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Meningitis vaccine software alert turned on in GP practices

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A previously inactive software alert has now been turned on to help practice nurses ensure teenage patients are vaccinated against meningitis, after questions were asked by bereaved parents.

The move affects GP practices in England that use the EMIS primary care software system, which its developers claim is used by more than half of UK practices.

“It has been agreed that this alert will be enabled for all EMIS users in England”

Seema Kennedy

The automatic emergency vaccine alert for GP practices has been activated after agreement between the Department of Health and Social Care and the software company EMIS.

A charity said the move to turn on the automatic alert follows the death of young people who were eligible for meningitis vaccination, because the alert was previously in its default “off” setting.

According to the Meningitis Research Foundation, over a million people could be unaware they should get the “lifesaving” MenACWY vaccine.

The vaccine was introduced in August 2015 for teenagers and young people to stop a rapid rise in the new and particularly deadly MenW strain of meningococcal meningitis.

Teenagers who left school year 13 in 2015, 2016 or 2017 needed to get their free vaccine from their GP practice, but uptake among that group has been “worryingly low”, noted the charity.

Latest data from May 2018, published by Public Health England, shows that only around 40% of this cohort have taken up the vaccine.

“It is vital that systems are improved so that this never happens again”

Vinny Smith

The charity said that a family from Kent, whose son died from MenW, had discovered that EMIS had an alert that should flag to staff when a patient who attends an appointment is eligible for the MenACWY vaccine, but that this alert was released inactive.

Fiona and Gavin Mason’s son Tim, an apprentice electrical engineer, died aged 21 in March 2018.

“Tim had attended several GP appointments during the years after the vaccine was introduced in the UK,” said Ms Mason.

“Had the EMIS alert been activated, he would have been flagged to staff at those appointments as a patient eligible for the vaccine,” she said. “This didn’t happen.”

The Masons have been working with the Meningitis Research Foundation to investigate the issues with the vaccination programme further.

The charity said it had been told by EMIS that the alert for the MenACWY vaccine was previously set as inactive to avoid “alert fatigue”.

A letter sent to the charity by health minister Seema Kennedy stated: “The protocol was not activated by default, but instructions were sent out for local activation.

“It has been agreed that this alert will be enabled for all EMIS users in England,” said Ms Kennedy, who is also MP for South Ribble.

NHS Digital has now confirmed that the EMIS alert was enabled for GP Practices in England in the week commencing 1 April.

Vinny Smith, chief executive at Meningitis Research Foundation, said: “It seems absurd to us that an emergency vaccination programme to protect young people against a lethal disease had systems in place that were switched off.

“Practices needed to activate the MenACWY alert protocol in order to use it but this would rely on them knowing how to do so,” said Mr Smith.

“Practices told us they did not know how to activate the alert and we know deaths from MenW disease have occurred in young people who should have been offered the vaccine,” he said.

“He would have been flagged to staff at those appointments as a patient eligible for the vaccine”

Fiona Mason

He added: “We admire the courage of the Mason family as they have raised awareness and triggered change within the NHS that will help avoid further deaths from this preventable, treatable disease.

“It’s positive news from government that the alert has now been activated across England and that patients attending GP appointments opportunistically will now be made aware if they are eligible for the vaccine,” he said. “It is vital that systems are improved so that this never happens again.”

In a statement, Dr Shaun O’Hanlon, chief medical officer at EMIS Group, said: “EMIS Health provides software systems to GPs including tools (such as alerts) to help them manage their patients.

“We advise GPs of the availability of these tools as they are released and it is the responsibility of the GP Practice and NHS to define if and how they are used,” he said.

He added: “In July 2016, we proactively released an alert protocol for Men ACWY alongside instructions to all practices on how to activate it.

“We will always follow the guidance and instructions from the NHS on matters of this type and in this case activated the Men ACWY protocol alerts for all practices in April 2019 following instructions from NHS Digital,” Dr O’Hanlon said.

The MenACWY vaccine is routinely offered to teenagers in around school year 9 in England and Wales.

Anyone born between 1 Sept 1996 and 31 August 1999 remains eligible for the vaccine up until their 25th birthday. Anyone starting university for the first time and aged under 25 is also eligible.

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