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GPs' swine flu vaccination target revealed

By Lilian Anekwe

Exclusive: GP practices will be expected to vaccinate at least half of all patients in the priority at-risk group against swine flu during this winter's vaccination campaign, Pulse can exclusively reveal.

Details of the direct enhanced service for the H1N1 flu vaccination programme state practices will have to vaccinate 50.7% of patients aged between six months and 65 years in clinical at-risk groups to qualify for reduced thresholds on QOF access targets.

The plan had been to also measure practice performance in over-65s who fell in clinical at-risk groups, with an individual practice target based on its mix of older and younger patients.

But the GPC and DH have now decided against including at-risk over-65s, because of difficulties in obtaining exact numbers, meaning there is now a single national target for all practices based only on performance in younger patients.

As Pulse revealed last week, priority groups that do not overlap with the seasonal flu vaccination campaign, including pregnant women and household contacts of people with compromised immune systems, will not count towards the vaccination target. Even so, leading GPs are warning the target will still be tough for practices to hit.

The DH will lower the thresholds on this year's PE7 and PE8 QOF indicators by 10 and 20% respectively in practices that do reach the target – representing 3% higher uptake than for at-risk under-65s in last year's seasonal flu campaign.

‘To receive easement of thresholds, practices will need to achieve a patient uptake of 50.7% or more within JCVI priority group one – that is, six months to 65 years at-risk patients', the DES reads.

‘This means a comparison of the 2008/09 UK uptake of a completed course of vaccination for the under-65s clinically at risk seasonal flu group - 47.7% - with an equivalent completed course of one or two doses depending on requirements of vaccination.'

‘While a target of 50.7% has been set, GPs will seek to achieve a swine flu vaccination uptake of at least or better than that achieved by the practice for seasonal flu in 2008/09.'

GPC negotiator Dr Chaand Nagpaul said: ‘It's not possible to compare uptake of the over-65s for previous winter flu because we don't have a breakdown of over 65s at risk.'

He added: ‘The 3% is an arbitrary figure suggested by the DH. We would have preferred 0% but the Government wanted some incentive for practices and to make sure swine flu did not take less priority than winter flu. It's arbitrary but we feel it's is realistic and achievable.'

But Dr Sam Everington, a member of BMA council and a GP in Tower Hamlets, east London, said the target would be hard for GPs to hit. ‘It's inevitable you're going to get lower vaccination rates for swine flu because the chance to vaccinate people opportunistically is not there,' he warned.

GP practices will be expected to vaccinate at least half of all patients in the priority at-risk group against swine flu during this winter's vaccination campaign GP practices will be expected to vaccinate at least half of all patients in the priority at-risk group against swine flu during this winter's vaccination campaign Read the guidance for yourself

Click here to read the Government's new guidance on how the DES will work, and a document of Frequently Asked Questions.

The Direct Enhanced Service for the H1N1 vaccination programme

The DES sets out other arrangements for the swine flu vaccination programme, including:

• In order to receive the easement of thresholds, practices will need to achieve a patient uptake of 50.7% or more within JCVI priority group one (i.e. six months to 65 years)
• A six-week extension of the deadline for the collection of data on childhood immunisation for the third quarter of 2009 until 11 February 2010
• Practices can claim £5.25 for those housebound patients vaccinated even if arrangements are made with district nurses or other PCT staff to vaccinate housebound patients
• Practices that vaccinate their own staff should not qualify for the £5.25 payment ‘unless the member of staff is registered with their employing practice and falls into one of the JCVI at-risk groups'
• Locum GPs ‘should seek vaccination at the practice they are registered with in the first instance'

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