Immunisation: flu vaccine for people with diabetes
Indicator
The percentage of patients with diabetes, on the register, who have had influenza immunisation in the preceding 1 August to 31 March.
Indicator type
General practice indicator suitable for use in the Quality and Outcomes Framework.
This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.
To find out how to use indicators and how we develop them, see our NICE indicator process guide.
Rationale
This indicator measures the percentage of people with diabetes who have been vaccinated against influenza in the preceding 8-month period (1 August to 31 March). The aim of vaccination is to prevent complications from influenza in people with diabetes. NICE's guideline on flu vaccination: increasing uptake and chapter 19 of the green book recommend annual vaccination for influenza for people with diabetes as they are more likely to develop potentially serious complications from flu.
The 8-month timeframe has been chosen to allow practices to enough time to achieve sufficient uptake during the 6-month winter influenza vaccination programme (usually September to February).
Source guidance
Flu vaccination: increasing uptake. NICE guideline NG103 (2018), recommendation 1.3.1
Specification
Numerator: The number of patients in the denominator who have had influenza immunisation in the preceding 1 August to 31 March.
Denominator: The number of patients on the diabetes register.
Calculation: Numerator divided by the denominator, multiplied by 100.
Definitions: The diabetes register (NICE IND100) includes patients aged 17 or over with a diabetes diagnosis up to and including the achievement date which is not followed by a diabetes resolved code.
Exclusions:
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Patients with persisting flu vaccine contraindication, or an expiring flu vaccine contraindication in the previous 12 months, in their record.
Personalised care adjustments or exception reporting should be considered to account for situations where the patient declines, does not attend or if a flu vaccination is not appropriate.
Expected population size: QOF data for 2022 to 2023 (indicator DM017) shows that 6.1% of people in England are on the QOF diabetes mellitus register: 605 patients for an average practice with 10,000 patients. To be suitable for use in QOF, there should be more than 20 patients eligible for inclusion in the denominator, per average practice with 10,000 patients, prior to application of personalised care adjustments.