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GPs will have to set up registers of high-risk under-65s for flu campaign

GPs will be ordered by the Government to set up registers of all high-risk patients, including the under-65s, in time for next winter's flu immunisation campaign.

The Department of Health is planning to issue guidance to ensure all practices have standardised registers as part of its drive to improve vaccine uptake in younger at-risk patients, Pulse has learned.

Payments for setting up registers and vaccinating under-65s are likely to be included in the new contract.

Public Health Laboratory Service monitoring of vaccine coverage will be extended to at-risk under-65s next winter. Monthly uptake data will be collected from all PCTs and poorly performing trusts will be targeted for closer scrutiny.

PHLS officials believe formal registers will help ensure GPs provide accurate returns.

Registers will have to include all over-65s as well as younger patients with diabetes, underlying respiratory, heart or renal disease and

immunosuppression.

PHLS data published last week in Vaccine (March) showed the 68 per cent national uptake achieved in over-65s in 2001-2 masked huge variations. In the lowest performing health authorities, GPs immunised just 50 per cent of patients, while the best performing authorities managed 76 per cent.

Dr Carol Joseph, consultant epidemiologist at the PHLS, will present final uptake figures for 2002-3 to the Government this week. GPs are believed to have met the 70 per cent target among over-65s well ahead of the New Year deadline.

Dr Joseph said: 'There is a plan to monitor uptake in

under-65s this winter. We are discussing with the Department of Health how to standardise the data. One big problem is that for things like chronic heart disease and renal disease, one doctor will define it differently from another.'

Dr George Kassianos, RCGP spokesman on immunisation and a GP in Bracknell, Berkshire, said registers should not pose a problem as lists of patients with heart disease and diabetes were already set up for national service frameworks.

But Dr Ian Dumbelton, chair of Cambridge LMC, said the plan implied the Government did not trust GPs to collect accurate uptake data.

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