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
THAMES VALLEY AREA TEAM Thames Valley SCREENING AND IMMUNISATION Head of Public Health Commissioning Jonathan Smith PUBLIC HEALTH Screening and Immunisation Leads Paula Jackson Adult Programmes & Seasonal flu Nisha Jayatilleke Childhood Immunisations & ANNB Programmes Public Health Commissioning Manager Cath Carter Public Health Administrator Joanna Wierzbicka Screening and Immunisation Managers Christine Cook Adult Programmes & Seasonal flu Nisha Sharma Childhood Immunisations & ANNB Programmes Public Health Programme Contracts Manager Bhavna Mistry Public Health Programme Manager Christine Matthews Screening and Immunisation Co-ordinators Responsible for developing relationships and working with practices, CCGs, community providers in their geographic locality. Amber Codd 0.8 wte Berkshire West 55 practices Harpal Aujla 1 wte Berkshire East 51 practices Catryn Dixon 1 wte Bucks 56 practices Heather Duignan 1 wte Oxon 81 practices Amy Peterson 08 wte maternity cover TBC 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 Cervical and Breast screening Seasonal flu and adult immunisation AAA and DES Bowel Cancer screening Seasonal flu ANNB screening Targeted imms (BCG and Hep B) Maternal pertussis Childhood Immunisation * and School based immunisation TBC (?School based and adolescent and young people
The commissioning cycle
Pre 2010 The Commissioners Tale Post 2013 Pre 2010 Providers and commissioners lived happily together Buckinghamshire PCT Oxfordshire PCT West Berkshire PCT East Berkshire PCT CCGs (nine) GP s (240) Community Trusts (three) Local Authorities (LAs) (nine) Health and Wellbeing Boards NHS England Thames Valley Area Team 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) Planning flu season 2014/15 and extended cohorts
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 Applicability
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. What vaccination(s) should be considered?
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?
IMMUNISATION Data Recording GP System Child Health Information System(CHIS) Immform Clinical Commissioning Group Public Health England & NHS England Health & Wellbeing Board Local Authority POLICY
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 toolkit
Final thoughts The power of good data can: Provide sound information on coverage and uptake Expand knowledge base by generating best practice to steer actions Measure service provision to ensure safe and accessible services Improve patient care and public health