The Vaccine Management System (VMS) has been created to provide central reporting of vaccinations delivered throughout NI. It will be used to share vaccination information with primary care providers and provide insight as to uptake of vaccines in the population of Northern Ireland.

The app is linked to an online appointment booking platform, for those patients who have been asked to book online. For those patients who are not required or choose not to book online you will be able to add these patients and check their vaccination status before or when they come for their appointment.

The VMS has the following key functions to support your vaccination activity:

• Checking of the vaccination status of those that are wishing to be vaccinated for COVID-19, flu, shingles or MMR. This will allow you to see if the patient is booked in another location, has received a previous vaccination in another location, has the required previous vaccinations to make them eligible for booster dose.
• To assess eligibility for vaccination and carry out a clinical assessment for the patient before administration of vaccination.
• Create records of patients for your scheduled clinics in advance or at point of vaccination. The system has a mechanism to check patient identity against the health and care index when valid and complete details are entered.
• Create a full vaccination record for each patient and update their vaccination status as they journey through your service and record any adverse reactions observed.
• Update a patient’s GP and other vaccine providers on a patient’s vaccination journey, i.e. a patient is booked in for vaccination or that they have been vaccinated.
• To access a record of the vaccinations that you have provided. This can be used to reconcile any payments made by BSO. You will not have to submit vaccination record claims to BSO for payment as this will occur automatically upon submission of a vaccination record on the VMS.

The COVID-19 vaccination programme requires up to date and complete data relating to vaccination activity taking place across all Northern Ireland. This data supports the operational programme but also informs research and health surveillance. VMS gives us a single master record for all vaccinations taking place and matches data against key indexes including the Health and Care Index and contact tracing.

The annual flu programme offers the best protection against seasonal influenza which due to its unpredictable nature can result in recurring pressure across HSCNI. The need for up to date and complete data relating to flu vaccination activity as well as for health surveillance is vital.

We are not using clinical systems to record vaccinations because there is currently no automated way to securely and rapidly exchange complete and accurate information to a centralised master record. VMS is the single source of truth for Covid vaccinations and the Covid verification service uses this data to issue vaccine certificates.

The aim of the shingles vaccination programme is to reduce the incidence and severity of shingles disease in older adults as they have an increased risk of severe disease and subsequent post herpetic neuralgia. From September 2023 Shingrix will replace Zostavax in this vaccination programme and the age range of those eligible for vaccination will be extended. A two-dose schedule has been recommended for all eligible to receive a shingles vaccine. VMS offers a data recording system for the shingrix vaccination programme so that vaccine uptake can be accurately monitored as the new programme is rolled out.

The aim of the MMR vaccination programme is to reduce the incidence of Measles, Mumps and Rubella disease in children and adults, and to reduce the risk of severe disease and subsequent complications. A two-dose schedule has been recommended for all eligible to receive an MMR vaccine. VMS offers a data recording system for MMR Vax Pro and Priorix vaccinations so that vaccines can be accurately recorded for those aged 18+ during catch up programmes. The Child Health System will maintain data recording up to 17 years of age.

General Practice

If you have been identified as a suitable user of the system you will be sent an email inviting you to log in to VMS using your username and password.

If you are working at a primary care practice, then your practice manager will have sent us details of your username and should let you know to expect this invite.

Community Pharmacy

To meet HSC security standards the application can only be accessed outside the HSC network by applying multi-factor authentication (MFA). This means username and password plus another form of authentication. This is typically achieved by using a mobile phone or tablet to trigger a code or an extra layer of authorisation.

The BSO have assigned an additional active directory account (an email address with no inbox) to each pharmacy alongside your secure pharmacy email address. This is to allow two users to access the VMS from different devices at the same time to allow effective running of the service.

If you have signed a contract to provide the Community Pharmacy COVID-19 Vaccination and Flu Service, HSCB will send your pharmacy VMS usernames and passwords via secure email.

Trust

If you have been identified as a suitable user of the system you will be sent an email inviting you to log in to VMS using your username and password. The email will look like this:

As a Trust vaccinator your manager will have sent us details of your username and should let you know to expect this invite.

For some vaccination staff in Trusts, specifically District Nursing and other mobile teams delivering vaccines in homes the application may have to be accessed outside the HSC network therefore you will have to apply multi-factor authentication (MFA). This means username and password plus another form of authentication. This is typically achieved by using a mobile phone or tablet to trigger a code or an extra layer of authorisation.

How to use Multi Factor Authentication

Choose a method of MFA that will work for your location – that is accessible to all users or key user who will always be available to support signing into the application. The ideal would be a mobile device that says onsite. When setting up MFA choose multiple options in case one is unavailable when next needed.

MFA - options

1. Mobile phone or tablet (iOS or android) using authentication app
2. Mobile phone SMS
3. Mobile phone call
4. Landline phone number (with no automated answer)

Once signed in you can choose option to stay signed on which will keep you signed on for the day. For help and further information in relation to MFA please visit http://www.hscbusiness.hscni.net/services/3255.htm

Use this url to access the VMS application:

https://vms.healthandcareni.net/

A welcome page for VMS will then appear, allowing you to sign in. When you are signed into the VMS, using your assigned VMS log in details (and have selected your working location if you are registered to more than one location), your location details will appear in the top right hand corner of the screen

You will be able to search for a patient on your list by typing the HCN number or full name into the search field. You will also be able to create a new patient record or view upcoming appointments for that day for your location.

The homepage

From the homepage view from, you can take key actions.

• You can search for a patient using their Health and Care number or name (both first name and surname must be entered in order to see results) in the search field at the top of the page. Once located, you can view patient details by clicking on their name. From here you can manage appointments, view the vaccination status of the patient and book them in for an upcoming appointments.
• You can create a new patient record by selecting the appropriate link on the home page.
• You can view upcoming appointments for today’s date for your location by selecting the appropriate link on the home page.
• Clicking on the HSC logo at the top of this page will always bring you back to the home page, wherever you are in on the site.

• You can sign-out of your account on the link at the bottom of the page. Please remember to sign-out before closing the VMS or to switch locations (if you are registered to multiple locations). It is advised to sign-out of the VMS if it is not in use, in order to ensure patient confidentiality.
• You can view this list of FAQs anytime by clicking on the link at the bottom of this page or find where to get help using the support link; you do not need to be logged in to access the FAQs.

Upon booking, the patient should be searched for and an appointment booked to ensure the patient’s vaccination journey has been initiated. This can be done in advance of their vaccination appointment and should be completed as soon as possible.

If the patient cannot be found, a new record can be added using the ‘create a patient’ functionality.

In order to add a new patient onto the system you will need to add some basic patient details. Below are the patient data entry fields in VMS and some of these are mandatory to allow the system to match the patient to their central record.

Please advise patient that the best way to find them on HCN Index and match them for next step is by using the details their GP holds for them.

• First name* (FULL NAME AS PER HEALTH RECORDS)
• Last name*
• Health and care number
• Gender at birth*
• Date of birth*
• Address 1*
• Address 2
• Town / City*
• Postcode* (AS PER GP REGISTRATION)
• Ethnic background*
• Mobile number
• Phone number
• Email address

* = Mandatory Field

Please provide as much information as you can.

Select “create new patient record” from the home page.

You will be then asked to complete some patient details in a new page which will facilitate finding a match for the patient on the HCN index:

Please ensure when you are entering any dates, you open the calendar and select the day, month and year to allow you to scroll through and select the correct option.

Data required to find a patient match on the HCN index will be asked first and then matching attempted. Following matching, you will have the opportunity to record further patient details.

Once the mandatory patient details have been entered, matching will be attempted. If a match is found, you will be asked to confirm the details are correct and proceed with the match found. Here you also have the option to edit the details entered and re-attempt matching.

If a match cannot be found, you will receive the following prompt. Confirm the details are correct with the patient and that these are the current details held by their GP practice, re-enter the details to ensure human error has not occurred. If the prompt persists to appear, in a limited set of circumstances, you can proceed without a match if the patient meets one of the stated exception reasons.

Select a reason for the exception. Some guidance on what each of the options relates to is provided below.

Definitions:

Migrant workforce

A migrant worker is defined as someone who has come to Northern Ireland to work and who is neither a national of the United Kingdom nor the Republic of Ireland.

Student

A person ordinarily resident in Northern Ireland or a person classed as an international student, who study at a UK institution.

Homeless

A person may be homeless if they are:

• staying with friends or family
• staying in a hostel
• staying in a bed and breakfast
• living in very overcrowded conditions
• at risk of violence if they stay in their home
• living in poor conditions that are damaging their health
• living in a house that is unsuitable for them
• rough sleeping

Approved by DoH

This may be a number of different types of individuals where the DoH have approved vaccination e.g. a person not normally resident in NI who has had a first dose in another region of the UK. Approval for vaccination will be confirmed by receipt of a DoH email or letter.

You will then need to confirm you understand the implications of proceeding in this way.

You may wish to refer patients to the following BSO website to request a H&C number if they do not have one or to update their HSC record if they have changed name, address etc: http://www.hscbusiness.hscni.net/services/2507.htm

When a match has been found, you will be prompted to enter some further patient details which are not relevant for matching but are an important part of the patient record on VMS.

• Ethnic background*
• Mobile number
• Phone number
• Email address

Following this, the system will ask for an appointment to be booked. Enter the vaccine type and date of appointment to continue. This step needs to be completed in order to save the new patient record you have created.

If the patient record has already been created, when viewing the patient record, you can manage their appointments, including booking, editing and cancelling appointments

Selecting Manage appointments allows new appointments to be booked.

Upcoming appointments for a patient can be viewed on the patient record. Select ‘manage appointments’ and then choose the ‘manage appointments’ link from the VMS appointments section of the screen

Appointments scheduled for today’s date for your location can be viewed from the home page by selecting ‘view upcoming appointments’. A new screen will display detailing the patient name, date of birth and vaccine type for all listed appointments at the location the user is logged into.

Once a patient record has been created, you are not able to delete this record.

First try to find the patient record by typing their Health and Care number or full name into the search field on the home page.

Once you have searched, the page will update to show you a listed of suggested patients. When you find the patient select their name to open the patient record.

To proceed with a vaccination there are 3 options. If the patient has an upcoming appointment, this will be visible in the upcoming vaccinations section and select ‘check patient ID’ to proceed.

If the patient is a walk-in and no appointment has been previously booked, then a vaccination type needs to be selected under the ‘Record a walk in patient’ section and click on ‘Record vaccination’ to proceed.

If the patient vaccination record is being entered retrospectively, then a vaccination type under the ‘Record a historical vaccination’ needs to be selected and click on ‘Record vaccination’ to proceed.

For booked appointments and walk-ins, you will need to confirm that you have checked the patient’s identity.

For Covid-19 or flu vaccinations, you will then see a simple form to allow you to enter further patient details relevant to the vaccination. If the patient is a health and social care worker, further questions will appear for you to record information about their role. This information may already be populated if they patient booked their appointment online. The answers can be updated here.

A multi-select question allows you to choose all patient details that apply.

For care home staff and residents, you will be asked to enter the RQIA code. If you are unsure of the code, please visit the RQIA website: https://www.rqia.org.uk/what-we-do/register/services-registered-with-rqia/

You will then be asked whether a clinical assessment has already been completed for the patient. If it has already been completed by the vaccinator offline, then select ‘Yes’ and continue to the consent question.

If the clinical assessment hasn’t been previously completed, then select ‘No’. You will then see a form to allow you to complete clinical assessment questions. Different questions are asked depending on the appointment type (flu, Covid-19 or MMR). The clinical assessment for Shingles and MMR vaccinations must be completed and recorded outside VMS.

Covid-19 page:

Tip: use the tab button to move to the next field.

MMR page:

The information you have entered can be saved as a draft by selecting the form is not ready for submission and clicking on save record. Please follow the instructions on the screen.

Once you have completed all mandatory clinical assessment questions, you can select ‘Save & continue’ to continue to record the consent question.

The consent question page requires you to confirm whether you have received consent from the patient to proceed or a decision has been made in their best interest. If you select that ‘A best interest decision has been made to ‘Do not proceed with vaccination’’ and click on ‘Save and continue’, then the vaccination is complete and the vaccination status for that appointment set to ‘Did not proceed’

If consent has been given to proceed, a final question is asked to confirm you are happy to proceed to the vaccination. If you select ‘No’ then you will also need to select a reason why the vaccination is not proceeding and that will complete the vaccination for the patient. If you select that you do wish to proceed and click ‘Save and continue’, you will be taken to the record vaccination details page.

Please note: If the appointment type you are recording a vaccine for is flu, you will only see flu dose options in the vaccine administered drop-down. If the appointment type is Covid-19, you will see both booster, dose 1 and dose 2 options in the drop-down. If the appointment type you are recording a vaccine for is shingles or MMR, you will see dose options in the vaccine administered drop-down.

Vaccine types will be amended to include new types as they are approved and adopted for use; system rules will change to suit the operational needs of the vaccination providers, for example booster doses. Please ensure you select the correct vaccine that has been administered.

Batch Field: this field is for batch number. This field is mandatory and you should only enter batch number here, no text.

You can cancel out of the patient record at any time by clicking the logo at the top of the page OR by clicking ‘cancel and return to patient record’.

Once you have completed the form and are ready to submit, please confirm and then select the save button.

Once you have saved the vaccination record you will be returned to the patient record page and the status of the patient will have changed.

From here you will be able to book the patients second vaccination appointment using the manage appointments link. If the patient is having another vaccine, you will also be able to progress to the next vaccination from here.

If at any time you want to view the record of a patient who has previously received a vaccination you can click on their name to open the patient record.

From the patient details page, you can see can their upcoming appointments and can take action to manage their upcoming appointment.

From the patient details page, you will see a summary vaccination history.

Selecting ‘view and edit details’ will present a detailed view of their vaccination history.

If the vaccination you are viewing was carried out by a location of the same type you are logged into, e.g. another pharmacy, then you will see a button to ‘Edit vaccine record’. Selecting this will present the vaccine record in edit mode, allowing you to make and save changes. This could be useful to correct errors, for example a typing error in the batch number. Please note that changes made beyond the day on which the record was created will not be updated in GP systems. You should contact the relevant GP to make changes to their record.

For providers who are eligible for payment, this will happen for those patients who have had a vaccination record submitted to show a vaccine has been administered.

Appointments shown in VMS will be separated into online bookings and other bookings.

Appointments coming from the booking portal (online bookings) can be viewed but cannot be cancelled from VMS. The patient must cancel their own appointment online using the patient portal and VMS will be automatically updated.

Appointments made in the VMS (other bookings) can be edited and cancelled from the manage appointments screen.

Both the appointment type and the date can be edited.

When ‘manage appointments’ is selected, the ability to cancel an upcoming appointment will become visible.

The VMS has a built in .csv report based on the patients you have vaccinated which can be exported and used in combination with other excel reports you have created from other sources.

This contains information on vaccination status, cohort and other key demographics for patients on your list.

This can be accessed by selecting “Download Patient Report” at the bottom of the page.

Once downloaded, the report is no longer protected by the security mechanisms built into the app. Please ensure you have protocols in place at each location for restricting user access to patient report; we recommend that this is used by a nominated user and saved to a secure location and password protected if necessary. The VMS will retain the patient vaccination record therefore it is not recommended to save the report for longer than is necessary for checking against monitoring reports/payments.

The data you enter will go into the main VMS master data file which can be viewed by all vaccine delivery partners. It will be matched to the relevant practice GP Clinical system from there and will be updated daily.

The VMS is capturing all other vaccination data from other centres (Trusts, Care Homes, and GPs etc.) and collating this to update the patient records held on GP clinical systems.

Yes, all vaccines given in VMS are searchable by all users. Only locations of the same type will be able to edit records e.g. a pharmacy can edit records created by it or other pharmacies but a GP could not edit such records.

Recording a vaccination

Covid or flu - https://vimeo.com/814530643/85856ed452

Shingles - https://vimeo.com/856857867/d2b8da711a?share=copy

MMR - https://vimeo.com/910119691/bdbd99ea00

Viewing a clinic list

Vimeo - https://vimeo.com/814530670/c1f9b77c22

Managing appointments and creating patients

Vimeo - https://vimeo.com/814528973/fdd7c999ce

Editing patient details and re-matching

Vimeo - https://vimeo.com/814528955/0dbdeac72c