that search here and repeating the 'check patient' function on the appropriate search, you will see which code(s) have been identified on the record to place them in the cohort.



To watch a short video on how to use the Check Patient feature, please see the following support article.


Please do remember The Green Book clearly states that "prescribers should apply clinical judgement to take in account the risk of COVID-19 exacerbating ANY underlying disease, as well as the risk of serious illness from COVID-19". This means clinicians can include ANY PATIENT in cohort 6 who they feel clinically should be prioritised for the vaccine. 


If practices wish to add any patients in cohort 6, this can be done via the Ardens COVID Vaccination Template and coding the patient as "Moderate risk category for developing complications from COVID-19". Please note - adding the "Low Risk" code will only remove patients from cohort 6 if they had the "Moderate risk" code added. 


Please note -  version 4.7 above separates Learning Disability and pregnant patients. 


0.6a Immunosuppressed patients & contacts

JCVI published the following guidance that recommends adults living with adults who are immunosuppressed should be prioritised for the COVID19 vaccine. This folder contains searches to identify all immunosuppressed patients that need contacting.


07. Age 60-64 (excl patients in cohorts 1-6)

This search folder identifies patients aged 60-64 to be invited in for the vaccination. It will exclude anyone in cohort 1-6. 

 

08. Age 55-59 (excl patients in cohorts 1-6)

This search folder identifies patients aged 55-59 to be invited in for the vaccination. It will exclude anyone in cohort 1-6. 

 

09. Age 50-54 (excl patients in cohorts 1-6)

This search folder identifies patients aged 50-54 to be invited in for the vaccination. It will exclude anyone in cohort 1-6. 


10. Age 40-49 (excl patients in cohorts 1-6)

This search folder identifies patients aged 40-49 to be invited in for the vaccination. It will exclude anyone in cohort 1-6.


11. Age 30-39 (excl patients in cohorts 1-6)

This search folder identifies patients aged 30-39 to be invited in for the vaccination. It will exclude anyone in cohort 1-6.


12. Age 17y9m-29 (excl patients in cohorts 1-6)

This search folder identifies patients aged from 17 years and 9 months (3 months before their 18th birthday) to 29years old to be invited in for the vaccination. It will exclude anyone in cohort 1-6. Please note - you will need to run these regularly as patients will fall into this cohort as they come of age.


13. Age 12-15 with specific Underlying Health Cond

This search folder identifies the 12-15 year olds with specific underlying health conditions, as per the JCVI guidance issued on 19th July 2021.


Ardens Manager Reports

This suite of reports contains a report which can be uploaded to Ardens Manager to view in dashboard format. Please see this support article on uploading the Ardens Manager data to your online dashboard.

 

Data Quality Searches 

The Data Quality searches folder helps practices to identify coding errors and ambiguous codes (e.g. care home residents and Health and Social Care workers).



The ?High clotting risk search identifies patients at risk of high clotting which you may wish to review before inviting the patient in for the Astra Zeneca vaccine. 


The For review after vaccination I As <50y + not in cohort 1-9 search looks for patients that have been vaccinated under the age of 50 years, however they do not full into the 1-9 cohorts. Practices may wish to further review these patients. 


The '*Second vaccine dose coded with no first vaccine dose coded' search identifies patients coded with 'Administration of second dose' but not first, you may want to review these patients and record details of the first dose.


The Gestational Diabetes and CEV since 15th Fed and NOT on Diabetes Register search is to support practices in identifying Gestational Diabetes patients to review. Clinicians are to decide if the patients are to remain on the CEV list and to add or remove them if appropriate. If the clinician decides to leave the patient as high risk, this will mean the patient remains in cohort 4. If the clinician decides to add a moderate risk code this will move the patient to cohort 6. If a low risk code is added, the patient will appear in the relevant  age cohort. Please note, the Ardens COVID Vaccination template can be used to update the CEV code.


The Patients coded as 'moderate risk of complications from COVID' <1st Feb 21 will display patients coded with a moderate CEV code, you may wish to review this list of patients and amend the CEV code if appropriate. 


For patients appearing in the 'All patients coded with severe allergic reaction OR issued auto-injector' search, you may want to check if coding is still applicable for the patient.


For patients appearing in the 'Coded as housebound' search, if this no longer applies to the patient, to add the 'no longer housebound' code to the patient record.


For patients appearing in the 'Generic COVID vaccination code used' search you may wish to replace the vaccination codes used with the 1st and 2nd dose codes.


For the 'Patient currently coded as pregnant' search this will include patients who have a code in their record within a time frame which indicates they are still pregnant. It is possible that some of these patients may no longer be pregnant, we recommend to review these patients and check the accuracy of the coding.


For patients appearing in the 'Patients coded with occupation SNOMED codes' search, you may wish to review the occupation details recorded for the patient, which suggests they may appear under the 'HSC Worker' category. Please note the Ardens searches will only include residential care workers at this time.


Denominator searches

If you wish to find out why a patient has been included in a cohort such as Residential home, Healthcare worker or Pregnant, please use the searches within the Denominator searches folder:



From the searches in this folder, you are able to use the 'Check Patient' function described above and it will let you know which code is on the record and is putting the patient on the relevant list.


Enterprise Reports

The following searches are useful for CCG monitoring to understand those patients that have declined or not yet vaccinated by certain patient groups (Asylum Seekers, BAME Patients, Homeless Patients).


Miscellaneous COVID Vaccination Searches

This folder includes patients in cohorts 1-9 with a BMI>30 and their vaccination status.


Recalling Patients for COVID19 Vaccinations

Folders 01 - 12 will break down searches and reports for 'Housebound' and 'Not Housebound' patients. The reports display details of the patients' date of birth, ethnicity, age, QOF conditions, flu vaccination date this year and more. Practices may wish to export these reports to further filter the information to risk stratify each cohort based on ethnicity and co-morbidities, invite higher risk patients or older patient fist.



To run the searches, right click on the relevant folder and select the Run option to run all searches in the folder. 


To see the results of reports, click on the View Results button on the ribbon to see the information.


Please see the following support article on how to filter the exported report.


For further information on the available Ardens COVID resources to manage Long COVID patients or those patients requiring remote monitoring (CO@H), please see the following support articles.


To watch the recording of the Ardens COVID Resources webinar, please click here.


If you require any further assistance on the process above, please contact Ardens support on: support-emis@ardens.org.uk