How to establish and manage site-specific booking capacities for the administration of the COVID-19 vaccination

Official

Version 2 will be released on May 20, 2021.

C1277 is the approval number for publications.

1. introductory paragraph

1.1 The purpose of this standard operating procedure is to provide information and guidance to Vaccination Site operational leads and site managers on how to set up and manage each site's booking capacity.

2. Basic information

2.1 The National Call Recall Solution includes the following components:

• NBS stands for National Booking System.
• Call/Recall Call Center (letters and follow-up calls)
• Operations Center (for assistance with bookings via the 119 service)

2.2 The NBS provides a system function that allows individuals to book appointments for COVID-19 vaccination at a vaccination site, either online or by phone through the Operations Centre (via 119). Some PCNs use NBS to manage vaccination appointments for cohorts 10-12.

2.3 The NBS supplements other existing Primary Care Network (PCN) and secondary care booking services where vaccinations are already provided.

2.4 Q-Flow is the administration program and booking engine that works in tandem with the NBS. More information is available on the NBS (Q-Flow) website for vaccination sites, as well as a dedicated user guide.

2.5 The most important NBS parameters are:

• The NBS oversees a variety of vaccination types.
• To avoid under/over booking, invites are distributed in proportion to vaccination site capacity.
• The Medicines and Healthcare products Regulatory Agency (MHRA) has approved a two-dose schedule for the COVID-19 Vaccine (AstraZeneca), COVID-19 mRNA vaccine (Pfizer/BioNTech), and COVID-19 mRNA vaccine (Moderna). For more information, please visit:
• According to JCVI guidance published on December 30, 2020, all Vaccination Centres and Community Pharmacies should ensure second dose appointments are scheduled by the twelfth week following the first dose. The Vaccination Program has decided to open bookings after the first vaccination dose in week 11, with the expectation that most second doses will be completed by the 12th week.
• In response to advice from the independent JCVI, the government updated this instruction on May 15, 2021, to accelerate second doses for priority cohorts 1-9, bringing forward second dose appointments for remaining people in these priority groups from 12 to 8 weeks. Those under the age of 50 will continue to receive their first dose, followed by their second dose at 12 weeks, as has been the deployment strategy thus far. This guidance is available in its entirety here.
• In response to the updated guidance, AstraZeneca's NBS configuration for second dose intervals has been changed from 77-84 days to 56-84 days. Because few people in cohorts 1-9 who would be expected to book their second dose via NBS have had Pfizer and Moderna as a first dose, the interval for Pfizer and Moderna remains set at 77-84 days. This will be updated later for this group.
• The vaccination priority groups for the various phases of the COVID-19 vaccination program are defined by JCVI guidance.
• Pregnant women should be offered the Pfizer-BioNTech vaccine or the Moderna vaccine, according to recent JCVI guidance, and they can now book appointments on the NBS at a site that offers PfizerBioNTech or Moderna after answering a series of screening questions.
• All vaccination sites that provide the Moderna or Pfizer BioNtech vaccines must allow pregnant women to schedule appointments based on their age and clinical group. The Green Book of Public Health England has been updated to reflect this advice. More information is available here.
• Every woman who is pregnant or suspects she may be pregnant should be offered a discussion with a clinician about the potential risks and benefits of vaccination so she can make an informed decision about whether to receive it. Pregnant women will be able to speak with a healthcare professional during their vaccination appointment, or they can contact their maternity team or GP service.
• Individuals in England must be registered with a GP in order to book a COVID-19 vaccination on the NHS. Individuals who are not registered with a GP, such as homeless people or traveling communities, will be identified by commissioners.
• Individuals who use the NBS will be required to book both doses at the same time. Individuals who have already received their first vaccination dose will receive the second dose of the same vaccine, according to current recommendations.
• If appointments are available within the required 77 to 84-day window, the NBS will offer a choice of second dose appointments at sites that deliver the same vaccine as individuals received at their first dose.
• The NHS will contact individuals in priority cohorts 1-9 who have booked through the NBS and whose second dose appointment is due on or after May 25 (where that is more than 8 weeks after their first dose) to encourage them to rebook an earlier appointment.

3. Request for a vaccination appointment

3.1 In accordance with JCVI guidelines, eligible individuals will receive a notification (text/letter) inviting them to schedule a vaccination appointment online or by calling 119. This video contains additional information about the 119 call appointment booking process for call handlers.

3.2 The NBS verifies citizens' eligibility against NIMS and directs them to available appointments for which they are qualified. This includes the following scenarios:

• Individuals in an eligible cohort are directed to all appointments that are available within a 60-mile radius.
• Individuals under the age of 40 (excluding the clinically vulnerable and clinically extremely vulnerable) are directed to Pfizer-BioNTech or Moderna vaccine appointments rather than AstraZeneca, according to JCVI guidance.
• Individuals who declare pregnancy are directed to Pfizer-BioNTech vaccine or Moderna vaccine appointments, according to JCVI guidelines.
• Individuals who have previously received a first dose of the PfizerBioNTech vaccine are shown appointments for the second dose of the PfizerBioNTech vaccine. This holds true for all vaccines.

If their first dose was delivered in a Vaccination Centre or Community Pharmacy, call centers can expect to be contacted by health and social care workers (HSCW) who want to book their second dose in a Vaccination Centre or Community Pharmacy. Anyone who did not schedule their first dose through NBS will have to wait 24 hours after their first dose to schedule their second dose. This is due to the fact that their first dose vaccination is recorded in the Point of Care System and will not appear in the NBS until the next day.

Individuals can book appointments until midnight the day before the appointment; vaccination sites should create a backup list of the day's appointments at the start of each day in case access to Q-flow is lost.

3.5 Most appointments will be scheduled through the NBS. However, some eligible individuals may be denied access to the NBS, or individuals may be vaccinated as part of reducing vaccine waste, and community pharmacy-led sites may also conduct local booking with permission from the commissioner under the terms of the LES. In such cases, patients can be vaccinated and manually added to the Outcomes4Health/Pinnacle Point of Care system. Within 24 hours of that record being created, the patient will be able to book their second dose appointment through the NBS, just like any other patient. Please see the SOP for COVID-19 local vaccination services deployment in community settings and the Operating Framework for Vaccination Centres for more information.

3.6 It is anticipated that the vaccination site will have local arrangements in place to fill appointments that are not booked through the NBS, such as engaging with local health and social care workers to fill empty slots or utilizing 'walk-in' operating models. More information on outreach models is currently being developed.

3.7 Patients with NBS appointments must check in on the NBS system as well. More information is available on the NBS (Q-Flow) website for vaccination sites, as well as a dedicated user guide.

4. Provider configuration

4.1 Previously, NBS regional managers were in charge of creating sites within Q-flow. The national team has been creating sites centrally since Wave 13. After creating the site in Q-flow, site managers will be able to add site attributes and appointment availability, which will then be visible to the public via the NBS.

4.2 The national team will register the vaccination site by entering the COVID19 vaccination center Organization Data Service (ODS) code, site address, and creating the necessary accounts for the user(s) designated as site manager. Approximately one week before the expected go live date, nbso[email protected] sends site managers their login information.

4.3 The site manager(s) of the Vaccination Centre, Community Pharmacy, or PCN will log into Q-Flow using their user account(s) to configure their site attributes and create appointment availability on the NBS.

4.4 Step-by-step videos and training materials are available to help site managers navigate the process. Please see Training Section 14 for more information.

Adding the site and its attributes to the database

4.5 Site managers are responsible for keeping the site's accessibility and transportation information up to date. The longitude and latitude details of a site are entered at the time of site creation, corresponding to the address provided. Site managers should double-check this because site coordinates are used to calculate distance from postcodes entered into the NBS by individuals.

Individuals scheduling vaccination appointments can select a location that meets their accessibility and transportation needs. They will be informed of the distance between the site and the entered postcode.

Workforce user access

4.7 Site managers must create user accounts for any other site managers, arrival stewards, and assessment clinicians who will be using Q-Flow at their sites, assigning appropriate roles and permissions.

4.8 Site managers should deactivate the user accounts of any site personnel who no longer work at the vaccination site in order to remove their access to patient data stored in NBS. Instructions for doing so can be found at https://digital.nhs.uk/coronavirus/vaccinations/q-flow-guidance/createand-manage-user-accounts.

5. Appointment capacity management strategy

5.1 To avoid DNAs, cancellations, and confusion, site managers at Vaccination Centres should publish two weeks (or as otherwise agreed at the regional level) of appointments at a time when individuals can book their first vaccination appointment.

5.2 When booking through NBS, individuals must book both their first and second doses. As a result, site managers should publish an additional three weeks of appointments during the appropriate second dose window to allow people to schedule their second appointment and provide additional capacity for HSCW/walk-ins. This will ensure an extra week of appointments, giving people a 7-day window to schedule their second appointment.) For AstraZeneca clinics, the appropriate second dose window begins 56 days after the first clinic and ends 84 days after the last clinic. The appropriate second dose window for Pfizer-BioNTech vaccine or Moderna clinics can be calculated as beginning 77 days after the first clinic and ending 84 days after the last clinic.

5.3 Initially, site managers should not differentiate between first and second vaccination appointments (unless agreed upon at the regional level). Any appointments that are not used as second dose appointments during the second dose window will eventually be filled as first appointments, but only after appointment capacity has been scheduled during this period when people can book corresponding second dose appointments.

5.4 Community pharmacy and PCN site managers should publish one week's worth of appointments at a time, in accordance with confirmed vaccine deliveries (or as otherwise agreed at a regional level), with corresponding second dose appointments. For AstraZeneca clinics, the appropriate second dose window begins 56 days after the first clinic and ends 84 days after the last clinic. The appropriate second dose window for Pfizer-BioNTech vaccine or Moderna clinics can be calculated as beginning 77 days after the first clinic and ending 84 days after the last clinic.

5.5 Site managers should add additional availability each week as the site receives confirmation of vaccine supply - keep in mind that appointments should only be released when vaccine allocation is confirmed (along with the corresponding second dose period).

5.6 Site managers must ensure that there are enough second dose appointments available on any given day. This is:

• to allow those who have not yet scheduled their second dose to do so
• so that people in cohorts 1-9 who need to reschedule a second dose appointment within 8 weeks of their first dose appointment due to updated guidance issued on May 15, 2021 can do so

5.7 For Pfizer-BioNTech clinics, site managers should ensure that 20 second dose appointments are available on any given day. Smaller sites may be able to provide a lower number based on their second dose allocations and capacity. Astra Zeneca clinics' second dose capacity will be agreed upon at the regional level.

6. Scheduling appointments

6.1 Site administrators can view and print the calendar, as well as view appointment details and cancel a scheduled appointment.

6.2 It is critical to print out site appointments at the start of each working day. This will serve as a backup in the event that the internet connection is lost, keeping in mind that appointments on a given day can be booked up until midnight the day before.

6.3 Each day's appointments list can be accessed in two ways: by printing appointments from the calendar or by running the Unit Appointments Listing report.

7. Appointment cancellations

Individuals can cancel appointments using the same NBS online function or call center that they used to book them. Individuals cannot cancel an appointment on the same day. Vaccination sites, on the other hand, can cancel appointments on the spot.

7.2 If an appointment must be canceled at the site, the site manager must log into the system and complete the cancellation. Please see this link for more information.

7.3 If the user's email address or mobile phone number is stored in the system, they will be notified of the cancellation automatically. If only a landline number is available, site personnel must call the individual to confirm the cancellation and advise them to re-book using the same method as before.

7.4 If no contact information is available, the individual is likely to attend their appointment. For more information, please see the Vaccine Booking Service FAQ document.

7.5 Vaccination sites are not required to re-book appointments for individuals who cancel their appointments. Individuals should make their reservations through the NHS website or by dialing 119.

7.6 At the moment, sites cannot cancel appointments in bulk.

DNAs (did-not-attend)

8.1 If a person fails to show up for their appointment (DNA), it is their responsibility to re-book their appointment from the day after their missed appointment.

8.2 If a person does not arrive for their appointment and thus is not checked in, their name will be recorded as a 'DNA' on the Unit Appointments List report. Individuals can then reschedule their appointment for the day following their missed appointment.

8.3 The Q-flow Unit Appointments List report can assist in calculating the number of DNAs on any given day. If an appointment is not checked in by 11:00 p.m., it will be changed to the 'DNA' status by midnight. The data collection via the Unit Appointments List report necessitates a site using the check in app to track who has attended.

8.4 Individuals who were reported as 'DNA' for their first appointment will not have their second appointment automatically cancelled. This is due to the fact that a 'DNA' notice on NBS is insufficient evidence that a person has not been vaccinated.

9. Personal check-in and validation

9.1 Arrival stewards will use a smart device to access the 'check a vaccination appointment' app. To gain access to the appointment records for that day, stewards must log in at the start of their shift and confirm the VC they are working at. The app can be downloaded here. The app instructs you on what questions to ask and what information to enter.

9.2 The service user check-in procedure can be found here.

9.3 Some people may show up for their appointments with a printout of the appointments they chose rather than having "confirmed" their appointment on the NBS. They would not have a booking reference, so no appointment would be recorded for them. These people are eligible for the vaccine and should be immunized. The NBS has been updated, and the need to confirm appointment details is no longer required.

9.4 In addition to individual appointment check-in, other check-in processes may be in place to ensure everyone's safety and to aid in the assessment of citizens prior to vaccination.

9.5 When an appointment is scheduled, the status is 'expected.'

9.6 When the individual is checked in using the check-in app, the status changes to 'waiting.'

9.7 After 11 p.m. on the day of the appointment, the waiting status automatically changes to 'completed.' NBS does not check against Qflow to confirm vaccination; it only confirms that the appointment was completed. As a result, it is possible that an individual will attend their vaccination appointment but will not be vaccinated (e.g. g Following the screening questions, no consent was obtained.)

9.8 If a person does not check in, the appointment status changes to 'no show' after 11 p.m. on the day of the appointment.

9.9 The data collected by the check-in app (e.g. g Individuals who booked an appointment and attended, as well as those who did not) feed directly into Foundry, resulting in vaccination sites no longer needing to provide those figures in the SitReps.

10. Vaccinating people who do not have NBS appointments

10.1 A vaccination site may occasionally vaccinate someone who did not have an NBS appointment, such as a HSCW, a volunteer at the site, or a caregiver for someone who did have an appointment. From the day after their first dose, the vaccination site should advise this person to make a booking for their second dose through the NBS or by calling 119.

10.2 If a vaccination site is vaccinating someone who does not have an appointment, they are not required to create an appointment on NBS.

11. Health and social care personnel

11.1 Eligible frontline health and social care workers aged 18 and up can book through the NBS using the self-declaration route, and local systems must continue to ensure local provision for all eligible health and care workers.

11.2 As stated in this letter dated 11 February, social care workers will be required to self-declare at the time of booking and will be asked for identification and written authorisation when they attend their vaccination appointment. A work photo ID card, a letter of authorisation from the local authority, a signed letter of authorisation from their employer, or a wage slip dated within the last three months are all acceptable forms of identification. Alternative photographic identification is required to support verification when a work photo ID is not available. This method is expected to be used at all vaccination sites.

11.3 The NBS is still accepting bookings from unpaid caregivers who are eligible for the National Immunisation Management Service (NIMS), i.e. e who have been identified as caregivers by the system While unpaid caregivers are not required to have an NHS number or be registered with a GP to be eligible for the vaccine, please keep in mind that an NHS number is required to book through NBS. Unpaid caregivers who book through this route do not need to provide identification.

Reporting 12

12.1 Site managers and regional managers can view a report that shows the number of scheduled appointments at each location for any date range. This will aid in capacity management in the future.

13. Service Desk for Vaccinations

13.1 If the Q-Flow system cannot be accessed or the check-in app is unavailable, individuals should be checked-in manually using the calendar printed at the start of the day and reconciled by the end of the day.

13.2 For technical and data queries and issues, ATOS operates a single point of contact Vaccination Service Desk. The service can be reached via email at [email protected] or by phone at 0300 200 1000, which is staffed daily from 06:00 to 22:00 (including bank holidays).

14th. Education

14.1 The NBS Onboarding team will distribute information about site manager training sessions for sites in the run-up to go-live. Advice can be found here.

14.2 Site managers have been invited to the NHS workspace titled 'Covid Vaccination IT Systems Training Future.' This is an online collaborative workspace for colleagues working on the Covid Vaccination program in health and care. There you will find all training materials related to the IT systems in use, such as guidance documents, videos, and FAQs. The NHS Futures platform's training calendar lists upcoming training sessions or drop-ins that are open to all vaccination sites.

14.3 If you are not already a user of the Future NHS collaborative platform, where the workspace is hosted, you must sign up as one before you can access the workspace's content.

14.4 If you have colleagues who want to be invited to the workspace, please email [email protected].