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A faulty production line

Should I bother running a flu campaign next season?

Dr Andrew Green advises

This season’s flu vaccination scheme has been plagued by difficulties. The Government’s new pharmacy flu vaccination programme aimed to vaccinate hard-to-reach patients, but has meant that fewer were vaccinated in GP practices. Many GP practices have been left with surplus vaccine, which the GPC has suggested could lead to a combined £4m loss to practices in flu payments. As GPs prepare to put in their orders for next season, Dr Andrew Green advises on whether it’s worth you offering the same scheme next season. 

Will the next season be any different to last year’s?

I would be amazed if there was any significant change. The pharmacy flu scheme is unlikely to change next year, even if there is no evidence of increased overall uptake, as the Government remains wedded to increasing choice for patients even when services are fragmented as a result.

Should I consider scrapping the service next season?

Even with reduced numbers of patients attending general practice, GPs will probably find this a worthwhile service to provide, as it should remain profitable providing the above factors are taken into consideration.

How many vaccines should I order? 

Practices will find it very hard to predict how many vaccines they will need next year, and every practice will be different so I can’t offer specific advice on whether practices should order the same number of vaccines as used last season. However, whatever you do, I would advise ensuring that you are not left with unused stock. You may do this by reducing the total number ordered, which might leave patients unprotected, or by ordering more on a sale-or-return basis, which will be more expensive so reduce practice profitability. Obviously neither option is ideal.

If I decide to order fewer vaccines, do I have to inform anyone?

Providing practices are genuinely trying to match ordering with expected demand, this remains a matter for the practice. Only if a practice is anticipating altering their previous arrangements significantly should they notify their commissioning body as soon as possible so that they can make alternative plans. This was, of course, exactly what didn’t happen in reverse last year, but that is no reason for us not to uphold basic professional standards.

How can I ensure I deliver more vaccines next season?

I would recommend practices ensure that their services next year are as patient-friendly as possible, for example looking into evening or weekend dedicated flu clinics. Practices do vary greatly in their arrangements and it might be worthwhile liaising with other practices to see what works well in your own area. Effective advertising is vital, and try targeting early those patients who went to a pharmacy this year. Having a ‘flu day’ when all the practice gets together - GPs, nurses, receptionists and bacon-butties - can be a team-building experience. Also consider talking to your patient participation group to see if they have any ideas as to how to make your service as convenient as possible. 

Is it worth liaising with nearby pharmacies to ensure there is no overlap next year?

The statement from NHS England last year that they expected GPs and community pharmacies to cooperate over provision simply illustrates that they have no idea as to the financial pressures that GPs are under. The PSNC and NHSE have set up a competitive environment and the resulting difficulties are not our responsibility to address. I think it would be more beneficial to liaise with local practices to share good practice and to consider joint advertising. Care must be taken to ensure that any publicity concentrates on informing patients about the benefits of immunisation, and informs them as to the services available in GP practices, rather than criticising pharmacies or implying that visiting pharmacies will result in reduced level of other GP services.

Dr Andrew Green is chair of the GPC’s clinical and prescribing subcommittee and a GP in Hedon, Yorkshire

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Readers' comments (17)

  • Buy fewer vaccines and when they run out signpost to nearest pharmacy

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  • It depends on whether the motivation is public health or profit.
    A poor take up does not mean it is not worthwhile doing, it may mean the publicity needs changing or that services need to be more focussed on patient's needs. Our practice was literally queued down the street with patients driving to alternative sites to access the jab, this was perhaps a much higher than normal uptake or lower supply of staff.

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  • I don't think your local pharmacist will mind that Dr Pfeiffer. We're used to patients coming from other pharmacies, so would not be offended as it isn't personal.

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  • If you don't want to ditch your stupid toxic contracts, maybe consider a mass boycott of this scheme and let pharmacists do all the flu vaccs. But this would cost you money in the short term though so you have to weigh principles against income (in the short-term anyway). But just imagine the utter chaos which would ensue if GPs stopped coordinating the process free of charge. Alternatively, you could just not code any data sent from pharmacists. This would have a smaller financial impact on practices but NHS England would be in complete disarray and unable to tell what is going on.

    Pharmacists have happily muscled in on this traditional GP earner and through transformation programs and integrated working they will poach even more. They will do this under the guise of "helping" general practice.

    Make no mistake, pharmacists are money grabbers who simply want to cherry pick at GP income whilst leaving GPs to do the real hard work for pennies.

    Pharmacists are not our colleagues. They are vultures from a completely separate profession. Do not trust them.

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  • Personally, I would like to see greater co-operation between GPs and Pharmacists. Those patients who normally go to their GP but came to me for their flu vaccination this year all said the same thing - they liked that they didn't have to make an appointment with me; they liked that they could come in on any day if the week, not just when the GP was holding the flu clinic (nb:many were 65+ so spend the weekend with grandchildren, so Saturday clinics were not much use to them) and they liked that they weren't (and here I quote) "treated like cattle, all lined up, bang, bang,bang and out you go" while we spend a little bit of time with them and the fact that our safety protocol dictates that they have to wait 10 minutes before being allowed to leave, in case of any reaction, meant we could have a bit more of a chat with them. Now, you could argue the benefit/purpose of the 10 minute wait but we turn it to our advantage.
    Next year, I will be only too delighted if I can double the number of vaccinations I do, in the same way as I did this year when compared to last

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  • Re:sessional gp 8:33
    Apart from having a good laugh at your vitriolic tirade (which does your professional credibility no good) please explain what is the difference between something being an "earner" and someone "money grabbing"
    We did not set up the pharmacy flu service (although it was running on a local basis through Public Health) but have simply provided an alternative.
    And as for muscling in, I presume you are similarly appalled when any of you colleagues operate dispensing practice's.
    It is you sort of small minded pettiness that means patients don't get the service they need, rather than the service YOU say they should have.
    Thank God the GPs I work with are more forward thinking and open-minded

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  • In all professions - be it GP/Pharmacist/Nurse/Manager - there are varying standards of professionalism so it might be more helpful to any debate to try to get beyond the name calling and focus on the message. Not so entertaining maybe, but perhaps more informative.
    The flu debacle in our area has left many practices with incomplete information as some national pharmacies choose not to tell us who they jabbed because 'they didn't have to' (? is that best interest of patient). We are obligated to call/recall non-vaccinated vulnerable patients - which means we spent resource chasing those who had it at the pharmacy - as well as waste resource throwing away unused vaccines (? is that good use of NHS resource).
    Our figures are at best incomplete, at worst a shambles - we don't actually know.
    When the few hundred attending the pharmacies turn in the several thousands we accommodate perhaps the easy access mentioned earlier will not be so easy !!
    I think for us, as for many colleagues, our ability to withstand the lost income this year will have a very negative affect on our provision the service next year and in the future. Fragmenting the service might suit the patient now - but any pretence that it is in their best interests will be unmasked as such at the first epidemic when we see how many go unprotected - and pharmacists may well find that they have hard choices to make in coming years when demand for flu jabs impacts on their core business. Since there is no real dialogue amongst either us as providers or patients as recipients I rather fear many people will be at risk in years to come by a pursuance of an misguided ideology

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  • To compete ,GP should be allowed to sell OTC drugs
    like 99 P Outlets.

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  • My local GP opened a pharmacy. It's funny how his condescending attitude towards the profession changed when he was reaping the rewards of OTC sales, commissioned services etc.

    You'd believe in voodoo if you got QOF points for it.

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  • I cant believe some of the negative comments posted from GP's
    The flu vaccine is still our main tool in the box against influenza
    If you prefer to have your patient presenting with flu and secondary bacterial infection then giving them what would been unnecessary antibiotics do not bother running the flu vaccination clinics this coming season. Better still consider early retirement and do your patients a favour

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