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Practice challenges NHS chief over ‘£4m wasted flu vaccine’

A practice manager has written to the head of the NHS in England asking for advice on what to do with hundreds of flu vaccinations that the practice will have left over this year, after a new scheme allowing pharmacists to vaccinate patients was brought in at the eleventh hour.

Elaine Smith, practice manager at the West Walk Surgery in Bristol, said the practice is likely to have around 350 unusable vaccines left at the end of the flu season as a result of pharmacists ‘poaching’ their patients.

She added that by a ‘fag packet’ estimate, this means across the whole country over a million flu vaccines will end up in landfill this year, costing general practice nearly £4m ‘that could have been spent on caring for patients’.

The letter, addressed to NHS chief executive Simon Stevens, read: ‘I’d be really grateful if you could advise me what you think I should do with the flu vaccinations that I ordered in October 2014, many of which will now be of no use to my practice.

‘The sudden swerve to the contract for provision of flu vaccinations that crept up on us in September 2015 has had a significant impact on general practice.’

NHS England insists the pharmacy scheme was not designed to compete with practices but that it will increase patients’ choice ’meaning a greater proportion of at-risk patients will be able to access this important intervention, including those patients who may not otherwise have been vaccinated’.

However, local GP leaders have already warned that the flu vaccination campaign has become a ‘shambles’ this year as a result of the pharmacy scheme, with pharmacists being advised by NHS managers to tell patients they should get the flu jab at the pharmacy this year because their GP is too busy.

The GPC has warned the scheme is unlikely to improve uptake in at-risk groups based on experience from local schemes - and called for compensation to be paid to practices, who are likely to lose out having already ordered enough vaccine to cover their eligible patients for this season.

Ms Smith said she can only return 10% of her stock and estimated the loss to her own practice will be around £8,000.

She wrote: ‘The lack of foresight in suddenly pulling that funding from general practice makes me once again question the decision making at higher levels.’

Mr Stevens, what should I do with my leftover flu vaccinations?

 

Readers' comments (12)

  • I had actually completed just over 350 vaccines by the end of September and the invoice generated to the NHS was £5,625. These 350 vaccines cost me £1,137.50 giving a profit of £4,487.50.

    I thought pharmacists were getting paid more than surgeries for vaccines? How can the practice be £8,000 down? This would suggest a payment of £26 per vaccine or that she is paying way too much per vaccine!!! 20% sale or return is also quite easy to secure if you ask nicely or agree to pay a little more per vaccine.

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  • The £8,000 includes postage and unfilled appointments and additional staff costs. I accept that I din't include this in my calculation.

    Postage I can accept, but surely not every leftover jab was the result of a DNA appointment (if it is then patients should be told). You also have to staff a 'drop in' flu clinic for the time it is open, and you will never truly know how many people will attend so are likely to over or under staff it.

    To extrapolate this questionable estimate to a national figure (albeit fag packet) doesn't work. Many surgeries don't post letters anymore, many don't do appointments and many neqotiate better returns percentages.

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  • Simple answer: BUY AS YOU GO. This is what we do every day in our pharmacies even with flu vaccines. You operate a very protected business unlike us and that's why you don't buy stock like a real business.

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  • Pharmacists are often accused at delivering quantity rather than quality. To a certain extent this is true as dispensing volume is vital to our survival. This is why we are good at recruiting flu vaccine patients. It is a relatively simple task and the way we are used to putting the customer first seems to work for them.

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  • I'm not sure of the calculation of costs but this is one helluva lost oppeortunity. At flu jab appointments we catch up weights/BMIs/BPs/ do blood forms and patients are advised to make appointments with GP for annual checks which are due. It must be remembered that some patients come only for flue jabs once a year and can't be bothered otherwise. Over the last two years this has helped monitor patients who would have otherwise slipped unnoticed.
    This 'scattering' of flu jabs and other services too is going to in the long run add to disintegrating care because you lose track of who's doing what. Unless, of course, that is the aim of our Notorious Heavily Secretive Elite.(NHSE)

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  • I don't mind pharmacist giving flu jabs , its not like everyone meets the flu targets anyway , and reinforces the msg that flu vaccines are important,

    it's staggering the Amount of people who refuses to have the flu vaccine and given the availability of this vaccine and benefit it has to society and NHS resources perhaps NHS England and public health an get their act their act together and encourage everyone to get their flu vaccine, rather then dumping it on busy GP's,

    If public truly value their free NHS then they should be encouraging everyone to have their immunisations .

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  • NHS England might well have intended that opening this service up to pharmacists would improve uptake in those patients who are eligible yet do not usually get the vaccine but this does not appear to be the case in reality - my patients vaccinated so far by the pharmacist have always had their flu vaccine at the practice.
    In my practice, the local pharmacist was attaching labels to patient medication which read 'reduce winter pressure on your GP - get your free NHS flu vaccination at this pharmacy'. This is misleading as patients then thought they were helping us out by going elsewhere.
    Regarding ordering smaller vaccine numbers as you go along, we have a duty to ensure there is enough vaccine for all our eligible patients. The only way to guarantee this is to order a lot in advance.
    Had NHSE told GPs about the new plans, we could have amended the order then.

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  • The scheme was doomed either way! General practice are never happy! Even though they don't have to do the work and they still get to claim the DES payment for the flu vaccination for the mere cost of read coding it to the patients record. NHS England could have left them to it but given last years winter pressures of seeing sick people they tried to help manage demand.
    Perhaps the practice could reduce its loss by working with local businesses, community centres and schools to deliver staff vaccinations privately? perhaps they could get in contact with their neighbouring practices and see if anyone has under ordered and needs more. Damned if you do, damned if you dont!

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  • Anonymous | NHS Manager02 Nov 2015 3:26pm

    Be prepared to be called an idiot very shortly!!

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  • I wouldn't pass judgement on mental ability but I think in this instance the manager's post at 3.26 is untrue - perhaps a reflection of how little NHS managers understand general practice.

    GPs give the immunisations (along with nursing staff for whose time we pay) and update the compute record. They also arrange call and recall systems (or pay admin staff to do so).

    Winter pressures don't generally hit until after the September/October vaccination programme.

    Criticising us for complaining that the "help" imposed is not actually helpful, will have consequences in terms of delivery of the flu vaccine programme next year and there are many more areas of work with which we have asked for and would benefit from help is akin to feeling aggrieved when the old lady you help across the road is not grateful because she only wanted to ask directions.

    NHS England's own immunisation plan notes that vaccine orders are placed early in the year - they would have known we were committed when they announced the change.

    Do people really think we have time to faff about off site touting for private business?

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