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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)

  • To Arrogant, sorry, anonymous session/locum GP -
    MOST GPs are forward-thinking and supportive of what Pharmacists can do. I can only surmise from your foam-flecked rhetoric that you can not be counted among them and you use anonymity to hide your own short-comings. That, I feel, is to the detriment of you and your patients and I am pleased you are not representative of those of your profession it is my pleasure to work alongside

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  • One aspect is not covered in the comments above. Surgeries maintain the clinical records and produce the lists. We send out mail shots, text and phone patients to get them in. We hold Saturday flu clinics where a doctor is present and the nurses get time and a half. All this costs a great deal. The drop of 5% in uptake can make the difference between profit and loss. I know that doctors are not meant to consider economics but when you are going through the through a GMS contract imposition you have to question everything. Next year I will reduce my vaccine order and if the enhanced service becomes unviable we will consider not opting in for future years. What will NHS England do then?

    They talk of patient choice. More like the wild west. The system was not broken; it is now.

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  • Here we go again. We want cooperation between health professionals not criticism and competition. There are good doctors and not so good doctors just like pharmacists. I can still remember some of the prescribing mistakes I have had to correct during my career. The NHS needs us to work together respecting each others slightly different skills.

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  • Jose Mourinho has just been sacked as Chelsea manager. See what happens when you disagree with a doctor...

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  • Time wasting excercise. There should be central hubs with administrators doing home visits.

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  • As a practice nurse I have given hundreds of flu vaccinations to patients this season. I see patients who rarely visit their GP. This gives me the opportunity to check their electronic notes & bring them up to date with annual reviews.

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  • According to the GPC “A GP, even a dispensing GP, is not allowed to sell any ‘over the counter’ medicines.”
    According to the Telegraph this is to “make sure that decisions to recommend medication are based solely on clinical factors.”
    But it’s ok to tell patients to consult with someone whose significant interest is to make profit from the sale of medication.
    Anyone else spot the contradiction here?

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  • I have been told that one of the highest performing pharmacies in the country for flu jabs is owned by a group of GP's.

    Is that ok?

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  • Dispensing GP. Anyone spot the conflict there?

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  • DH just announced 6% cut to community pharmacy contract https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/486941/letter-psnc.pdf

    "GP practices allocated 4% funding boost every year until 2021" http://www.pulsetoday.co.uk/home/finance-and-practice-life-news/gp-practices-allocated-4-funding-boost-every-year-until-2021/20030738.article whose "pockets are being lined" Anon Sessional/Locum GP?

    If some GPs "don't see Flu jabs as viable in future" there is somebody whos income is about to drop waiting in the wings to step up!

    Pharmacists DO have a role to play in managing patients health and minor illness and providing clinical services to patients whether egotistical Locum/sessional GP likes it or not. The "commercial interest" of pharmacists is negligible at most as most pharmacy income comes from NHS services (90%) http://psnc.org.uk/wp-content/uploads/2013/07/The-community-pharmacy-guide-for-GPs-and-practice-staff-July-20131.pdf . Most pharmacIES are owned by a multinational conglomerates and pharmacISTS get a salary like any other employee, they usually have little concern in what buying choices patients make [Patient: "I'll stick to the Nurofen because its got a nice shiny packet and an advert with a target in it so it must be better than the generic Ibuprofen which you're recommending as its cheaper/the same, thanks anyway though Mr. Pharmacist"] .All businesses need to make a profit though, otherwise they are not sustainable, whether thats a pharmacY or a General Practice. The double standards of "pharmacists are only in this for the money" vs. "I'm really upset beacuse I'm losing profit is laughable!"

    Can't we all just get along for the benefit of the NHS, ourselves and most importantly the patients? If they make a choice to get their jab from a pharmacy for whatever reason they choose, should we be denying them that? Particularly in the era of Patient Centred Care

    Rant over!

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