CQC Inspections – Immunisation Services

Following the completion of the 1st round of CQC inspections, it was found that most practices are running very efficient immunisation services, despite the complexity and the regularity of changes.  Below are some of the issues identified:

Cold chain

  • Vaccines must be stored within the conditions of their product licence – between 2ºC and 8ºC.
  • Temperature outside of this range, vaccine effectiveness cannot be guaranteed and the medicines licence may no longer be valid
  • Findings outside of this range and usually higher than 8ºC degrees are being recorded with no action taken
  • Recording of the fridge temperature is delegated to staff who do not understand the correct procedure to follow if the temperature is outside of the required range
  • The fridge is overstocked with vaccines with air less able to circulate freely between boxes of vaccines
  • Use of a data-logger being used as a justification for failing to record daily temperatures
  • Failure to re-set the temperature when minimum and maximum temperatures recorded
  • Fridge temperature set too high resulting in frequent rise to above 8ºC when door opened.
  • No defined responsibility for oversight of vaccine ordering and storage – new stock not placed behind shorter dated vaccines and unclear system for ensuring refrigeration of vaccines on delivery
  • CQC recommends vaccine cold chain monitoring is undertaken by suitably trained staff
  • Where temperatures outside of the recommended range are found further action should be taken in keeping with practice policy

Coverage of eligible population 

  • On occasions low uptake is reported for individual vaccines, e.g. pneumococcal conjugate vaccine (PCV) that is out of step with other vaccines given at the same time
  • CQC recommend that practices liaise with their local CHIS to ensure records of all vaccines administered are appropriately notified to CHIS
  • To address low uptake, CQC consider whether the following are in place:
  • Adding alerts to the records of non-attenders, contacting and reminding parents and provision of appointments at varied times and days

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/643758/VU_269_August_2017.pdf

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