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Pharmacy flu scheme 'leaves GPs with £4m loss'

Exclusive The Government’s pharmacy flu vaccination scheme is leaving GP practices with a predicted £4m bill without reaching intended groups, GP leaders have claimed.

The latest immunisation data from the Pharmaceutical Negotiating Services Committee showed that pharmacies have administered some 470,000 (5%) out of 8.9m flu vaccinations recorded by Public Health England to date this season.

The GPC said the figures could translate to a combined £4m loss to practices in flu payments, money they had budgeted to provide other key services throughout the year.

One practice had already estimated the cost to general practice could be as much as £4m, ’money that could have been spent on caring for patients’.

NHS England announced the new pharmacy scheme over the summer, which it said would help boost uptake in ‘hard to reach’ patients, but the GPC warned pilots have consistently shown that pharmacy schemes do not change the overall number vaccinated - and that national scheme would undermine practices.

PHE has said the latest figures on flu immunisation uptake are ‘encouraging’ but GP leaders said the uptake remained largely the same as at the same stage last year. Although there was a marginal increase among some groups compared to last year, including pregnant women, concerns remained about coverage in other risk groups under 65.

And LMC leaders said there was no signs that the pharmacy scheme was reaching the hard-to-reach groups that the Government had targeted, who would not normally visit their GP.

Dr Andrew Green, chair of the GPC clinical and prescribing subcommittee, said: ‘What is clear is that while GPs continue to do the grunt-work for the vaccination programme, providing care to about 19 out of every 20 patients, they are being deprived of resources required to fund their practices.

‘The loss of 5% of vaccinations equates to at least £4m of resource being unexpectedly lost to GPs – money which will have been budgeted to provide services throughout the year.’

Dr John Grenville, secretary of Derbyshire LMC, said: ‘I don’t think we’re seeing an increase in overall uptake in any of the groups – I think we’re just seeing a redistribution of who is being done where.’

Solihull LMC secretary Dr Peter Scott said ‘around one in 20’ eligible patients who would usually have been vaccinated at the practice in previous years had opted to be seen in a pharmacy instead.

He said: ‘That has been the figure, so we are left with 5% of our vaccine undesignated. These are all low-hanging fruit. Not one of them was by any definition what I would call a hard-to-reach patient, a patient who would not ordinarily have seen us. None was receiving their first flu jab.’

NHS England said that as with ‘all new schemes’, this one would be reviewed and evaluated ahead of next year’s flu season but maintained that patients had benefited.

A spokesperson said: ‘The new community pharmacy service extends choice for patients wishing to get their flu vaccination in an accessible and convenient location.

Since the scheme got underway GP leaders have been warning this year’s flu immunisation campaign risked becoming a ‘shambles’, partly because of confusion caused by pharmacists, with some wrongly informing people their GP is too busy to give them the jab this year.

Correction: The story was updated 18 Dec to clarify that the £4m loss to practices is due to lost item of service fees, rather than unused vaccine

Readers' comments (30)

  • NHS England gave pharmacists the opportunity to provide flu vaccines in a deliberate attempt to destabilize general practice finances and line the pockets of pharmacists. NHS England has plenty of otherwise unemployed pharmacists, active in its ranks and devising ways of employing and funding their professional colleagues.
    It has become unviable for GP practices to mailshot their patients in the face of a dwindling return for their investment and this has lead to a breakdown in the coordinated recall system that worked so well.
    Pharmacists represent a massive threat to GP’s. In spite of lacking the skills of doctors, these retailers wish to muscle in on our work and are happily misrepresenting their skills (or lack of) to achieve this. Most people are shocked to learn that pharmacists have absolutely no training in diagnosis. So why do we tell people to see their pharmacist when they are unwell?

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  • This comment has been moderated.

  • I am pretty sure that our unused vaccinations can be returned without a loss to the surgery.

    We do lose out on not giving them (which is a major issue), but not because of wasted vaccinations.

    I think that spreading the vaccinations was always going to make the scheme work less well - but spinning the outcome benefits nobody.

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  • Slightly unfair. Pharmacists have been commissioned to do flu jabs and are trying their best to do so, within the constraints of the PGD and our access to records.

    On the whole I don't think that we are after your business and I was trained to respect the superior knowledge and training of the GP.

    In reply to the earlier comment. We are trained to diagnose minor conditions and if we weren't there to field these patients then GP's would be even more under the cosh.

    I also feel that this website churns these allegations out time after time with no evidence whatsoever, with the sole aim of stoking the argument between professions.

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  • I don't think that we as a practice are going to have unused vaccines on our hands as a result of the pharmacists carrying out 'Flu imms. In our surgery pharmacists have done around 50 out of 2 700 which is a statistically insignificant sum. However these 50 so called "hard to reach patients" are without exceptions able bodied individuals who have had regular 'Flu immunizations in the past and were consequently not exactly hard to reach OR were non at risk patients immunized privately. And then of course we have to do the work of entering the data onto the patient record as well-that's if they bother to send it. And then telling the patients "have it here and it will save your surgery the work". In other words cherry picking some easy patients, getting paid in excess for doing it and leaving us to enter the data. Cannot say that I am overly impressed with this. We as a surgery have very high coverage rates 83% of 65s last year I cannot see a pharmacy getting anywhere near this.

    So all of this for what? A few patients having their jab at a slightly more convenient time / place?

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  • A DH/NHSE spokesman called Ivan said 'we applaud the (predetermined) success of this scheme in improving patient choice'.

    Mo - We welcome....

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  • To 11.56
    Here we go again, trying to give the impression that your colleagues are trained in minor illness. The vast majority of pharmacists have not been trained in this. Whilst pharmacists can opt to do a minor illness course, it is not a standard part of their training. Furthermore, there is no revalidation of pharmacists.
    Pharmacists should stick to what they know. When I visit a restaraunt I expect the waiter to serve the food, not cook it.

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  • Integration? No

    Fragmentation, duplication, inefficiency, waste, confusion, professional resentment

    Any advantages of this scheme?

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  • Anonymous | Sessional/Locum GP17 Dec 2015 12:33pm

    Minor Ailment schemes are merely a vehicle for patients to get over the counter medicines without having to pay for them. Pharmacists are trained to deal with these ailments otherwise we would not be allowed to sell 'pharmacy only' medicines.

    Nice analogy about the restaurant. Friendly, hardworking and approachable waiter out front and aloof, self-righteous chef in the back. Takes both to make the restaurant work efficiently. That one was a tongue in cheek response for you and not for the GP's who don't feel threatened by pharmacists. There is no need to be as we can't do a great deal of what you do. That doesn't mean that there are jobs that you need to pass on if you are not to be swamped.

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  • If a flu jab was so hard to do then you wouldn't delegate it to someone who was answering the phones last week.

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  • The Pharmacist's Hymn:
    "Take this and if you are getting worse or not better very shortly go and see your GP as soon as possible."

    When waiting my turn I cringe to hear most pharmacists taking histories and advising. Most of their profit making "medicines" we stopped prescribing due to lack of evidence years ago.To be fair they do not get their feedback- we do and it teaches us a lot about the in-effectiveness of most of the stuff.
    One ancient way of paying doctors was to do so whislt one was well and stop it wnen ill till better.Consider that below.
    GBS's statement about private medicine fees is very applicable to pharmacies"If you pay a judge only to find accused guilty would it influence them in their judgements?.
    I have been trying to teach patients not to seek treatment but to let nature take its course with advisements of course.This takes time and sometimes extra reviews. This principle is undermined by some other professions. The pharmacy ethos is to make profits. I have never heard of a pharmacist just giving advice though I suppose this is possible.
    Their selling tactics undermine the priciple of natural cures where-ever possible.
    The NHS to some degree acts like the ancient payment method. If you do not satisfy your patients they will come back more often - more work less pay.
    Unfortunately if you are a hateful doctor you may frighten them away makeing your colleagues overwork.These do exist.

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