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You are here: Home / Resources / SystmOne Resource Centre / Vaccination Overview / Pneumococcal Vaccination

Pneumococcal Vaccination

The CDRC Pneumococcal vaccination system is designed to help maximise uptake of pneumococcal vaccination whilst minimising the burden on general practice. 

To use the system: 

  1. Ensure that you have completed the Set-up steps 
  2. Ensure that you have read and understood the Patient Identification mechanism and considered excluding any patients that should not be vaccinated/including any patients that should be vaccinated 
  3. Consider adding PSDs to eligible patients’ records  
  4. Arrange Patient Invitation Patient Invitation 

Additional Information

  1. Instructions for clinician administering the vaccine
  2. Report and Audit Support and Information
Set-up
  1. Ensure that the immunisation patient status alerts (icons) are enabled 
Machine generated alternative text:
Setup Links Clinical Tools 
Users 8 Policy 
Prescribing 
Vaccinations 
Appointments 
Data Entry 
Data Output 
Reference 
Referrals 8 Letters 
Workflow 
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System Help 
Mobile Working 8 Integration 
Mews Protocols Status 
Refresh 
Form Maintenance 
Document Library 
Patient Status Alerts 
OOF Alen Actions
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Imms - Influenza Vaccination - nasal 
Imms - Influenza Vaccination - standard 
Imms 
Men ACV" recommended 
Imms - Pneumovax recommended 
Imms 
Varicella Zoster Vaccination Recommended 
NHS Health Check (Any level of risk 40-75y) 
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Patient Status Marker 
Patient Status Marker 
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Patient Status Marker 
Patient Status Marker 
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  1. It is worth considering setting S1 to carry over vaccine batch numbers. The screenshots below show how to do this:
  1. To make full use of the CDRC pneumococcal vaccination system you will need to add two vaccination templates to your system. This cannot be done centrally. 

Go to the vaccination template then click New Template and complete the template as shown below. 

Machine generated alternative text:
Setup 
Links Clinical Tools 
Users 8 Policy 
Prescribing 
Vaccinations 
Appointments 
Data Entry 
Data Output 
Workflow 
user 
System Help 
Available Vaccinations 
Vaccination Batch Numbers 
Vaccination Templates
Machine generated alternative text:
Add Vaccination 
Template name Pneumovax 23 
Vaccination 
Contains 
Dose 
Reason 
Travel area 
Nature of risk 
Method 
Notes 
GMS status 
Claiming GP 
Pneumovax 23 
PNEUMOCOCCAL 
05mI 
Routine Measure 
Not Applicable 
Unspecified 
Intramuscularly 
PNEU 
@ Practice GMS C) other GMS O 
Not Under GMS 
O Make IOS Claim 
@ Registered GP O 
specific GP 
Cancel 
Generics 
Obsolete

All practices will need the following templates : 

  • Template name: Pneumovax 23 
  • Vaccine: Pneumovax 23 
  • Method: Intramuscularly 
  • GMS Status: Practice GMS 
  • Template name: Pneumococcal Polysaccharide MSD 
  • Vaccine: Pneumococcal Polysaccharide Vaccine (MSD) 
  • Method: Intramuscularly 
  • GMS Status: Practice GMS 
Patient Identification 

The CDRC Pneumococcal System identifies patients who might be eligible for  vaccination based on the Enhanced Service specification, Green Book and the PCC business rules.  These rules are complicated and sometimes not aligned. 

CDRC will identify patients who may be eligible for vaccination but it is up to the individual clinician to confirm that they should receive it. 

If patients are not identified by the CDRC system you can flag them for vaccination by adding the Requires a pneumococcal vaccination (XaM2n) code.  Please note – they must fall into one of the categories from the enhanced service. 

The following reports will identify patients who are likely to be eligible for pneumococcal vaccination but who are not detected by the ES business rules. If you do not wish these patients to be identified and flagged for vaccination please add the code Pneumococcal vaccination not indicated (XaKFY) 

You can add the code Requires a pneumococcal vaccination (XaM2n) to the record to add the patient to the ‘business rules list’.  You can do this systematically at any time or the pneumococcal vaccination protocol will prompt you to do this as you vaccinate patients. 

Patient identification: Chronic Hean Disease but no business rules code 
Patient identification: Chronic Liver Disease but no business rules code 
Patient identification: Chronic Respiratory Disease but no business rules code 
Patient identification: Suspected Cochlear Implant but no business rules code 
Patient identification: Suspected Immunosuppression but no business rules code 
68 
000%

Identifying Why A Patient Is Eligible 

To identify why a patient has been flagged for vaccination, right click on the pink square icon and select Why is this Alert on this Patient?  You can then expand the report 

Machine generated alternative text:
Action 
Vvhy is this Alen on this Patient? 
Re-evaulate Alerts for Patient

This information is also shown, in a less detailed format, on the Pneumococcal Vaccine template. 

Home More details Resources PSO 
Pneumococcal Vaccine 
Pneumococcal vacc verbal invite 
A Pneumococcal Vaccination Refusal 
Pulse Regular 
Pulse Irregular 
Pneumococcal 
Vaccination 
A Pneumococcal Vaccination Elsewhere 
Eligibilitf 
Pneumococcal Exceptions Persisting 
Pneumococcal Exceptions Expiring 
All vaccinations in the past 10 years 
03 Dec 200g 
03 Dec 200g 
12 Oct 20150 
12 Oct 20150 
12 Oct 20161 
Td/IPV 1 
DIPHTHERIA, poc 
12 Nov 2014 
10 Oct 2016 
2g Nov 2017 
2 Oct 2018 
Pneumococcal vaccination declined Xaly•y) 
Pneumococcal vaccination declined [Xalyy) 
Pneumococcal vaccination declined [Xaly-y) 
Pneumococcal vaccination declined xaly-y) 
Typhoid 
Revaxis 1 
DIPHTHERIA, poc 
TyphimVl Sin TYPHOID 
Avaxim BoosterHEPATITIS A 
Pneumovax PSD Information 
06 Apr 201 g 
Notes 
25 Apr 201g 
Pneumococcal vaccination administration [XaKFd) 
This patient is eligible for 0 5ml pneumococcal vaccination intramuscularly into the deltoid 
muscle until 6/4/20 Dr Gareth Forbes 
O/E- pulse rhythm regular (2431) 
Appears eligible for pneumococcalvaccination under ES rules 
Heart Disease
Risk Factor (correct as of Sept 2019) ES Business rules Green Book CDRC
Asthmatics continuous or frequently repeated systemic steroids  ✓ X (✓) ✓ 
Other Chronic respiratory disease ✓ ✓ ✓ ✓ 
Heart disease ✓ ✓ (partial)2 ✓ ✓ 
CKD 4-5 ✓ ✓ ✓ ✓ 
Chronic liver disease ✓ ✓ (partial)3 ✓ ✓ 
Diabetes on treatment ✓ ✓ ✓ ✓ 
Immunosuppression1 ✓ ✓ (partial)4 ✓ ✓ 
Cochlear implants ✓ ✓ ✓ ✓ 
CSF Leaks or Shunts ✓ ✓ ✓ ✓ 
Certain occupations X X ✓ X 
  • 1Patients immunosuppressed due to long term corticosteroids will not be identified automatically by CDRC as it is not possible to search for steroid doses.  The enhanced service recommends that only patients on 20mg prednisolone or equivalent for more than 1 month should receive influenza vaccination. 
  • 2 The 2018/19 specification seems to miss many heart disease codes such as heart failure and ASD 
  • 3 The 2018/19 specification seems to miss many liver disease codes such as NAFLD, NASH 
  • 4 The 2018/19 specification misses patients who have repeats of relevant drugs that are being issued in secondary care such as transplant immunosuppression.  It also discounts any ‘patient immunosuppressed’ codes (and some others) that are older than 1 year old. 
PSD 

The CDRC system allows you to add a PSD to individual records. This PSD message will then be displayed on the relevant vaccination template. Only PSDs recorded within the last 12 months will be displayed as PSDs must be time limited. 

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o avoid tnls: cancel and press 
Home More details Resources P 
Vaccinations in the past 10 years 
All vaccinations in the past 10 years 
Pneumococcal Exceptions 
Pneumococcal Exceptions Persisting 
Pneumococcal Exceptions Expiring 
16 Sep 2015 Pneumococcal vaccination declined (Xaly-y) 
Pneumovax PSD Information 
23 Sep 2016 Pneumococcal vaccination administration (XaKFd) 
More pneumococcal details 
Notes 
This patient is eligible for a 0 5ml pneumococcal polysaccharide 
vaccination intramuscularly into the deltoid muscle until 23 417 Dr G 
Forbes 
Launch Pneumococcal Vaccination Refusal 
aunch Pneumococcal Vaccination 
Pneumococcal vaccination verbal invte 
Information 
Print 
Suspend 
Cancel

To add the PSDs: 

  • Navigate to the CDRC > Pneumococcal > ! PSD: Eligible for pneumococcal vaccination but no PSD>18 report 
  • Show the patients 
  • Select the patients you wish to add the PSD to. 
  • Click on the scroll icon to add a Read code 
  • Bulk add the code Pneumococcal  vacc. Administration (XaKFd) using the following text: “This patient is eligible for a 0.5ml pneumococcal vaccination intramuscularly into the deltoid muscle until [date one year hence].  [Doctor’s name]” 
  • Move to the next page of results if there are more than 250 patients and repeat 
Machine generated alternative text:
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Add Diagnosis 
Read code R 
Notes 
Date 
intramuscularly into the deltoid muscle until 23417 Dr G Forbes 
Sever ty 
Problem status 
Do not put in the summary 
Do not promote to Problem 
Informing patient of named accountable general 
Pneumococcal vaccination administration CXaKFd) 
Patient allocated named accountable general pra 
Meningitis C vaccination offered IXaaG8) 
Influenza vaccination invitation letter sent (Xa18d) 
Influenza vaccination telephone invite xaK2d) 
Influenza vaccination invitation SMS text message 
Influenza vaccination declined xa181) 
Influenza vaccædministratNOS (gOXZ) 
Other recommended vaccine U 3550)
Machine generated alternative text:
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A PSD can be added to individual patient on the PSD tab of the Pneumoccocal template.  The standard text is added as a preset 

Pn eu mococcal Vaccination 
141g q, 
x 
Other Details 
Changing the consultation date will affect all other data enterel To avoid this: cancel and press the 'Next button 
mel 
More detai 
Hide Warni 
Pneumococcal vaccination administration 
Safeguarding Children OCS 
Safeguarding Children OCS (old- ended March 2015) 
Information 
Print 
Suspend 
Cancel 
/ Safeguarding 
• DOS / Archive

To remove a PSD, right click on the PSD Information box on the page 1 of the template and choose Mark in Error.  

Keeping the Records Up to Date 

To ensure that the records are kept up to date it is possible to create a batch report that alerts the clinician at set intervals of PSDs that need to be added or removed. For details on automated reporting follow this link : 

Automated Reporting 

Amend Batch Report 
Batch name Imms P SD 
Details 
Run these reports Repon 
Remove 
On this date 
Then re-run every 
Send task 
report 
Has a PSO but not eligible for shingles vacc in 201 6/1 7 
Eligible for shingles 201 6/1 7 but no pso (OCS / Shingles 
Has a PSO but does not need flu jab (standard) (OCS / 
Needs flu jab (standard) -18 but no PSO (OCS / Flu) 
Eligible for pneumococcal vaccination but no PSO -18 
sep 2016
Patient Invitation 

The Enhanced Service for Pneumococcal vaccination requires: 

  • Opportunistic vaccination for those not ‘at risk’ i.e. those who only indication for vaccination is age 
  • Call/recall for those considered to be at risk 

The vast majority of patients who are eligible for pneumococcal vaccination will be eligible for influenza vaccination so will be subject to the same call recall system.  In addition, the majority will be called/recalled for annual LTC reviews when they could be vaccinated. 

The CDRC searches have three reports to allow variation in patient invitation strategies: 

  • All patients currently eligible for vaccination 
  • Only patients with an at risk condition 
  • Only patients with an at-risk condition who don’t have a condition that makes them eligible for influenza vaccination 

This latter category will include conditions such as VP shunts, CSF leaks and cochlear implants 

CORS: PNEU03 Requires Pneumococcal vaccination but no risk code Claimable (2-64y) 
Patient Invitation: Eligible for pneumococcal vaccination (all patients) 
Patient Invitation: Eligible for pneumococcal vaccination (at risk patients only) 
Patient Invitation: Eligible for pneumococcal vaccination (at risk patients only) BUT not eligible for flu vaccination 
PSD: Eligible for pneumococcal vaccination but no PSO -18 
Quality: Pneumococcal vaccination this season but no Read code
Vaccine Administration

To administer the vaccine click on the pink square icon at the top of the screen. The pneumococcal vaccine template will open and lead you through the process adding the correct Read codes. 

For patients without the icon, you can launch the Pneumococcal Vaccine template by searching for using the search bar in the lower left-hand corner of the main screen. 

Home More details Resources PSO 
Pneumococcal Vaccine 
Pneumococcal vacc verbal invite 
A Pneumococcal Vaccination Refusal 
Pulse Regular 
Pulse Irregular 
Pneumococcal 
Vaccination 
A Pneumococcal Vaccination Elsewhere 
Eligibilitf 
Pneumococcal Exceptions Persisting 
Pneumococcal Exceptions Expiring 
All vaccinations in the past 10 years 
03 Dec 200g 
03 Dec 200g 
12 Oct 20150 
12 Oct 20150 
12 Oct 20161 
Td/IPV 1 
DIPHTHERIA, poc 
12 Nov 2014 
10 Oct 2016 
2g Nov 2017 
2 Oct 2018 
Pneumococcal vaccination declined Xaly•y) 
Pneumococcal vaccination declined [Xalyy) 
Pneumococcal vaccination declined [Xaly-y) 
Pneumococcal vaccination declined xaly-y) 
Typhoid 
Revaxis 1 
DIPHTHERIA, poc 
TyphimVl Sin TYPHOID 
Avaxim BoosterHEPATITIS A 
Pneumovax PSD Information 
06 Apr 201 g 
Notes 
25 Apr 201g 
Pneumococcal vaccination administration [XaKFd) 
This patient is eligible for 0 5ml pneumococcal vaccination intramuscularly into the deltoid 
muscle until 6/4/20 Dr Gareth Forbes 
O/E- pulse rhythm regular (2431) 
Appears eligible for pneumococcalvaccination under ES rules 
Heart Disease

Click on the Launch Pneumococcal Vaccination button to record the vaccination and then complete the vaccination template with batch number, site and which parent consented for children. 

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Safeguards 

If the patient is not eligible for vaccination under the business rules you will be prompted to consider if the patient needs the vaccination and to add the Requires a Pneumococcal Vaccination code.  The latter will ensure that payment is made. 

Qu estion 
This patient does not appear to be eligible for vaccination according to the Read codes in their recorl Ifyou think this person is 
eligible you can add the code 'Requires a Pneumococcal Vaccination' and the vaccination will be eligible for payment You may 
need to justify this decision to the area teanm 
Add Requires a pneumococca! Vaccination Code 
Uaccinate wthout adding code 
End Protocol 
Pause

If you choose to add the Requires a pneumococcal vaccination code, you will be prompted for a reason to ensure that any future audits can be dealt with easily. 

Other Details 
Exact date & time 
Fri 23 sep 2016 
1454 q 
x 
Changing the consultation date will affect all other data enterel To avoid this: cancel and press t' 
Please record reason for pneumococcal 
vaccination 
Requires a pneumococcal vaccination
Report and Audit 

Internal Audit 

There are two quality control reports in the CDRC > Flu folder. 

Patient Invitation: Eligible for pneumococcal vaccination (at risk patients only) 
Patient Invitation: Eligible for pneumococcal vaccination (at risk patients only) BUT not eligible for flu vaccination 
PSD: Eligible for pneumococcal vaccination but no PSO -18 
Quality: Pneumococcal vaccination this season but no Read code 
Quality: Pneumococcal vaccination this season but not in business rules 
Vaccine Ordering: Eligible for pneumococcal vaccination 
Fad pneumococcal pan 3/MenCH18 (children) and claimable 
# At risk patients for pneumococcal vaccination (business and non-business rules) 201 6) 
# At risk patients for pneumococcal vaccination (business rules) 201 6) 
# Potentially eligible for pneumococcal vaccination (business and non-business rules)

The first identifies patients who have been vaccinated but have not had the appropriate Read code.  You should add the code Pneumococcal vaccination given (XaCKa) if the vaccination was done at your unit. 

The second identifies patients who have been vaccinated but do not appear to be eligible under the terms of the Enhanced Service.  You should check this list so that you can either: 

  • Add the code Requires a Pneumococcal Vaccination  if appropriate OR 
  • Provide feedback to the clinician who performed the vaccination  

It is sensible to run these reports before the end of any reporting period.  Ideally run these reports in an automatic batch report. 

CQRS Reporting 

In the event that GPES is not working the performance reports can be found in the CDRC > Flu folder. 

These reports must be broken down to get the appropriate figures for your practice. This only needs to be done once. 

PNEUOI Claimable over 65s 
PNEL102 Claimable (2-64} with at risk condition) excluding 5 year vaccines 
PNEU02a Claimable (2-64} with at risk condition) 5 year vaccines - will need to be manually added 
PNEL103 Requires Pneumococcal vaccination code but no at risk code (2-64y) 
343 
243 
17

To breakdown the reports: 

  • Right click on the report and choose breakdown 
  • Tick the boxes as shown below and then click Refresh 

To Breakdown ! CQRS: PNEU01 Claimable (over 65s) 

Payment Pneumococcal vaccination Read code (65+ - earliest) not other provider (OCS Vaccinations Pneumoc• 
Patient Count 
Coded Entries 
Current Referrals In 
Demographics 
Event Details (3) 
[3 Event authorised by 
Event consutation method 
Event date 
Event day 
Z] Event done at 
Event done at ID 
Event done by 
Event done by (textual) 
[3 Event entered date 
Event entered time 
Event hour 
Event linked referral ID 
Event location type 
Z] Event month 
Event recorded by 
Event staff type 
Event time 
Event year 
Financial Quarter

To breakdown ! CQRS: PNEU02 Claimable (2-64y with at risk condition) excluding 5 year vaccines 

Payment Pneumococcal vaccination Read code (age over 2 - earliest) not other provider (OCS Vaccinations Pn 
Patient Count 
Coded Entries 
Current Referrals In 
Demographics 
Event Details (3) 
[3 Event authorised by 
[3 Event consutation method 
Event date 
Event day 
Z] Event done at 
Event done at ID 
Event done by 
[3 Event done by (textual) 
Event entered date 
[3 Event entered time 
Event hour 
[3 Event linked referral ID 
Event location type 
Z] Event month 
Event recorded by 
Event staff type 
Event team 
Event time 
Z] Event year

To breakdown ! CQRS: PNEU02a Claimable (2-64y with at risk condition) 5 year vaccines – will need to be manually added 

(these show five year boosters for patients with CKD4/5 and splenic problems and CQRS must be manually adjusted for these vaccines as they are not automatically extracted) 

Payment Pneumococcal vaccination Read code (age over 2 - latest) not other provider (DCS Vaccinations Pnel 
Patient Count 
Coded Entries 
Current Referrals In 
Demographics 
Event Details (3) 
[3 Event authorised by 
Event consutation method 
Event date 
Event day 
Event done at 
Event done at ID 
Event done by 
Event done by (textual) 
[3 Event entered date 
Event entered time 
Event hour 
Event linked referral ID 
[3 Event location type 
Z] Event month 
Event recorded by 
Event staff type 
Event team 
Event time 
Event year

To breakdown ! CQRS: PNEU03 Requires Pneumococcal vaccination code but no at risk code (2-64y) 

Payment Pneumococcal vaccination Read code (age over 2 - earliest) not other provider (DCS Vaccinations Pn 
Patient Count 
Coded Entries 
Current Referrals In 
Demographics 
Event Details (3) 
Event authorised by 
[3 Event consutation method 
Event date 
Event day 
Z] Event done at 
Event done at ID 
Event done by 
Event done by (textual) 
Event entered date 
Event entered time 
Event hour 
Event linked referral ID 
Event location type 
Event month 
Event recorded by 
Event staff type 
Event team 
Event time 
Z] Event year

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