Charlotte Keel Medical Practice
Teenage booster recalls SOP
The teenage booster immunisation programme is predominantly given via the schools programme. If the child has missed the schools immunisation sessions then the GP practice can give this. However it is not expected that the GP practice will have a formal call/recall (GP contract 2021-22). Good practice is to attempt to call in on 3 occasions.
CKMP teenage booster recall picks up children age 15 who have not had their boosters. Teenage boosters include a 3in1 diphtheria, tetanus, and polio booster immunisation and men ACWY immunisation given at age 14yrs (school year 9). Boys and girls age 12-13yrs (school year 8) are also offered HPV vaccination at school (eligibility for boys include males born on or after 1/9/2006). From Sep-23, HPV vaccination will change to a 1 dose schedule given with other teen boosters at age 14yrs.
We are able to offer HPV to both Boys and Girls aged between 14 and 25 years who were eligible to receive HPV vaccine under the routine schools immunisation programme but missed it. This can be offered opportunistically or if requested in primary care until they reach 25years of age N.B Eligibility for boys include males born on or after 1 September 2006. This can be claimed for.
Step 1: Teenage booster without recalls
Every month the recall list should be updated with any patients who have become 15yrs old and not had their teenage booster. The list excludes those who have been called 3 times already and coded with ‘Immunisation invitation – not replied’ as well as those who have declined either verbally or via letter and coded “ Immunisation consent not given”
- Run the recall list by going to EMIS population reporting à Childhood immunisations (not enhanced service) à Teenage booster 15-16yrs olds à No DTP and no recall.
- Go into patient record and check in diary to see whether the patient is due any immunisations (DTP booster, men ACWY, HPV, MMR). Check to see whether has declined, whether is active patient, whether needs immunisation record request letter, and whether has been contacted a minimum of 3 times before.
- If the patient is due immunisations, contact child health on 01278 589 225 to check whether they have any additional immunisation data not already recorded in EMIS. Record and code any missing immunisation data in the appropriate way. (Please see separate protocol).
If you have a large number of patients to query with child health can email up to 30 at any one time via nhs email hil.bnsssg.swchis@nhs.net
- After having spoken to child health, if the patient is still due immunisations, add the diary entry ‘Immunisations due’ using today’s date. This will get picked up in the recall list next month. Please also include an EMIS entry confirming you have spoken with child health under ‘Active Immunisation’ problem heading to ensure people don’t need to contact child health again.
- However, if child is up to date but remains on list as not given as per schedule then please code them “Up to date with immunisations”. This will then remove them from the list
- Move on to the next patient on the list and continue until the list is complete. Any queries to LDT or TRNs. Once the list is complete, move on to step 2.
Step 2: Teenage booster with recalls
- Run the monthly recall list by going to EMIS population reporting à monthly recalls à GAF – Teenage boosters. This should automatically run on 1st of every month.
- Go into the patient record and check the diary. This should display both the above step 1 recall ‘Immunisations due’, and any specific EMIS-generated entries detailing the precise immunisations due.
- Check the patient’s care history and immunisation tab to ensure the vaccinations have not been given. If the patient is up to date, complete the ‘Immunisations due’
- If the patient still requires vaccinations, for first attempt at contact send text message using Accurx template ‘teen booster’ adding a self book link. 2nd attempt preferable phone call and book in, or a letter if unable to phone. 3rd attempt telcon or letter (1 attempt at a phone call at least should be made) contact them by phone and book into ‘TRN – Childhood immunisations’ slot.
Under the problem heading, ‘Active Immunisations’, code ‘SMS (short message service) text message sent to patient’, ‘Telephone encounter’ and free text the outcome of the call, or if a letter sent ‘Teenage Td/IPV booster immunisation invitation first letter’.
- If parent verbally declines vaccines please code ‘immunisation consent not given’ and then remove ‘Immunisation due’ recall from diary. This will remove them from recall lists. Also send a letter (no consent to vaccinate) and ask them to sign but no further chasing needed.
- If the patient cannot be reached by phone, send the following letter: ‘Letter – Patient – Recall – Imms – DTP Booster -13-18yrs – parent letter’. For 16 and over use: ‘Letter – Patient – Recall – Imms – DTP Booster -13-18yrs’.
Under the problem heading ‘Active Immunisation’, use the code: ‘Teenage Td/IPV booster immunisation invitation first/second/third letter’. (Please note, previous contacts we have made via imail will only show in the care history).
Move the diary entry date forward 2 months.
- If the patient has been contacted by phone and letter three times with no response, double check the contact number and address by looking at other household members. Try alternate phone numbers if possible.
If unable to contact after three attempts via phone or letter, complete the diary entry ‘Immunisations due’.
Under the problem heading ‘Active Immunisation’, code ‘Immunisation invitation – not replied in EMIS’. These children will then be excluded from the teenager booster list.
** Please note, every year the conditions of the ‘Childhood immunisations (not enhanced service) à Teenage booster 15-16yrs olds à No DTP and no recall’ list need amending. On the 1st of September, please change the date in rule 1 to the subsequent year:
e.g. in Sep-23 change the dates to ‘after or on 01/09/2020
in Sep-24 change the dates to ‘after or on 01/09/2021
in Sep-25 change the dates to ‘after or on 01/09/2022 etc