1. Flu Service 2014 Carol Trower Berkshire LPC Thames ValleyLPCs Better and Stronger Together

2. What will we cover tonight? Background to service commissioning Why Vaccinate? Targets for the Service Service specification Who is covered Accreditation Engaging Patients PGD Recording and Reporting Local Support What else is happening locally Thames ValleyLPCs Better and Stronger Together

3. Background to Service Commissioning Pilot in Berkshire West in 2012 and 2013 Showed Pharmacy could deliver vaccinations Public liked Pharmacy as a location Public trusted pharmacist to vaccinate GPs slowly realised that there was room in the market for both services Tested the service and the reporting structure Thames ValleyLPCs Better and Stronger Together

4. Who were we vaccinating? Thames ValleyLPCs Better and Stronger Together

5. Age range Thames ValleyLPCs Better and Stronger Together

6. Clinical Conditions Thames ValleyLPCs Better and Stronger Together

7. When were we vaccinating Thames ValleyLPCs Better and Stronger Together

8. Why were patients choosing pharmacy? Thames ValleyLPCs Better and Stronger Together

9. Why Vaccinate? To protect vulnerable individuals from flu To protect the population at large Reduce hospital admissions and pressure on healthcare services in the winter Economic issues; less time off work Flu kills! Thames ValleyLPCs Better and Stronger Together

10. Uptake targets for Flu Service Over 65s – 75% Under 65 at risk groups -60% in 2014-15 Pregnant women- 60%in 2014-15 Children Thames ValleyLPCs Better and Stronger Together

11. Seasonal Influenza Vaccination Uptake Rates in Thames Valley. CCG 65 and over (%) Under 65 at risk (%) Pregnant women (%) 2013-14 AYLESBURY VALE73.553.143.1 CHILTERN73.550.939.5 OXFORDSHIRE75.854.545.9 NEWBURY & DISTRICT75.759.443.6 N&W READING76.958.845.5 SOUTH READING73.756.138.9 WOKINGHAM74.453.544.8 BRACKNELL & ASCOT73.259.146.5 SLOUGH69.652.730.9 WINDSOR, ASCOT & MAIDENHEAD 71.451.541.6

12. Uptake in clinical risk groups 2013-14 and influenza related mortality ratios (age adjusted relative risk Sept 2010-May 2011) 12

13. Service Specification Vaccinating: – Over 18 and under 65 in “at-risk” groups – Pregnant Women – Carers in receipt of carer’s allowance Must meet training requirements Must have read, understood and signed the PGD Must be pharmacist Thames ValleyLPCs Better and Stronger Together

14. Service Specification No need to send certificates to Area Team PharmOutcomes has been set up with recording for accreditation- will cover later Each pharmacist will need to declare their competency Practical training and CPR Thames ValleyLPCs Better and Stronger Together

15. National Guidance The influenza chapter of ‘The Green Book’; Immunisation against infectious disease https://www.gov.uk/government/collections/immunisation-against- infectious-disease-the-green-book https://www.gov.uk/government/collections/immunisation-against- infectious-disease-the-green-book The annual flu letter (DH, PHE and NHS England) https://www.gov.uk/government/publications/flu-immunisation- programme-2014-to-2015 https://www.gov.uk/government/publications/flu-immunisation- programme-2014-to-2015 Thames ValleyLPCs Better and Stronger Together

16. Promoting the Service Use posters and postcards or stickers Use your PMR to identify patients Make sure the surgery knows you are vaccinating and will be happy to take their referrals If no e-mail address in the system- will the surgery provide one? If not, how would they like you to handle notifications Thames ValleyLPCs Better and Stronger Together

17. Engaging Patients Using your team to engage patients: Train your team to sell the service Encourage team to talk to patients Use stickers as badges Local activity? Thames ValleyLPCs Better and Stronger Together

18. PGD Sent out by Area Team Each pharmacist who will provide the vaccination must sign the PGD in the pharmacy If working in several pharmacies, then need to sign in each one Keep PGD in branch – do not send signed copies to Area Team PGD is the legal instrument that allows you to administer vaccine Must follow PGD Thames ValleyLPCs Better and Stronger Together

19. Recording and Reporting Use PharmOutcomes for recording Do it at the time When click save it will e-mail notification to GP if this is set up Secure e-mail- nhs.net account System deals with invoicing – you do nothing Patient consent form Record form Thames ValleyLPCs Better and Stronger Together

20. Login Login at https://pharmoutcomes.org If you have any problems logging into the system please contact the PharmOutcomes Help Desk from the Help tab

21. Accreditation Before providing the FLU service for the first time you will need to complete the Enrolment Process : Log into Pharmoutcomes Click on Services and select Seasonal Flu 2014 You will now see a screen titled “Enrolment Requirements” Click on the box and then “enrol me” On next screen – enter your name and GPhC number then answer the questions about training, PGD and SLA Thames ValleyLPCs Better and Stronger Together

22. Service data capture Access the service data capture from the services tab Once logged in click on the services tab as below System functionality runs from left to right across the top of the screen. The home page is a message inbox. You will find commissioner communications here. Click on the services tab to find data capture question sets Click the services tab to go to the service delivery screen

23. Data entry Access the service question set from the left hand side of the screen that shows your pharmacy accredited services. If the Flu service does not appear here contact your LPC Chief Officer or Area Team The main screen on the service tab show the service history. The side bar shows the list of accredited services. Click the service title to go to the data capture screen Clicking on the service title here will take the provider to the service data capture screen

24. Data capture Data capture screens have been designed to use patient facing as saving data generates GP notification and populates the audit for commissioner. It also populates the claim for the pharmacy. Service questions have been included to ensure compliance with PGD and to support the provider Enter data requested. Please note where specific format is required Side bar provides useful service information

25. Data capture You will find useful links in side information boxes to information or patient information leaflets Side boxes give useful information and useful links to support Documents. The side bar text also provides links to other material such as PGD’s and SLA’s Clicking the link here will take the provider to the EMC patient information leaflet

26. Data capture Saving data will generate GP notification (sent by secure email or by fax), populate claim for pharmacy and audit for commissioner GP notifications will be automatically sent using secure email when data is saved as long as an nhs.net address has been provided for the GP. The provider sends the notification using the in-built PharmOutcomes nhs.net account Clicking the “save” button will save data, populate claim and audit and trigger GP notification

27. GP notifications The system will send a read coded GP notification as data is saved GP notifications are read coded to enable efficient entry at the GP practice Read code hard coded on notification letter

28. GP notifications The system will send a read coded GP notification as data is saved. If no email information has been provided for a GP practice the message below will appear on the service screen. These notifications will need printing and either posting, faxing or delivering by hand. Some notifications will not be sent if no secure email is held in the system. These will need printing and sending by hand –either by fax or post within 24 hours of vaccination Clicking the link will show the provider which notifications have not been sent by secure email

29. GP notifications Clicking the link will take the provider to the provision page. Please note the message in the left hand side of the service screen. The notification can be printed by clicking the GP notification link and then the orange button “sent manually” should be clicked to acknowledge the notification has been sent Some notifications will not be sent if no secure email is held in the system. These will need printing and sending by hand Click the link to print GP notification then click the orange “Sent Manually” button to acknowledge this has been sent and cancel the alert message

30. Invoicing Claims will run on the 6 th of every month Invoice will be created and e-mailed to TVPCA Payment will be made based on: – Professional Fee of £7.64 – Vaccine cost of £6.25 plus VAT Thames ValleyLPCs Better and Stronger Together

31. Local Support Local PR – radio and press Posters and leaflets (NHS) Posters, postcards and stickers (LPC) LPC Chief Officers available to help PharmOutcomes help-desk Area Team support Thames ValleyLPCs Better and Stronger Together

32. What else is happening locally GP Surgery campaigns Maternity provisions – at antenatal clinics Special Schools Pandemic Flu planning HELP Thames ValleyLPCs Better and Stronger Together

33. Contacts at Area Team Screening and Immunisation Co-ordinators Amber Codd acodd@nhs.netacodd@nhs.net Harpal Aujla harpal.aujla@nhs.netharpal.aujla@nhs.net Screening and Immunisation Manager Chris Cook christine.cook5@nhs.net christine.cook5@nhs.net Thames ValleyLPCs Better and Stronger Together

34. And finally Thames ValleyLPCs Better and Stronger Together