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Independents' Day

NHS recommissions controversial pharmacy flu vaccination scheme

NHS England has announced that it will recommission its ill-fated pharmacy flu vaccine scheme for the 2016/17 season, despite fears that the scheme has contributed to a fall in uptake of the vaccinations and cost general practice millions of pounds.

A national contract, introduced last September, paid community pharmacists across the whole of England to give flu jabs as part of the annual NHS flu vaccination campaign.

Official figures have shown that uptake of the flu jab has fallen across all target cohorts of the population since the scheme was introduced and the GPC has warned it has disrupted established flu clinics and cost practices as much as £4m in lost vaccine payments.

GP leaders warned last month that renewing the pharmacy scheme risked it further destabilising the programme delivered by GP practices.

Alastair Buxton, PSNC director of NHS Services, said: ‘This early announcement of recommissioning will help pharmacy contractors prepare for provision of this important service and is to be welcomed.’

The terms and fees for the recommissioned service will remain the same as in 2015/16.

NHS England said that further guidance would be issued to contractors once legislation and associated documents have been updated to take into account the recommissioning of the service.

Dr Richard Vautrey, deputy chair of the GPC, said: 'Practices will be frustrated that NHS England is ignoring the evidence that the extension of the flu immunisation scheme this year failed to deliver significant improvements and in fact led to a drop in overall uptake, fragmentation of a previously good service to patients, wasted vaccine that had been pre-ordered by practices and in some cases undermined previously good relationships between practices and pharmacies.'

How the pharmacy flu scheme has impacted on GPs

GP leaders warned that expanding the pharmacy-led scheme last flu season risked leaving GPs out of pocket and disrupting the established flu vaccination campaign, based on results from a series of pilots across England and Wales, including a recently reported London-wide scheme

So far all the evidence suggests they were right. Coverage has fallen in all at-risk groups, with LMC leaders warning pharmacists were merely competing for ‘low-hanging fruit’ – motivated patients who would normally get their flu jab at their GP practice’s flu clinic.

In some areas pharmacists have ‘poached’ patients from their GP, under advice from NHS bosses. The GPC estimated it may have cost practices collectively as much as £4m in lost vaccine payments.

There are also concerns it is adding to practices’ administrative workload in order to keep track of who has been vaccinated, and disrupted other timely check-ups and services usually delivered at the same time as the flu jab – such as shingles vaccinations in the elderly.

Readers' comments (25)

  • Cant' believe that NHSE would be so short, hang on,...yes I can!! Yet again, a bunch of managers who have no idea about Primary Care dictating what we do and don't do...

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  • I have no problem with this as long as there is a level playing field, ie we need to be able to give private jabs and charge for this service.

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  • I suspect like many other PM's I have reduced the number of 'flu vaccines I have ordered for next year's campaign, and can see a time when we stop running Saturday walk-in sessions because of the cost/benefit business case.

    One very real problem countering pharmacies is that through scale they are able to get delivery ahead of general practice. This means they can start to cherry-pick all those patients visiting to collect their repeat prescriptions. Once you strip these out of the process, practices are left with the difficult, hard to reach population.

    Once this reaches a critical point, why continue to offer the service?

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  • As the article suggests. We miss the opportunity to carry out Shingles and Pneumonia vaccinations to those elgible, which we normally do when they attend for their flu vaccination. Some practices also like to catch patients to do blood pressures and other outstanding routine health checks.

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  • Sorry GPs
    As a patient I don't have a lot of sympathy
    As a dentist I had flu jabs over many years, our practice paid a local GP to come in one lunchtime and give all our staff (that were willing!) a shot every year in an attempt to keep them all

    Since I retired and moved to a different town I have found it very difficult to find a suitable appointment with my GP - having little choice of time and very few sessions organised.
    So in recent years I have had my yearly top up at Boots, either paying for it myself or last year being able to have it paid for by the NHS.

    It has either been done immediately that I turned up or I was given a time to come back, usually the same day.

    Most practices these days and certainly mine have more clinical staff than a branch of Boots. The jab takes up no more than 5 to 10 minutes of clinical time at the most. Does a GP have to give it? Surely practice nurses etc are as well qualified to provide the service as a pharmacist?

    I'm sure that there are plenty of missed appointments every day where there would be time to provide the service.

    BUT - I absolutely agree that there should be a level field and that GP practices should be allowed either to charge for the service and/or receive the same fee as Boots for those who are eligible for NHS jabs.

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  • Let's hope that this time NHS England reminds pharamacists that they are legally obliged to include each patient's NHS number when sending the clinical data back to the registered GP... we didn't update a single patient record with this data last year, as none of the notifications from pharmacists complied with the Health & Social Care (Safety and Quality) Act 2015, which came into force on 1 October 2015.

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  • The administration fee is now £2.16 more in GP than it is in pharmacy. The vaccine is administered by a professional that attracts a higher wage than those administering it in GP.

    You're right, the field isn't level.

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  • Its not a level playing field.

    Let all practices dispense. Where does it end?

    The fact is that the evidence shows there is no increase in uptake - in fact the opposite. The evidence shows that it is detrimental to the health of some patients who would usually be given additional healthcare when coming into surgery for the jab.

    Yet again the government and NHSE ignoring the evidence to choose a path with less patient benefit.

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  • Very bad publicity regarding effectiveness of the previous years vaccine will have had an effect on uptake.

    Vaccine rates were down in children too, where there wasn't pharmacy involvement. How does the evidence support GP-only supply in this case?

    The administration fee is for each vaccine, so in essence it it not correct to assume that all work can be done in one fell swoop. Patients often don't like leaving like a pin cushion as it suits the practitioner.

    That would be like me getting a prescription for one years worth of medication to dispense in one go, but expecting 12 dispensing fees. Not how it works even though it would benefit me with regard to workflow.

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  • 1. Evidence suggests pharmacists giving flu vaccines reduces flu vaccine uptake. So logic dictates don't do it - so why are are NHSE doing it?
    2. GP practices will be out of pocket and have to spend more money to do other things done at flu vaccine (BP checks etc), which may destabilise GP even further - so why would NHSE do it?
    3. Perhaps that's the point. Destabilise GP as much as possible, slowly move many of the GP functions into the hands of large companies (Boots, Loyds etc), then GP can go belly up and the privatisation of the NHS can continue as planned.
    4. Those pharmacists who will go on here going on about competition and fairness.... lets have an open playing field - you guys can give flu or shingles or whatever and we can dispense, sells P meds etc etc..... that'll make it fair.... or is it a one sided "fairness" you are after? Also please explain why FLu vacccine uptake fell with pharmacists involved?

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