November 2018
20181120 Gateway 08529 Vaccines for 201920 seasonal flu vaccination prog…
ALL PSNC Flu briefings for 2018/19
This addendum provides the legal basis for two activities to take place:
•For pharmacists to administer the recommended vaccine to patients who have inadvertently received the non-recommended vaccine for their age group during the 2018/19 Flu Vaccination Service, for example, patients aged 65 years or over who have received a quadrivalent vaccine (QIV) instead of the recommended adjuvanted trivalent inactivated vaccine (aTIV); and
•For pharmacists to re-vaccinate patients who have received an incomplete dose of vaccine, for example, if some of the vaccine was spilled in the process of administering the vaccine.
This addendum is in line with the recently updated PHE Inactivated influenza vaccine guidance for healthcare practitioners, which explains the process to follow if a patient has inadvertently been given a flu vaccine that is not recommended for their age group.
FAQs
Do I need to sign the addendum?
No. Pharmacists are not required to sign the addendum, but it is important that they are aware of it so, if either of the above circumstances occur, pharmacists are aware that the PGD allows them to re-vaccinate a patient.
Do I need to print a copy of the addendum and attach it to the PGD?
Contractors/pharmacists are strongly encouraged to print a copy of the addendum and attach it to the PGD in the pharmacy to ensure that new pharmacists signing up to the service are made aware of the addendum.
What should I do if I have inadvertently given a patient a non-recommended vaccine for their age group, for example, I have given a 65 year old patient the QIV instead of the recommended aTIV?
Pharmacists should follow the process in PHE’s recently updated Inactivated influenza vaccine guidance for healthcare practitioners, which states:
•Inform the patient of the error and its potential implications;
•Advise the patient that although the QIV and aTIV will offer some protection to all age groups, individuals aged 65 years and over (particularly those more than 75 years of age) may not respond as well to the QIV as they would to the aTIV, and individuals aged under 65 years will not benefit from the opportunity to make protection against an additional flu strain if they have been given aTIV;
•Following a discussion about the risks and benefits, advise the patient that they could, if they wish, be given a second dose of the vaccine they should have had;
•The clear benefit is the additional protection that may be offered by the correct vaccine, but they should be alerted to the potential increased risk of a local or systemic reaction. Although there is no data available on the safety and effectiveness of administering a second flu vaccine shortly after the first in adults, this advice is based on general principles of vaccination, experience of flu revaccination following cold chain and administration incidents and information about the high dose flu vaccine used in the United States (which contains four times the amount of antigen that is in a single dose of QIV or aTIV);
•If a decision is made to offer the vaccine the patient should have received, it is recommended that this is done as soon as possible after the first dose was given and ideally within a week. This will enable protection to be made as soon as possible. It can, however, still be given if more than a week has elapsed.
This advice also applies to those who have inadvertently been given non-adjuvanted trivalent influenza vaccine (TIV).
3rd October 2018
Cumbria County Council – Flu Vaccines for School Staff
Cumbria County Council are issuing flu vouchers to their employed school staff this year, as well as care staff. The vouchers – 8000 of them – are being sent out soon so please be ready. You will need a private PGD to provide this service. School and care staff are required to show some sort of ID when presenting a voucher – most school staff will not have photo ID, so some flexibility is acceptable, as long as you can be satisfied that they work for a County Council run school. Academies are not being provided with vouchers and are not part of the service
24th Sept 2018
NHS Flu Vaccination Guidance
FLU Guidance – Gateway ref 08443 180924 aTIV Local actions Final
PharmOutcomes System Update – 17.00 24/09/18
You will be aware that we have been experiencing technical problems over the weekend and today which have affected the performance of PharmOutcomes.
Users were previously unable to access postcode look-ups and CPPE enrolments and there was also a delay in messages being sent. We have now established that these problems were caused by technical changes made by our hosted service provider. These have been reversed and these services are now operational again.
Unfortunately we are still experiencing general performance issues. These are leading to a slow performance of PharmOutcomes and in some cases are affecting incoming referral messages because the response notification “times out”.
We will continue to work on the problem but do not expect to be able to resolve things fully today (Monday).
We will provide a further update at noon tomorrow or as soon as the problem has been fixed. In the meantime, please accept our apologies for the current service levels.
David Price
Chief Operating Officer
24th Sept 2018
Flu data
Due to the the technique issue with Pharmoutcomes, please be aware that it is possible to submit a claim twice if the system is slow.
Please check the ‘Recent Provisions” history if you are unsure. A service guide is available to help check any service Service Delivery – Service History
24th Sept 2018
PharmOutcomes Message Technical Issue
We are currently experiencing technical problems with:
Postcode look-ups,
Look-ups to the CPPE website during enrolments to services.
We are working to establish the cause of the problem and will provide an update as soon as we have further information.
Please accept our apologies for any inconvenience this may cause.
David Price
Chief Operating Officer
20th Sept 2018.
Appropriate use of flu vaccines (aTIV and QIV)
Over the last few days, PSNC has received many queries from contractors relating to the ordering and appropriate use of adjuvanted trivalent influenza vaccine (aTIV) and in what exceptional circumstances quadrivalent influenza vaccine (QIV) may be used in patients 65 years and over.
On Monday, we published a Briefing which summarises the different documents and news stories relating to the use of aTIV that have been published by NHS England, Public Health England and PSNC. The Briefing also explains what pharmacy contractors should do if they have no aTIV available, either temporarily or because they have been unable to obtain any aTIV for the 2018/19 flu season. We strongly recommend that all pharmacists providing the flu vaccination service read this briefing.
The advice on vaccinating patients aged 65 years and over remains: no vaccine other than aTIV (Fluad) should be administered at this point in the season*. Where despite this advice, a contractor seeks reimbursement for vaccine other than the recommended vaccine choice, NHS England may make enquiries to understand how the evidence of clinical efficacy of aTIV and QIV was considered and how the clinical judgement to use the relevant vaccines was reached.
Where an appropriate clinical justification cannot be provided, NHS England may seek to take action against a contractor for breach of the terms of service for failing to provide the service and exercise their professional judgement consistent with standards generally accepted in the pharmaceutical profession.
* except for patients with an egg allergy.
18th Sept 2018
Flu Update IMPORTANT PLEASE READ
This is an unusual, challenging flu vaccination season with the introduction of adjuvant trivalent flu vaccine (Fluad). Some deliveries have been received so far, many have not, and this places pressure on both pharmacies and surgeries from patients keen to be vaccinated. However, the current guidance – summarised by the PSNC, and attached here- reinforces the message that at this stage of the season it would be inappropriate to use quadrivalent flu vaccine in the 65+ age group. To do so risks both action by NHSE, and may even open a pharmacy – or surgery – to legal action.
From the early figures, it is apparent that SOME pharmacies have been vaccinating the 65+ group with quadrivalent vaccine.
Please be mindful of the guidance, for your own protection. The relevant section of the PSNC Guidance Flu 201819– please read it carefully.
You may also be aware that there is the option to provide domiciliary vaccination this season. If this is something you intend to do, please make sure you have read the National Flu Service Specification carefully, and comply with all the conditions – in particular, a DBS certificate will be required!
Jeff Forster
Regional LPCs
17th Sept 2018
PSNC Briefing 050/18: Flu Vaccination Service 2018/19: Adjuvanted trivalent inactivated influenza vaccine (aTIV)
17th Sept 2018
Fluad Survey
NHSE are worried about areas where there may be no Fluad available – there is some evidence that there are GP practices not getting any, so they would like to know if pharmacies have theirs sorted. Would very much appreciate you completing this survey if possible – no need for the multiples, the assumption is that they are taken care of.
https://www.surveymonkey.co.uk/r/L6GYLDM
Flu Vouchers
11th Sept 2018
6th Sept 2018
Flu staff training
NHS England have produced a powerpoint to help train your staff for any 2018/19 Flu season
4th Sept 2018
Increasing Flu Vaccination Uptake
NICE and PHE have published new guidance on how to increase uptake of NHS flu vaccinations by identifying and encouraging those who are eligible: Flu 2018/19
4th Sept 2018
• View the Video Guide
• View the Enrolment Guide
• View the Service Guide
3rd Sept 2018
It is therefore important to discard any previously printed versions of the Flu Vaccination record and consent forms from previous years and ensure that the new forms are used.
Patient consent form
Patient Consent Form (to which a pharmacy address can be added) (Word)
Patient Consent Form (PDF)
Contractors must use the consent form as detailed in the service specification or an alternative form which uses the same wording and captures the same information as the form set out in the service specification. The consent covers the administration of the vaccine. The form also notifies the patient of the information flows that may take place as necessary for the appropriate recording in the patient’s GP practice record and for the purpose of post payment verification.
If a community pharmacy contractor has access to an IT system which allows capture of the data elements within the Patient Consent Form, this can be used to maintain the clinical record for the service, but a printed version of the form will need to be produced from the system to allow the patient’s consent to be recorded in writing.
Relevant information from the Patient Consent Form may, on request, be shared with NHS England and the NHS BSA for the purpose of post payment verification.
Patient Record Form 2018/19 (Word)
Patient Record Form 2018/19 (PDF)
Contractors must maintain appropriate records to ensure effective ongoing service delivery. The minimum requirements for the information which should be included in a contractor’s record of provision of the service to a patient are the mandatory sections indicated within the Patient Record Form which is set out in Annex F of the service specification. Contractors can use this form to maintain their record of service delivery or the information can be recorded on an alternative form or in another way, such as an electronic system.IT support for the service
It has not been possible for NHS England to put in place a national IT solution to support provision of the service and electronic notification of GP practices of vaccination of their patients. However in many areas LPCs and local NHS England teams have been able to arrange IT support for the service. Contact your LPC to find out whether that is the case in your area.
Where IT support is not available, contractors will instead be able to use a paper-based record keeping system.Frequently asked questions
2nd Sept 2018
IT platform launched for Flu Vaccination Service patient questionnaire responses
NHS England has launched an IT platform to enable patient questionnaires from the Flu Vaccination Service to be completed electronically either by the patient themselves or with help from the pharmacy team.
- completing the questionnaire online – a tablet device could be used in the pharmacy (if available) and the patient could input their responses;
- using a QR code to access the questionnaire if the patient has a smart phone with a QR code reader App installed on it;
- providing the patient with a compliments slip detailing the website address and QR code for them to complete the questionnaire online at a convenient time; and
- a downloadable copy of the patient questionnaire which the patient can complete in the pharmacy.
Contractors can also view, for their own pharmacy, a high-level summary of patient responses on the IT platform. Contractors are encouraged to monitor this throughout the flu season to see how patients are responding to questions about the service being provided. It may also be beneficial to view this after the service has finished on 31st March 2019, so contractors have a high-level summary, for their pharmacy, of patient responses for the Flu Vaccination Service 2018/19.
When patient questionnaires are completed on paper, community pharmacy contractors should utilise the functionality available on the IT platform to submit patients’ responses to the questionnaire so that these responses can be collated and analysed along with those submitted electronically.
Contractors are reminded that it is a requirement of the service to ask all patients who have a flu vaccination to complete the patient questionnaire.
A guidance document on how to use to complete the process is available on the IT platform.
28th August 2018
Please find attached Vaccine_Update_Flu_Special_August_2018_ which includes
CONTENTS
Which flu vaccine to give?
NICE Guidelines: “Flu vaccination: increasing uptake”
Green Book revised chapter on flu
All influenza vaccines available in the UK for 2018/19 season
Patient Group Direction (PGD) Available to download
Flu immunisation consent form
Uptake Summary Tool – we are only as good as our data!
Annual Flu Marketing Campaign Stay well this winter- Remember to order posters and leaflets
20th August 2018
Flu Service 2018/19 – Fee Uplift and Improvements
PSNC have just announced that there is to be an uplift for this years flu service along with some improvements to the service. Please see the full announcement below.
PSNC has worked with NHS England to agree some key improvements to the community pharmacy Flu Vaccination Service for 2018/19, including an uplift to fees.
The changes include:
•The fee for the service will increase to £7.98 per administered dose plus an additional fee of £1.50 per vaccination, making the total payment £9.48.
•Contractors can now administer vaccinations in patients’ homes.
•Pharmacists need only undertake face-to-face training for the service every three years (this is an extension from the previous requirement for training every two years).
•The requirement for contractors to register to offer the service with NHS BSA has been removed.
•Payment claims from pharmacies can now be made electronically.
The changes are contained within the service specification and the Patient Group Direction, which have been published today. Further details of the changes are available in PSNCBriefing 041/18 – Changes to the Seasonal Influenza Vaccination Advanced Service 2018/19.
The service is due to commence on 1st September 2018, subject to amendments to the Secretary of State Directions being made by the Department of Health and Social Care. PSNC will notify contractors when the amendments have been made and the date they can commence provision of the service.
PSNC guidance and webinar
Following publication of the service specification and PGD, PSNC has published detailed guidance on the service and has rescheduled the postponed flu webinar.
Click here to register for the rescheduled flu webinar on Tuesday 21st August at 7pm
Please note, if you registered for the webinar which was postponed on 15th August, you should receive an email confirming the new date and time and your registration will still be valid, you shouldn’t need to sign up again
Further information, resources and FAQ’s are available on the PSNC website
Face to Face Flu Training
All Cumbria Face to Face flu training is now complete.
Refresher Flu Training – Online
The NPA are offering refresher training for those pharmacists who do not need live face to face training this year. This is being offered at a reduced rate of £23 plus VAT.
2018 – Online Update / Refresher Training and Private PGD – NPA
The NPA can supply you with online only refresher training which will also give you access to a private PGD to use. For further information about the private flu PGD service and the online refresher vaccination training programme, costs and/or how to book please click here for NPA link
If asked indicate your Pharmacy Name then add Cumbria LPC to ensure you the reduced rate. For example TEST Pharmacy – Cumbria LPC.
NB: You do not have to use the NPA for online only training a list of providers should you want to source an alternative online can be found below
There are a number of organisations that provide vaccination training for pharmacists and those that PSNC has been made aware of are listed below for information (listing on this website does not constitute endorsement of the course or provider by PSNC):
AAH Pharmaceuticals
Alliance Healthcare
Avicenna
Buttercups Training Ltd
Cambrian Alliance
Clockwork private health centre
ECG Training
Global Health Medical
National Pharmacy Association
Numark
PharmaDoctor
RxAdvisor
Sonar Informatics
Voyager Medical
If you have any queries regarding training please email – info@communitypharmacycumbria.org
New Vaccination Services Declaration of Competence launched
The Community Pharmacy Competence Group (CPCG) has published a new combined Vaccination Services Declaration of Competence (DoC) which is hosted on the Centre for Pharmacy Postgraduate Education website.
Previously, there were two separate DoC frameworks for vaccination services; the NHS Seasonal Influenza Vaccination Advanced Service and other locally commissioned Immunisation services; these two have been merged into a single DoC.
Pharmacy professionals who will be providing the NHS Seasonal Flu Vaccination Advanced Service and a locally commissioned influenza service will now only be required to complete one DoC.
The 2018 National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners include the requirement for supervised clinical practice following training and this has been highlighted in the new DoC and statement of declaration. PSNC has published Frequently Asked Questions (FAQs) which explain this requirement in more detail.
FAQs on the new DoC
Q. I have already completed a DoC for the NHS Seasonal Influenza Vaccination Advanced Service 2017/18. Do I need to complete it again?
The CPCG recommends that pharmacists revisit their DoCs every two years, so if you last completed the flu vaccination DoC in 2017/18, you would not need to complete the new vaccination DoC until the 2019/20 flu vaccination season.
As the new DoC covers all vaccinations, the competency framework should be revisited, and the statement of declaration re-signed whenever a pharmacist starts to offer a service with different vaccines to those that they have previously administered..
Q. How soon can I complete the DoC for the NHS Seasonal Influenza Vaccination Advanced Service 2018/19?
Pharmacists that need to complete a DoC for the 2018/19 flu vaccination season can now start to work through the DoC framework and complete any learning, training and assessment to fill any gaps identified. However, the service documents such as the service specification and Patient Group Direction (PGD) for this service are not available until later in the summer. You will need to read, understand and sign these documents before you sign your statement of declaration for this service.
Q. How can I find out more?
For more information and to access all DoCs, visit the CPPE website.