Screening and Immunisation Team -
Commissioning and Performance
Management
Nisha Sharma
Manager - Screening & Immunisation Thames Valley Area Team
Learning objectives
• Describe the team structure and roles
• Describe how immunisation services are broadly
commissioned and performance managed
• Apply best practice for documentation of
immunisation records
• Describe legislation pertaining to documentation and
why accurate recording is essential
Head of Public Health Commissioning Jonathan Smith Paula Jackson Adult Programmes & Seasonal flu
Christine Cook
Adult Programmes & Seasonal flu
Amber Codd 0.8 wte Berkshire West 55 practices Cervical and Breast screening Seasonal flu and adult immunisation Harpal Aujla 1 wte Berkshire East 51 practices
AAA and DES Bowel Cancer screening Seasonal flu Nisha Jayatilleke Childhood Immunisations & ANNB Programmes Nisha Sharma Childhood Immunisations & ANNB Programmes Catryn Dixon 1 wte Bucks 56 practices ANNB screening Targeted imms (BCG and Hep B) Maternal pertussis Heather Duignan 1 wte Oxon 81 practices Childhood Immunisation * and School based immunisation Amy Peterson 08 wte maternity cover TBC TBC (?School based and adolescent and young people Public Health Programme Contracts Manager Bhavna Mistry Public Health Programme Manager Christine Matthews Public Health Commissioning Manager Cath Carter Public Health Administrator Joanna Wierzbicka
THAMES VALLEY AREA TEAM
Thames Valley
PUBLIC HEALTH SCREENING AND IMMUNISATION
Screening and Immunisation Co-ordinators Responsible for developing relationships and working with practices, CCGs , community providers in their geographic locality.
Core functions for all co-ordinators include: - Maintaining performance dashboard for lead area. - Immunisation programmes; universal 0-5 year old programmes and seasonal flu in locality.
- Supporting work at a local level to reduce local variations in uptake of immunisation and screening. - Practice/locality related issues for other
programmes.
LEAD AREAS; each co-ordinator will also support the strategic and developmental work for specific
programmes. *Including CHIS and training
Screening and Immunisation Managers Screening and Immunisation Leads
Pre 2010
Pre 2010 Providers and commissioners
lived happily together… Buckinghamshire PCT Oxfordshire PCT West Berkshire PCT East Berkshire PCT Community Trusts (three) NHS England Thames Valley Area Team CCGs (nine)
The Commissioners Tale Post 2013 Local Authorities (LAs) (nine) Health and Wellbeing Boards GP’s (240) Acute Trusts (four)
Priorities for the next two years
• Increased coverage and uptake of Screening and Immunisation programmes to reduce the gap in health inequalities
• Responding to national developments/changes in
Immunisation Schedule (adolescent dose of Men C, Pertussis, Shingles etc.)
• Responding to national developments/changes to Screening programmes (Bowel scope screening, surveillance of high risk women for breast cancer screening, New Born Physical Examination NIPE screening)
Performance Management
- To ensure that eligible cohorts have
access to effective and safe Immunisation
and Screening programmes
- To use service data effectively to
improve uptake and reduce local variation
and health inequalities
DATA
Detail
Accuracy
Timing
What is effective documentation??
• Vaccine name, product name, batch number & expiry date • Dose administered
• Site used, and clear description of where they were given i.e. upper/lower if 2 in same limb
• Date
• Name & signature of vaccinator
Information recorded in:
• Patient held record or Red Book (PCHR) • GP / Clinic system
• Child Health Information System • Unscheduled forms, if appropriate
Detail: Changes to Men C schedule
Example:
Liam, a 4 month old, was previously immunised with Meningitec at 3 months before the Men C schedule changed.
What should the practice nurse being looking for in his imms history when he
presents for his 4 month primaries?
Accuracy: MMR coverage
Example:
Uptake data from the surgery at 234 High Street in Cowley suggests a relatively high proportion of 10-16 year olds who have not had any MMR vaccination. The practice manager questions the accuracy of these data and doesn’t want undue pressure from the CCG.
What steps can be done to ensure a well-defined cohort? Who might be involved from the community?
Timing: Transfer of patients
Example:
Mary, a 32 year old pregnant woman (24 weeks), completed on her family’s first house purchase last week. She is on top of things and informs her old practice that she is moving
and registers with the new practice shortly after unpacking the last boxes.
Applicability: COVER data
Immunisation
Children completed DTaP, IPV, HiB age 1 year
Children completed PCV age 2 years Children completed Hib/Men C age 2 years Children completed MMR age 2 years Children completed DTaP/IPV age 5 years Children completed 2 doses MMR age 5 years
Example:
Quarterly COVER data reflect activity for primary immunisation uptake. The
national target is 95% as this coverage confers herd immunity for the
population.
What will affect the numerator and denominator?
How well do the data reflect performance?
Data Recording GP System Child Health Information System(CHIS) Immform Clinical Commissioning Group Local Authority Health & Wellbeing Board POLICY IMMUNISATION Public Health England & NHS England
It’s the LAW!
There are many different standards and legal rules that apply to information handling, including:
The Data Protection Act 1998.
The common law duty of confidence.
The Confidentiality NHS Code of Practice. The NHS Care Record Guarantee for England. The Social Care Record Guarantee for England.
The international information security standard: ISO/IEC 27002: 2005.
The Information Security NHS Code of Practice. The Records Management NHS Code of Practice. The Freedom of Information Act 2000.
• Department of Health’s Information Governance
