FLU Vaccinations

Enrolment and Parental Consent

Once a vaccination programme has been set up, schools will follow their internal process to send a link to the enrolment form to parents and guardians.

Consenting adults should:

1. Open the link (or copy the URL into a web browser).

2. Click Start.

3. Enter the school's code (also known as an LEA code) and click Next.
   The school code should have been confirmed within the email from the school.
   If an invalid school code is entered, a red box will appear advising to enter a valid code.

4. Check that the school name shown at the top of the Child information form is correct.
   
   If it is not, contact the child's school to obtain the correct code.

5. Complete the online form with the child's details.
   All fields are mandatory unless they are marked (optional).

6. Click Next.

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   If the year group chosen is outside the applicable school years for this vaccine type a red warning will show.

   If the date of birth is outside the normal range for the selected school year an amber warning will show. an additional field to confirm if the child has been placed outside of their normal age group will also appear.
   

7. On the following screen, complete the contact details of the consenting adult then click Next.
   

8. A verification code will be sent via email. This may take a few minutes to arrive.

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   Check junk/spam folders if the email has not arrived.
   A new code can be sent if "no, please send me another code" is selected.
   A different email address can be used by selecting "No, the email address above is incorrect".

9. When the code arrives, select Yes and enter the code into the field that appears, then click Next.
   If an incorrect code is entered a prompt will show to try again. If a code is entered incorrectly 5 times, there will be a prompt to re-enter the email address.
   

10. The next page allows a choice to enter additional contact details.

    • Yes will display additional fields to enter contact details for a second person. These additional contact details added won't receive communications, and will only be used if the primary contact is not responding to urgent communications.
      
    • No will not display any further fields.

11. Click Next and the Consent status screen will appear.
    
    Details regarding the vaccine, which may result in a consenting adult not wanting to give consent, will appear within a blue info block.
    E.g. Nasal flu vaccines contain porcine gelatine, this ingredient is often a cause of objection for religious reasons. If this is the case, an alternative (injected) vaccination may be offered within the enrolment form. If an alternative form of vaccine is chosen, the child may be given an alternative date and/or location for their vaccine.

12. All questions are mandatory. Parental responsibility must be confirmed.
    If consent is not given, an additional (optional) field to enter the reason why will appear.

13. Click Next and the health questions screen will appear.
    

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    Dependant on whether consent has been given for the nasal vaccine or injection, different questions may appear.

14. Complete all questions as they are designed to make sure the vaccine process will not affect the child's health.
    Some answers will reveal additional fields and questions which must be completed to provide more information.

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    A link to further information about the specific vaccine and its ingredients is included on this page.
    This link will open in a new window.

15. Click Next and the Review screen will appear.

16. Check all details are correct and confirm whether they are/aren't correct by answering the question at the bottom of the form.
    Please confirm that the information you have provided is accurate and correct:

    • Yes - this will allow you to continue with submitting the form by clicking Submit
    • No, I need to go back and correct the relevant information - if this is chosen, clicking Submit will take you back to the beginning of the form to overwrite any answers that need changing.

17. After submitting the online form, a Thank you screen will display which includes a Start another button. This will begin a new form e.g. if there is another child requiring a vaccination.
    

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The consenting adult can re-complete the form for their child if they wish to change their consent or if the child's health details have changed.

Emails to Consenting Adults

Following the submission of a form, emails will be sent to the email address confirmed on the form:

1. The first email will thank you for completing the enrolment form (whether consent was given or not).

2. The second email will be one of the following:

   • A confirmation of the school immunisation session - this will be sent if the answers on the enrolment form all indicate that the child will be vaccinated and there is an available session slot for this type of vaccine. The earliest available school session will be used. If answers submitted require review from the triage team, this email may be delayed until their review has been completed.

   • A link to book a clinic slot for the child's vaccination - this will be sent if the school has chosen not to do on-site vaccinations and instead chooses to book children into clinic sessions, or if no school session is available at the time of completing the enrolment form. This will be resent every 28 days until a booking is made.

   • Confirmation that consent was not given - this will be sent if No was chosen when consenting to the vaccination. Instructions of how to re-enrol will also be included if consenting adults wish to change their minds.

   • An update advising that vaccinating the child is not recommended - this will be sent if the triage team review the answers provided on the form and have deemed it unsafe to administer the vaccine to the child (there is a Contraindication regarding answer(s) to the health questions in the form).

   • Already vaccinated - if the child is confirmed to already have been vaccinated for this year, a thank you email will be sent.

3. If an appointment has been booked, three days before the appointment will take place, a reminder email will be sent. In cases where the appointment will be taking place within 3 days of the confirmation email being sent, a reminder email will not be sent.

WARNING

If the session date or location is modified, every child booked on that session will receive a new confirmation email for the updated session, and a reminder will still be sent three days before the appointment is due to take place.

Additional emails which can be sent after the appointment has taken place.

• Confirmation that the child was immunised on the day

• Confirmation that the child was not immunised on the day (e.g. refused or were unwell on the day)

• Catch-up - for if the child was not vaccinated but should have been/are still eligible for a vaccine e.g. unwell on the day. If an applicable school session is available, they will be auto booked onto that. If no school session available, a link to choose an available catch-up will be sent within the email. A reminder to complete the link will be sent if it is not done within 7 days, with a further reminder sent every 28 days after that until a session is booked (or the programme ends).

• End of programme - this email will be sent at the end of the vaccination programme if the child was eligible, but not successfully vaccinated during the course of the programme, e.g. they did not attend their vaccination.

Booking a Clinic session

If a school session is not available, consenting adults will be emailed a link to book their child onto a clinic session for their vaccination.

The link will prompt for the date of birth associated with the service. The child's date of birth should be entered.

The next screen will allow consenting adults to choose an available clinic session from the drop-down options.

After submitting their selection, they will be sent a booking confirmation email.

Duplicate Enrolment

If a consenting adult has already enrolled their child using the consent form, they will be shown the Duplicate Enrolment screen.

They will need to choose to:

• Continue with enrolment - to complete the form and make changes to previous answers.
• Exit enrolment - to close the form and make no changes.

Depending on any new answers submitted, a new set of emails will be sent to the email address confirmed on the form.

If a duplicate form is submitted, an Enrol Duplicate Consent task will be created for a member of the admin team to process.

Admin Team Tasks

Dependant on the answers submitted on an enrolment form, one of the following tasks may be created for members of the Admin team to process.

These tasks can be accessed via the Care Facilities dashboard while logged in as a member of the Admin team.

Enrol Duplicate Consent

This task will appear if more than one enrolment form is submitted for the same patient.

To process this task:

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To remove the duplicate information without updating the enrolment details with the new form (i.e. no changes are needed to be made to the current consent status), skip to step 7.

1. Navigate to the running service on the patient record.

2. Click View Service Details.
   A Deactivate Service task will show.
   

3. Click Process Task.
   The Deactivate Service screen will open.
   

4. Select Yes to deactivate the patient.

   WARNING

   Under normal circumstances, service deactivation should NOT be completed for a patient. Only in the event that you are processing a duplicate consent form should this be done.

5. Click Next.
   The Review screen will show.

6. Click Finish and then Exit.

7. Navigate to the Care Facility dashboard.

8. Click Process task for the Enrol Duplicate Consent task for this patient.
   

9. Check the details shown on the Duplicate consent screen.
   
   These details can be overwritten/amended if necessary.

10. Choose an Action:

    • Re-enrol - this option will replace the current consent information with the new consent details.
    • Duplicate - this option will file the new form as duplicate information. The new submissions will appear in the readings tab of the patient record. No changes to current consent status will be made.

11. Choose whether to view the consent form:

    • Yes - this will display answers entered on the new enrolment form. If they differ from previous answers, both answers will display.
    • No - this will not display the answers on the form. Selecting this option does not affect the processing of the task.

12. Click Next
    The Review screen will open.

13. Click Finish followed by Return to dashboard

Enrol No Match

If the details entered on the enrolment form do not match the details found on PDS for the patient, this task will be created.
The main PDS details used to match patients are:

• Date of birth
• NHS number

Further details that can be used to match the PDS record are:

• First name
• Last name
• Gender
• Postcode

To process this task:

1. Click Process task
   

2. Check the details shown on the No match screen.
   Incorrect details should be overwritten/amended if necessary.

3. Choose an Action:

   • Retry - this option will retry matching the PDS details using any amended details on this task.
   • Create as unmatched to PDS - this option will add the patient to the service without matching any PDS details, e.g. if the patient does not have a registered GP but can still be vaccinated.

   WARNING

   This option should only be used in exceptional circumstances. If this option results in duplicate records for one patient being created within the IHC system, this can be rectified by contacting Inhealthcare, who will perform a Patient Merge.

   • Discard - this option will discard the details of the enrolment form. If chosen an additional question will appear asking you to confirm the discard. If Yes is chosen, the patient will not be enrolled onto the service and no further communications will be sent.

4. Choose whether to view the consent form:

   • Yes - this will display answers entered on the new enrolment form.
   • No - this will not display the answers on the form. Selecting this option does not affect the processing of the task.

5. Click Next
   The Review screen will open.

6. Click Finish followed by Return to dashboard.

If the changes you have made now match the PDS record, the applicable email will be sent to the consenting adult's email address.

If the changes you have made still do not match the PDS record, a new Enrol No Match task is created.

Enrol Unknown Error

If the patient is unable to be enrolled on the service for an unknown reason, this task may appear.

WARNING

If an Enrol Unknown Error task is created for your organisation contact the Inhealthcare team.

To process this task:

1. Click Process task

2. Check the details shown on the No match screen.
   These details can be overwritten/amended if necessary. The patient's first name, surname, date of birth and post code need to match what is on the PDS record for this patient.

3. Choose an Action:

   • Retry - this option will retry matching the PDS details using any amended details on this task.
   • Discard - this option will discard the details of the enrolment form. If chosen an additional question will appear asking you to confirm the discard. If Yes is chosen, the patient will not be enrolled onto the service and no further communications will be sent.

   

4. Choose whether to view the consent form:

   • Yes - this will display answers entered on the new enrolment form.
   • No - this will not display the answers on the form. Selecting this option does not affect the processing of the task.

5. Click Next
   The Review screen will open.

6. Click Finish followed by Return to dashboard.

Admin Team Service Options

The following service options will become available to members of the Admin team through the running of this service.

To access these options, open the patient record and click View service details on the running Service.

Amend existing FLU booking

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This Service option will only appear if consent has been provided and the patient has already been booked onto a session. The session booked will be confirmed within the service option name.

To amend the session booked for your patient, select this service option:

1. On the Change booking screen the details of the current session will be displayed. Select what type of change you wish to make:

   • Choose Session - if selected the following screen will display a dropdown of alternative sessions available for this patient.
   • Choose Catch Up - if selected the following screen will display a dropdown of alternative catch-up sessions available for this patient.
   • Force Catch Up - Email Parent - will cancel the current booking and send an email to the consenting adult which includes a link for them to book onto a catch-up session. A reminder to complete the link will be sent if it is not done within 7 days, with a further reminder sent every 28 days after that until a session is booked (or the programme ends).

   

2. Click Next.

3. On the Select session screen, choose an alternative session from the drop-down.
   If on the previous screen you selected force catch up this screen will not display.

4. Click Next.

5. If the session selected is a clinic session, the Select slot screen will show.
   
   Choose an available slot from the drop-down.

6. Click Next.
   The Review screen will show.

7. Click Finish to save your changes.

Amend existing school details

To amend the school for your patient, select this service option.

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Changing the school for a patient will not amend any sessions booked. If you wish to amend the booking follow the amend booking steps above.

1. On the Change booking screen, click the x to remove the auto-populated school from the Select the school dropdown and select the new school.
   

2. Click Next.

3. On the Select year group screen, if the year needs to be amended, click the x to remove the auto-populated year from the Year group dropdown and select the applicable year.

4. Click Next.

5. On the Select class screen, if the year needs to be amended, click the x to remove the auto-populated year from the Class dropdown and select the applicable class.

6. Click Next.
   The Review screen will show.

7. Click Finish to save your changes.

Booking required FLU

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This task will only appear if the patient has not booked onto a session, but consent has been provided.

To manually book a session:

1. On the Change booking screen the details of the current session will be displayed. Select what type of change you wish to make:

   • Choose Session - if selected the following screen will display a dropdown of alternative sessions available for this patient.
   • Choose Catch Up - if selected the following screen will display a dropdown of alternative catch-up sessions available for this patient.
   • Force Catch Up - Email Parent - will cancel the current booking and send an email to the consenting adult which includes a link for them to book onto a catch-up session. A reminder to complete the link will be sent if it is not done within 7 days, with a further reminder sent every 28 days after that until a session is booked (or the programme ends).

2. Click Next.

3. On the Select session screen, choose an alternative session from the drop-down.
   If on the previous screen you selected force catch up this screen will not display.

4. Click Next.

5. If the session selected is a clinic session, the Select slot screen will show.
   Choose an available slot from the drop-down.

6. Click Next.
   The Review screen will show.

7. Click Finish to save your changes.
   A confirmation email will be sent to the consenting adult.

Change sensitive and LAC record marker

To add or change a sensitive/LAC marker:

1. On the Sensitive or Looked After record screen, select the applicable radio buttons for Sensitive record marker and Looked after child record marker.
   

2. Click Next.
   The Review screen will show.

3. Click Finish and then Exit to save your changes.

Any markers added will appear in the Patient banner at the top of the screen.

Create adhoc task

To create an adhoc task using this service option:

1. On the Adhoc task screen, select if you want the task to be for the Triage team or Admin team.
   Only the selected team will be able to view the new task.
   

2. Add a Task note and a Due date.

3. Click Next.
   The Review screen will show.

4. Click Finish and then Exit to save your changes.

Triage Team Tasks

If answers on the consent form require intervention from the triage team the following tasks may be created.

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Only a member of the Triage team will be able to view and process these tasks.

Red flagged: Triage required

A red flag task will be created if:

• Any answer from the enrolment form indicates a possible contraindication for the child's vaccination.
• If Outstanding - Keep this alert open as a Red Flag has been chosen when processing another triage task.
• If Outstanding - Keep this alert open as a Red Flag has been chosen when using the Modify triage details service option

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If answers on an enrolment form trigger more than one red flag, these will be collated and all details will be included within the blue info-block shown on the task.

If a matching school session is available for the patient, the red task will show a due date of the next matching school session.

If there is no matching school session available for the patient, the red task will show a due date of the same day it was created.

To process this task:

1. Click Process task
   

2. A blue info block will outline the reason(s) for the red flag, allowing the triage team to make a decision regarding administering the vaccine.
   

3. Confirm whether the child can be immunised:

   • Yes - The child can be immunised - this option will trigger an appointment to be booked (if one is available), and will confirm this via email to the consenting adult.
     Additional questions will appear to confirm the type of injection (if applicable), and whether the child is a priority for immunisation.

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   If the consenting adult has indicated they want their child to receive the vaccine by injection (they oppose the use of gelatine products), this option will be auto populated.

   • Yes - But keep this alert open as an Orange Flag - this will resolve the Red Flag task, but create a new Orange task to be reviewed by the triage team.
     Additional questions will appear to confirm you wish to create an additional Orange flag within the readings section of the patient record, as well as the type of injection (if applicable), and whether the child is a priority for immunisation.
     
   • No - Consent has been withdrawn - this will remove the child from the programme and send an email to the consenting adult confirming that consent has not been given.
   • No - Child already vaccinated - this will remove the child from the programme and send a thank you email to the consenting adult advising of this action.
   • No - There are blockers to immunisation (Contraindications) - this will remove the child from the programme and send an email to the consenting adult advising that their child should not be vaccinated this year.
   • Outstanding - Keep this alert open as a Red Flag - this will keep the Red task to be reviewed by the triage team but will allow you to enter a review date which will become the task's new due date.
     
     Optional boxes will appear to confirm if you wish to create an additional Red and/or Orange flag within the readings section of the patient record.

4. Add your triage details in the free text box.

5. Confirm whether to add these triage details as a Clinical decision or just a Note on the patient record.
   If you have selected Outstanding - Keep this alert open as a Red Flag, this option will not appear and your triage details will automatically be added as a note.

6. Click Next.
   The Review screen will open.

7. Click Finish followed by Return to dashboard.

Orange flagged: Triage required

An Orange flag will be created if:

• additional needs have been indicated on the enrolment form.

• a member of the triage team has processed a red task and chosen to keep the alert open as an Orange Flag.

• Yes - But keep this alert open as an Orange Flag has been chosen when using the Modify triage details service option

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If an Orange flag is triggered at the same time as a red flag, this will create a red task, but the info-block on the task will also outline the details for the Orange flag.

If a matching school session is available for the patient, the orange task will show a due date of the next matching school session.

If there is no matching school session available for the patient, the orange task will show a due date of the same day it was created.

To process this task:

1. Click Process task
   

2. A blue info block will outline the reason(s) for the orange flag, allowing the triage team to make a decision regarding administering the vaccine.

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   If the orange task has been created during the processing of a red task, it will include all details from the original red task within the blue info-block shown on the task.

3. Confirm whether the child can be immunised:

   • Yes - The child can be immunised - this option will trigger an appointment to be booked (if one is available), and will confirm this via email to the consenting adult.
     Additional questions will appear to confirm the type of injection (if applicable), and whether the child is a priority for immunisation.

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   If the consenting adult has indicated they want their child to receive the vaccine by injection, this option will be auto populated.

   • Yes - But keep this alert open as an Orange Flag - this will resolve the Orange Flag task, but create a new Orange task to be reviewed by the triage team.
     Additional questions will appear to confirm you wish to create an additional Orange flag within the readings section of the patient record, as well as the type of injection (if applicable), and whether the child is a priority for immunisation.
     
   • No - Consent has been withdrawn - this will remove the child from the programme and send an email to the consenting adult confirming that consent has not been given.
   • No - Child already vaccinated - this will remove the child from the programme and send a thank you email to the consenting adult advising of this action.
   • No - There are blockers to immunisation (Contraindications) - this will remove the child from the programme and send an email to the consenting adult advising that their child should not be vaccinated this year.
   • Outstanding - Keep this alert open as a Red Flag - this will escalate it to a Red task to be reviewed by the triage team but will allow you to enter a review date which will become the task's new due date.
     
     Optional boxes will appear to confirm if you wish to create an additional Red and/or Orange flag within the readings section of the patient record.

4. Add your triage details in the free text box.

5. Confirm whether to add these triage details as a Clinical decision or just a Note on the patient record.
   If you have selected Outstanding - Keep this alert open as a Red Flag, this option will not appear and your triage details will automatically be added as a note.

6. Click Next.
   The Review screen will open.

7. Click Finish followed by Return to dashboard.

Modify Triage Details: Service Options

This Service option will appear for patients who have been booked onto a vaccination session, but the session has not yet taken place.

To access this option, open the patient record and click View service details on the running Service.

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If there are any outstanding red or orange tasks, this service option will not appear until the task is processed.

1. Select the Modify triage details service option.
   The Flu Clinical Triage screen will open.

2. A blue info block will display the details of any previous triage or immunisation status.

3. Follow the same steps above for processing a red or orange triage task.

On the Day Procedure

On the day of the booked vaccination session one or more of the following teams will process tasks to complete the vaccination process:

• Immunisation team - this team will perform the vaccination.
• Clinical on the day team - this team can triage the patient on the day, and confirm whether the vaccination can or cannot be done. This is an optional team which can be used in addition to the immunisation team.
• Admin team - this on the day admin team can mark the patient as arrived for their vaccine. This is an optional team which can be used in addition to the immunisation team (and clinical team, if configured).

On the day users will process tasks using the Inhealthcare Professional app. They will need to ensure that they are logged into the correct team to see the patients on their list.

When opening the Inhealthcare Professional app, the patient list will be auto-populated with the number of patients for that day, as well as listing their name and surname.

The search (red spyglass) option at the top right of the screen can be used to easily search for specific patient in the app.
The total number of patients for that day will be displayed at the top of the list.

WARNING

Regularly re-sync the app by swiping downwards. A sync symbol will appear. While syncing the date and time of the last sync will appear at the top of your patient list.

Select the applicable patient for the appointment and the list of tasks associated with that patient will appear.

To add filters to your list:

1. Click spyglass at the top right of your screen.
   Blue Additional filters text will appear with the number of filters selected displayed in brackets.
   

2. Click the wording to show the filters available for that day:
   Possible filters may include:

   • Class
   • Priority (this marker will be added by the triage team when processing a red or orange flag task).
   • Session
   • Session type - the vaccination programme
   • Year group

   

3. Once your filter(s) are chosen, click the arrow in the top left of the screen to return to the filtered view of your list.

4. Selecting a patient will display any tasks related to them (for the team permissions you are logged in with).
   

Admin on the day team

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This team and the tasks below are not a mandatory part of this service.

Once you have loaded your patient list on the Inhealthcare Professional app:

1. Click the applicable patient to display any tasks associated with them.

2. Click the applicable task.

3. Details of the session, and contact details for the consenting adult will be displayed.
   Mark the arrival status of the patient.
   

4. Click Submit.
   The task will be marked as completed.

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To access tasks while logged in on a laptop, a member of the admin team can open individual patient records and select View service details or they can access the full list of tasks for their team through the Care facility Dashboard.

Clinical on the day team

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This team and the tasks below are not a mandatory part of this service.

Once you have loaded your patient list on the Inhealthcare Professional app:

1. Click the applicable patient to display any tasks associated with them.

2. Click the applicable task.

3. Details of the session, and contact details for the consenting adult will be displayed.
   Any triage notes (e.g. additional needs flagged) will also appear. Questions and info-blocks shown will depend on answers given on the enrolment form and any triage tasks that have previously been processed:
   

   • The following information blocks may appear:
     • If the child has a fever consider postponing the immunisation - if they are having their flu vaccine administered by injection.
     • If the child has a fever or heavy nasal congestion consider postponing the immunisation - if they are having the nasal flu vaccine.
     • NB This child is contra-indicated for the live nasal spray and requires the inactivated injection - if allergy has been indicated on the enrolment form, but triage task has confirmed injection can be carried out.
     • NB: Parent has reported this child has chest or breathing difficulties - the consenting adult has consented to a nasal vaccine but breathing difficulties have been indicated on enrolment form.
   • The following questions may appear:
     • Has the child had an acute exacerbation of symptoms e.g. increased wheezing and/or required additional bronchodilator treatment in the past 72 hours? - this will appear if a consenting adult has indicated any breathing problems on the consent form (e.g. asthma or bronchitis). If Yes is selected an info-block will appear stating This child may require the inactivated vaccine (injection). Please liaise with the lead nurse
     • Has the child started taking oral steroids (tablet or liquid suspension) in the last two weeks? - this will appear if a consenting adult has indicated any breathing problems on the consent form, for the nasal vaccine only. If Yes is selected an info-block will appear stating This child may require the inactivated vaccine (injection). Please liaise with the lead nurse
     • Has the child received treatment with influenza anti-viral agents in the last 48 hours? - this will appear for the nasal vaccine only. If Yes is selected an info-block will appear stating This child may require the inactivated vaccine (injection). Please liaise with the lead nurse
   • The child is well enough to receive their vaccination.
     • Yes
     • No
     • N/A - this should be used if the child is not present to answer the question (DNA).
       If no or N/A was selected as an answer to "Is the child well enough to receive their vaccination?", a Reason not immunised needs to be selected. Optional notes can be added to the free-text field.
       

   WARNING

   If any answer included on this task results in the child not being able to be immunised (e.g. consent withdrawn, contraindications, or already vaccinated), the applicable email will be sent to their consenting adult.

4. Click Submit.
   The task will be marked as completed.

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To access tasks while logged in on a laptop, a member of the clinical on-the-day team can open individual patient records and select View service details or they can access the full list of tasks for their team through the Care facility Dashboard.

Immunisation Team

WARNING

Only members of the Immunisation team will be able to access these tasks.

Once you have loaded your patient list on the Inhealthcare Professional app:

1. Click the applicable patient to display any tasks associated with them.

2. Click the applicable task.

3. Details of the session, and contact details for the consenting adult will be displayed.
   Any triage notes (e.g. additional needs flagged) will also appear.
   Questions and info-blocks shown will depend on answers given on the enrolment form and any triage tasks that have previously been processed:
   

   • The following information blocks may appear:
     • If the child has a fever consider postponing the immunisation - if they are having their flu vaccine administered by injection
     • If the child has a fever or heavy nasal congestion consider postponing the immunisation - if they are having the nasal flu vaccine
     • NB This child is contra-indicated for the live nasal spray and requires the inactivated injection - if allergy has been indicated on the enrolment form, but triage task has confirmed injection can be carried out.
     • NB: Parent has reported this child has chest or breathing difficulties - the consenting adult has consented to a nasal vaccine but breathing difficulties have been indicated on enrolment form.
   • The following questions may appear:
     • Has the child had an acute exacerbation of symptoms e.g. increased wheezing and/or required additional bronchodilator treatment in the past 72 hours? - this will appear if a consenting adult has indicated any breathing problems on the consent form (e.g. asthma or bronchitis). If Yes is selected an info-block will appear stating This child may require the inactivated vaccine (injection). Please liaise with the lead nurse
     • Has the child started taking oral steroids (tablet or liquid suspension) in the last two weeks? - this will appear if a consenting adult has indicated any breathing problems on the consent form, for the nasal vaccine only. If Yes is selected an info-block will appear stating This child may require the inactivated vaccine (injection). Please liaise with the lead nurse
     • Has the child received treatment with influenza anti-viral agents in the last 48 hours? - this will appear for the nasal vaccine only. If Yes is selected an info-block will appear stating This child may require the inactivated vaccine (injection). Please liaise with the lead nurse
   • The child is well enough to receive their vaccination.
     • Yes
     • No
     • N/A - this should be used if the child is not present to answer the question (DNA).

   TIP

   If an On the Day Admin or clinical team have completed arrival or on the day clinical tasks, the answers to questions will be pre-populated. However, answers can be amended if needed.
   If a previous task results in the child not being vaccinated during this session (e.g. consent withdrawn, contraindications, or already vaccinated), the patient will be removed from the Immunisation team's task list.

4. If the child was confirmed to be well enough to receive the vaccination, tick Yes under Have you completed the vaccination?
   If no or N/A was selected as an answer to "Is the child well enough to receive their vaccination?", a Reason not immunised needs to be selected.

5. If the child was not immunised, skip to the Notes field.
   If the child was immunised, on the Vaccination details screen confirm the Dosage and Batch number for the vaccination used.
   If the vaccine is an injection, fields will show to confirm the vaccination site and method used.
   If Other is selected for the batch number a free text field will appear to enter the batch number and expiry date.

6. Add any optional notes into the optional Notes field and click Submit.
   The task will be marked as completed.

TIP

To access tasks while logged in on a laptop, a member of the immunisation team can open individual patient records and select View service details or they can access the full list of tasks for their team through the Care facility Dashboard.

The applicable email will be sent to the consenting adult to confirm the child was vaccinated, or to confirm why the vaccine was not carried out.

TIP

If the appointment was missed, but the child is still eligible for the vaccination, e.g. they did not attend:

• If another school session is available the child will be auto-booked onto it, and a confirmation will be sent to the consenting adult.
• If no school session is available, an email will be sent for the consulting adult to book onto a clinic session.

Correct Immunisation Decision

If for any reason incorrect information has been entered while processing the On the day immunisation task this can be amended.

Once the patient has been immunised, a new service option will be available to Triage team members.

To access these options, open the patient record and click View service details on the running Service.

1. Click the Correct Immunisation Decision - FLU option.

2. On the Correct Immunisation Decision screen, enter your reason into the free-text field.
   

3. Click Next.
   The Review screen will show.

4. Click Finish to save your changes.

The patient will re-appear on the task list for the Immunisation team with a note stating Last action: Correct Immunisation Decision.

Details of the Correct Immunisation Decision can be viewed within the Communication section of the patient record:

Recall for Second Dose

Patients will be required to be recalled for a second dose of the flu vaccine if all of the following criteria apply:

• the child is under 9 years old
• the child has a long term condition (LTC)
• this is the first time that the child has been given a FLU immunisation

If this is the case, a member of the triage team must manually confirm that a second dose is needed for this patient by processing the red 2nd Dose Clinical Decision task.

TIP

This task will not be available until after the first dose has been administered by a member of the Immunisation team.

To confirm a second dose decision:

1. Click Process task.
   

2. The Child 2nd dose screen will confirm all previous triage and immunisation status details.
   
   Does this child require a second dose to be provided by the service?

   • Yes - will trigger the sending of an applicable email to the consenting adult.
   • No - will need no further action.

   TIP

   If the patient's second does has been organised directly with their GP, please select no as the second dose will not be fulfilled by this service.

3. Click Next.
   The Review screen will show.

4. Click Finish and then Exit to save your changes.

If the child needs 2 doses, the 2nd dose must be 28 days or more after the 1st dose.

If there is an available School session, the patient will be auto-booked onto it and a confirmation email sent to the consenting adult.

If there is no available school session, the consenting adult will be sent an email containing a link to book onto an appropriate clinic session. A reminder to complete the link will be sent if it is not done within 7 days, with a further reminder sent every 28 days after that until a session is booked (or the programme ends).

The second dose will follow the same On the day process as their first vaccination.