The Ardens flu search suite is a comprehensive suite of searches to support practices with the work associated with flu season.
IMPORTANT: The eligibility as defined in the Green Book for seasonal influenza and COVID-19 vaccines is similar but not identical. This has resulted in differences between the underlying code-sets which are used in the Ardens reports for both. This means that whilst you may think some patients should be included in both the seasonal influenza and COVID-19 invitation reports, some patients might just be included in the seasonal influenza invitation reports but not the COVID-19 invitations reports, and vice versa. Some practices may be planning to give both vaccinations concurrently if clinically appropriate.
We are aware that some practices may be planning joint clinics , but the patient would still need separate flu and COVID invitations, even if they are booked into a single joint clinic. The invitation wording for each vaccine could refer to the possibility of administering both but the individual patient’s eligibility and suitability for either / both vaccinations should be checked prior to vaccination.
Locating and Running the Searches
To access the searches, navigate to the Population Reporting module > Ardens Searches > 3.15 Vaccinations - Flu 2023-24 folder.
It is important to note that these searches may change depending on the latest advice. Before performing any large tasks on this area, we strongly recommend checking the Ardens Portal to see if you are using the latest version of the search suite.
When running the searches, we recommend to run the individual search folder required at that time to reduce the speed time of the running of the searches.
Right click on the folder and select Run. To view the patients that meet the criteria of the search, click on the Population Included tab.
There are known limitations of our searches:
- There is currently no published code-list to define "clinical risk groups" or "immunocompromised individuals". We have built a high quality code-list based on The Green Book definition to identify at-risk patients but we know that our searches will differ slightly from the codes that EMIS Health will use as The Green Book definitions are open to interpretation.
- The EMIS flu vaccine "alert" in the pink alert box is usually released in September. It advises when a patient is eligible for a flu vaccine. It will be based on the EMIS code-list for the above patients. This "alert" will not 100% align with patients identified using the Ardens searches.
- This means that some patients will be identified as eligible for flu vaccine by Ardens but not by EMIS, and vice-versa. A solution is to add the "9OX4" (Needs Influenza immunisation) code to these patient records on an ad-hoc basis where clinically appropriate. This code will ensure payment will be made for vaccination.
Flu Search Folders
1. CLINICAL review before recall
We recommend practices action this folder prior to recalling patients, we then suggest monitoring this area throughout the flu season.
The Egg Allergy search folder contains searches to identify patients coded with an egg allergy. Due to the risk of an allergic reaction if given a flu vaccine, depending on the patient age you may wish to offer the patient a different type of vaccine. The Egg Allergy, contraindication not coded (for flu) search will display all currently registered patients that have an egg allergy. You may wish to add a flu contraindication code to the patients record if appropriate. We have further broken down this search to identify those patents at risk by age groups.
The Misc folder includes searches to identify patients coded with living with an immunocompromised person, carers aged under 65 and other at risk patients that you may deem appropriate for inviting in for the flu vaccine, you may wish to code these patients with '9OX4 - needs flu immunisation'. Other searches include data quality checks for housebound and care home resident patients and those patients with expiring contraindication codes. This folder also includes a search identifying patients aged 50-64yr, not otherwise eligible, vaccinated last season, to help identify how many vaccines were used last season which may not be needed this season.
The Pregnancy-for review (check still pregnant) search folder identifies patients currently pregnant according to the coding in their record in the last 42 weeks, these patients will appear in the at-risk flu groups. We suggest reviewing the list of patients to check the accuracy of this coding.
2. CLINICALLY eligible call & recall
This search folder contains recall lists for inviting patients in for the flu vaccine. The searches are based on the eligibility criteria provided by JCVI.
The 1. Age 65+ (need aQIV or QIV-HD vaccine) search folder includes all patients over the age of 65 years at risk who are not a housebound or care home resident.
The 2. Age 2 & 3 yr olds search folder includes healthy 2- 3 year olds. Please note - that all older not at-risk children (particular secondary school children) will most likely be vaccinated elsewhere (e.g. school).
The 3. Age 18-64 (need QIVc or QIVr vaccine) search folder includes all 18-64 year old patients at-risk.
The 4. Age Under 18 (need LAIV vaccine) search folder includes all patients under the age of 18 years at-risk.
The 5. Housebound or Care Home search folder identifies housebound and care home residents, providing the correct code has been entered in the patient record.
The 6. Excluded from recall as contraindication code search folder includes all eligible patients with a contraindication code recorded this fiscal year and will not be included in call and recall searches.
Recalling the patients above - each folder includes searches to identify 1st and 2nd flu invitations due. Patients will fall into the 2nd invitation category if they have had one flu invitation sent this flu season more than 7 days ago but there is no indication a flu vaccine has been given. The searches are further broken down by ways of communication (except 2-3 year olds), depending on consent and recording of contact details.
SMS - includes patients with a mobile number that have not declined text messaging. You may also wish to review patients appearing in the 'Mobile phone number in wrong field' search folder to correct patients with the mobile phone number entered incorrectly.
Email - includes patients that have declined SMS (or have no mobile number) but do have a recorded email address and have consented to emails being sent.
Post - includes patients that have declined SMS and Emails (or have neither) therefore a letter is to be sent.
All - lists all patients for invitations due, regardless of communication type.
Please note - if batch texting or emailing, the associated reports can be exported as a CSV file and will contain the relevant information for the third party messaging service. Please see further details on how to export reports here.
3. OVERVIEW of achievement
The Co-Administered with COVID search folder contains a search and report to identify patients coded with a flu and COVID vaccination on the same day.
The main search folder contains searches to support practices in monitoring the uptake of flu vaccine amongst the practice. The searches are broken down by cohort and report on the following:
- flu vaccines done by the practice (providing the right code has been recorded)
- flu vaccines done by other providers
- patients that have declined or contraindicated
- outstanding patients due the flu vaccine
- flu vaccines done but incorrect coding used
- flu vaccines recorded by an external user using the GP code (for example hub/vaccination clinic)
For patients appearing in the (Done) Vaccinated BY Practice using wrong GP code searches, we suggest reviewing the list of patients (Population Included) and adding the appropriate flu code. Ardens provides a flu protocol which can be launched in the patient record to add the correct code.
4. PAYMENT searches to support with flu CLAIM
The following searches support practices in identifying incorrect or missing payment codes for claims.
The Check coding for payment > Influenza Enhanced Service includes useful searches to check coding is accurate for payment:
- 1. Vaccination recorded using incorrect code - review the list of patients (Population Included) and record the correct flu code on the original date entered.
- 2a. Vaccination recorded but not clinically eligible for payment (season) - the correct flu code has been entered for these patients this season, however they are not deemed as eligible under the business rules for payment for the flu vaccine. Review the list of patients (Population Included) and consider adding the '9OX4' code to the patient record in order to receive payment.
- 2b. Vaccination recorded but not clinically eligible for payment (last month) - the correct flu code has been entered for these patients last month, however they are not deemed as eligible under the business rules for payment for the flu vaccine. Review the list of patients (Population Included) and consider adding the '9OX4' code to the patient record in order to receive payment.
- 3. Vaccination recorded correctly 1/8/23 - 30/8/23 (needs manual claim) - includes patients with the correct flu code recorded before 1/9/21, however they will not be picked up in automatic claims and practices will need to manually claim.
- 4. Vaccination recorded more than once (Immform data quality) - includes patients with more than 1 recorded flu vaccine. Review the list of patient (Population Included) and remove duplicate entries to avoid data not being extracted.
- 5. Not properly registered or left/died and vaccinated by practice last month - includes patients incorrectly registered, have left the practice or deceased. The associated report will contain details of the registration status and the date the flu vaccine is given, should the practice wish to correct any details. Click on the View Results option to view the report.
The Check coding for payment > NCD IIF only includes:
- 1. Non business rules contraindication - add business rules code - includes patients coded with a contraindication code that is not a recognised code for the business rules. Practices may wish to review the list of patients and add the relevant contraindication code. Please note - this is important for IIF flu indicators.
- 2. Non business rules decline code - add business rules code 822931000000100 - includes patients coded with a declined code that is not a recognised code for the business rules. Practices may wish to review the list of patients and add the relevant declined code. Please note - this is important for IIF flu indicators.
- 3. 2x invitations this fiscal year, but not since September - invite or decline - includes patients with a flu invitation code recorded before 1st September. To meet the requirements of the Investment Impact Fund (IIF), the 1st and 2nd invitation must be recorded after this time, for a personalised care adjustment to be applied if the patient does not respond. Practices are to review this list and invite the patient accordingly or add a decline code.
- 4. 2x invitations since 1st September, but wrong code for IIF - includes patients with an invitation code recorded but is not recognised by the IIF requirements. Practice are to review the list of patients and add the appropriate invitation code.
- 5. In IIF flu, not in EMIS clinical eligibility for flu - Immunosuppressed - includes patients who are not in the EMIS clinical eligibility cohort as per the green book and have not been vaccinated, but who are within the IIF flu denominator. Practices may wish to review the list of patients and invite for vaccination if appropriate.
- 6. In IIF flu, not in EMIS clinical eligibility for flu - Severely Obese - includes patients who are not in the EMIS clinical eligibility cohort as per the green book and have not been vaccinated, but who are within the IIF flu denominator. Practices may wish to review the list of patients and invite for vaccination if appropriate
The CQRS results search folders will allow practices to monitor the automatic extraction for CQRS claims. Please note, the searches are looking at 'last month'. The CQRS (left/died) folder will also include those patients not correctly registered, you may wish to refer to the Ardens registration anomalies search to identify and action these patients.
The Flu audit searches provides practices with a total number of flu vaccinations given by the GP practice this season.
The PPA claim report for flu (FP34D) provides practices with a report to claim vaccine costs. There is no need to issue a prescription for each flu vaccine administered as the Flu vaccine (along with some others) is a 'high volume vaccine', further information here.
Please note, some manufacturers may provide more than one type of flu vaccine and these types have different values. Therefore, just putting the manufacturer in your PPA claim may not be sufficient to ensure you get paid the correct amount for each vaccine and this may not be clear on the report. You may wish to cross match your batch numbers to find the vaccine type and add this information to the report to ensure you have all the relevant information to hand when completing your claim.
The Sub-reports folder includes the building searches of the search folders above, no further action is needed.
5. Ardens Manager Data
The Ardens Manager Seasonal Flu Data report, allows practices to import practice data to the Ardens Manager flu dashboard. Please see the following support articles for further information on Ardens Manager.
6. Ordering searches for next year 2024-25
The Ordering searches for 2024-25 search folder supports practices in planning for the next flu vaccination season. The searches will report on the number of
patients for each eligible cohort.
7. Seasonal flu immform upload
The following searches are available to support GP practices with data uploads for Immform, please see the following support article for further information.
8. School Age Children (for info)
School aged children will usually be vaccinated by their school, however we have provided searches for information only. These searches identify those not otherwise at risk, eligible for vaccination and also searches to show uptake.
Please note, there is no payment under the National DES for this cohort of patients.
zDenominators
If you wish to find out why a patient has been included in a certain eligibility cohort, please use the denominator searches:
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.
If you require any further assistance on the process above, please contact Ardens support on: