Maximising income from infant pneumococcal vaccinations

The potential target cohort for this service will depend on the age and demographics for your practice, but based on recent birth estimates, a typical 5,000-patient practice with 60 births per annum could expect full coverage to generate annual income of around £900.

Key points

• Vaccination involves two pneumococcal doses given at the same time as other routine infant immunisations
• Payment is dependent on also giving the Hib/Men C vaccination alongside the second dose
• Practices must be signed up as delivering or ‘accepting a quality service’ on CQRS (Calculating Quality Reporting System).
• Practices need to manually enter data into CQRS quarterly, based on searches of their clinical system.
• These should be promoted alongside the other infant vaccinations

The infant pneumococcal vaccinations are wrapped up with the combined Hib/Men C vaccination for the purposes of payment.

Details for the service were originally outlined in Section 13 of the SFE from 2013.¹ This involved three doses of vaccine at two and four months, alongside other routine immunisations, followed by a booster at one year and the Men C/Hib jab at the same time.

This has now been amended for 2020, so the first two doses of pneumococcal vaccine are now combined into a single dose at 12 weeks, again coinciding with other vaccines. Payment remains the same.²

When all vaccinations, including the Hib/Men C dose, are given the practice is paid £15.02. This is paid quarterly.

While the payment is not a large amount in itself, the injections can be given at the same time as other routine childhood vaccinations which attract target payments.

The first dose coincides with the six-in-one DTP, polio, Hib and Hep B and rotavirus jabs given at 12 weeks. The final vaccination can be given alongside the Hib/Men C combined injection, and the first MMR and final meningitis B dose.³

Ordering vaccine

Children should have the pneumococcal conjugate vaccine (PCV; Prevenar 13).

This is different to the polysaccharide vaccination given to vulnerable groups (patients over 65 and those over two years old who have a high risk of infection).

The vaccine is ordered centrally through the immForm portal, in common with other infant vaccinations, at no cost to the practice. They should not be claimed through the prescription system.

Tips to maximise coverage

• Take up of the offer of vaccination will be bound up with the rates for other vaccinations. As these are part of the childhood vaccination programme many of the written invitations may come from the local health authority office, so no call or re-call is required by the practice.
• Encouragement and promotion of vaccination at maternal and baby checks can help to increase the rate of vaccination. This is a very busy time for new parents so plenty of reminders will help.
• Often the first vaccinations will coincide with mother and baby health checks and this is a great way to introduce the immunisation programme.
• Parents will receive letters from the NHS about the vaccines but practices can follow this up with text messages, email reminders or telephone calls so that vaccination appointments are not missed by accident.

How to ensure payment

To be paid the practice will need to accept the service on CQRS at the start of the year. At the end of each quarter the practice should manually enter data into CQRS based on their own searches.

You can use prescription codes and search for three entries of pneumococcal and one of Hib/MenC. I find that it is easier, however, if each dose uses a separate code. The search would need to find those patients who had all three codes entered.

Don’t forget to make sure that any vaccinations that have been given at previous practices are correctly coded; you can still claim the full amount when you have completed the course.

While it may seem odd to claim when part of the course has been given by another practice, that’s what the specification currently says, and probably balances out the situation where patients have moved away from your practice before completing the course.

Dr John Allingham is medical secretary at Kent LMC

Reference

1. NHS General Medical Services Statement of Financial Entitlements Directions 2013. Section 13: Pneumococcal vaccine and Hib/Men C booster vaccine

2. NHS General Medical Services Statement of Financial Entitlements (Amendment No. 2) Directions 2020. Amendment of Annex I to the Principal Directions.

3. UK Government. The complete routine immunisation schedule. June 2020.