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GPC agrees deal to end unfair vaccine targets

GPs will be able to exclude

patients who refuse to have vaccines such as MMR from their target payment calculations under the new contract.

Negotiators told Pulse last week that some vaccinations and immunisations will be included in the quality and outcomes framework.

The move, which is a victory for the GPC, means patients who express 'informed dissent' will not count against GPs' target pay. A safety-net in the quality framework stops GPs being penalised if patients refuse to consent to treatment or take advice.

Until now all vaccinations and immunisations have been earmarked as an 'additional service', outside the quality framework, which must be done by all GPs unless they have a good reason to opt out.

GP vaccine experts predicted that the entire childhood immunisation schedule would be covered by the quality framework.

GPC joint-deputy chair Dr Hamish Meldrum signalled the shift when he said patients who refuse combined vaccinations being considered by the Joint Committee on Vaccination and Immunisation would not cause problems for GPs if the new contract was accepted.

Dr Meldrum said: 'I suspect by the time these combined vaccines do come out it will be under the new contract. If patients are properly informed about a vaccine then they have a right not to have it.'

The position was confirmed by NHS Confederation core negotiating team member Dr Tony Snell. He said: 'Agreement has been reached regarding putting some of the vaccines in the quality framework and there is some discussion around what goes into the additional services.'

The decision means an end to GPs missing out on substantial incentive payments if they are just one or two patients below target. Instead the quality markers have several graded tiers GPs can aim for.

Negotiators would not confirm whether MMR was among those vaccines in the quality framework. But Dr George Kassianos, a GP in Bracknell, Berkshire, and RCGP spokesman on immunisation, said all UK childhood immunisations should be included.

'It is the basic right of children to be vaccinated against these diseases,' he said.

Vaccines remaining under the additional services could include travel immunisations.

The JCVI said last week that it is considering introducing a number of combined

vaccines, including polio with DTP-Hib, pneumococcal with meningitis C vaccine and chickenpox with MMR.

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