This enhanced service requires practices to offer the vaccination to pregnant women. It does not require a call and recall system.
Based on recent birth rate estimates, a 5,000-patient practice can expect 60 deliveries per annum so complete coverage could provide around £600 in income per year.
Key points
- It is important to reassure women that the vaccine is safe during pregnancy and protects the baby.
- Set up a system for coding or tagging patient notes as soon as women inform the practice that they are pregnant.
- Pregnant women are also eligible for seasonal flu vaccination, so use the annual flu clinics as an opportunity to pick up any who may have missed the pertussis jab.
Since this programme was introduced in 2012, there has been a steady fall in neonatal deaths in babies infected with pertussis (whooping cough). However, there have still been 16 deaths recorded since 2014. The vaccine reduces the risk of infection by 90%.
It is important to emphasise to mothers that the vaccine is safe for women to receive during the pregnancy and offers protection not to the mother, but to the baby. The vaccine should be given between 16 and 32 weeks of pregnancy, but can be as late as 38 weeks.
The service specification states that GP practice requirements are:
- Offer and (where accepted) provide pertussis vaccination to all eligible patients registered at the GP practice; unless contra-indicated.
- Eligible patients are those who: i) are registered patients, ii) pregnant women who reach, or were already at, the 16th week of their pregnancy at the time of vaccination.
- The contractor is required to offer vaccination between 16 and 32 weeks of pregnancy, ideally between 20 and 32 weeks. The optimal time is from 16 weeks pregnancy, or soon after, to maximise transplacental transfer of antibodies to the unborn child. Pregnant women who miss vaccination and are beyond week 32 of pregnancy should be offered immunisation.
- Immunisation is contra-indicated where the patient has previously had a confirmed anaphylactic reaction to a previous dose of the vaccine, or to any component of the vaccine.
- Vaccination must be delivered during the period of this enhanced service, namely between 1 April 2020 and 31 March 2021.
What it is worth to practices
The item of service fee for this is £10.06 per dose administered, as detailed in the NHS England service specification. The vaccine can be ordered through ImmForm at no cost to the practice.
How to claim and ensure payment
Practices must be signed up as ‘delivering the service’ or ‘accepting a quality service’ on CQRS (Calculating Quality Reporting System) in order for payments to be made. Data are extracted via GPES (the General Practice Extraction Service) run by NHS Digital.
Payment is made using data extracted by GPES and requires the correct Read code to be entered. Errors can be reduced if everyone in the practice uses the same code, eg ‘Pertussis Vaccination in Pregnancy’ which is 6572. (NB The full stop is part of the code).
Payments will be made monthly. Check the Open Exeter statement every month to ensure all the claims made correspond with monies received and make sure that any errors are chased up swiftly. Any problems should be addressed initially with the commissioner (the CCG if delegated co-commissioning, or NHS England otherwise), and CQRS and GPES errors can also be pursued via NHS Digital.
How to maximise coverage
- Set up a system for coding or tagging patients’ notes as soon as women inform the practice that they are pregnant.
- Give information leaflets when patients book appointments and let them know when they are due the vaccine.
- Have a system for cross-referencing all antenatal communications to ensure no woman is missed.
- Liaise with the community midwifery team and encourage them to refer patients for vaccination.
- Run a monthly search of ‘patient pregnant’ and check if the vaccination is booked or has already been given.
- Pregnant women are also eligible for seasonal flu vaccination, so you can use the annual flu clinics as an opportunity to kill two birds with one stone.
- Make a women reaching 38 weeks without being vaccinated or coded as formally refusing the pertussis immunisation a ‘never event’ and consider any who slip through the net as significant events to discuss at clinical meetings.
- Include the information on the practice website under ‘services we offer’.
- Remind patients in the practice newsletter.
Dr John Allingham is medical secretary at Kent LMC
