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Independents' Day

Third of practices report being left out of pocket from pharmacy flu scheme fiasco

Exclusive Over half of GP practices were left with unused flu vaccine at the end of this year’s flu season following the last-minute introduction of a national pharmacy scheme that encouraged patients to get their flu jabs from their pharmacist, a Pulse survey has revealed.

The survey also found a third of all partners said their practice also lost out financially as a result of wasted vaccine – in some cases by thousands of pounds – as they were unable to negotiate a refund from their supplier on unused stock.

The national pharmacy flu vaccination scheme was introduced by NHS England for the 2015/16 seasonal flu vaccination campaign, but was only announced just two months before the start of the flu season in July.

This led to outcry from GP leaders who warned it would take work away from practices and risked them being out of pocket from unused vaccine that they could not return, as well as through lost vaccination fees and extra administration.

The Pulse survey found that out of 504 GP respondents, over half – 284 (56%) – said they were left with extra unused flu vaccine at the end of last flu season. Many commented that this resulted directly from the late introduction of the pharmacy scheme.

In addition, 168 GPs (33% of the total number of respondents) said they were out of pocket as a result of having left-over vaccine.

Some GPs reported they had been left with several hundreds of doses and lost thousands of pounds, because they were not able to negotiate a return on all unused stock with the vaccine supplier.

Dr Jonathan Ring, a GP partner in Huddersfield, told Pulse his practice had lost around £2,500 from unused flu vaccine as the practice could only return 10%. He estimated they had lost around £5,000 in total this year taking into account extra administration costs.

Dr Ring said: ‘We have wasted literally thousands in both ordering unneeded flu jabs and recalling and chasing patients who unbeknown to us had already had their jabs via the pharmacy.’

In Essex, another GP partner reported losing around £3,000 after being left with 400 unused flu shots.

Dr George Kassianos, RCGP lead on immunisation, and a GP partner in Wokingham, told Pulse this reflected experience at his practice.

Dr Kassianos said: ‘We did our very best with open days and opportunistic vaccinations but were disappointed at the end to see we were left with a huge number of unused vaccines, largely representing the flu vaccine doses the six pharmacists around us must have given.

‘For this year we have reduced our order of flu vaccine by 50% and reduced the number of vaccine providers from four to two. I am struggling to keep up the team’s enthusiasm for vaccinating but the feeling is that GP practices were undermined by the sudden move last year, resulting in huge losses because of left over vaccine in the practice fridges.’

The controversial pharmacy flu scheme

flu jab 2

NHS England recently gave the go-ahead for the pharmacy scheme for the 2016/17 flu season, despite the GPC warning that it should not be recommissioned unless there was any sign of improved uptake.

NHS England has insisted that the scheme offers patients more flexibility and picks up more ‘hard to reach’ patients, so helping to boost vaccination coverage, but official data indicate that vaccine uptake fell across all the at-risk target groups last season, and the GPC has warned it has disrupted established flu clinics and cost practices as much as £4m in lost vaccine payments.

Some local GP leaders reported that pharmacists were competing aggressively for practices’ usual patients, creating confusion and extra paperwork in the process.

Commenting on the survey findings, Dr Andrew Green, chair of the GPC’s clinical and prescribing subcommittee, said: ‘It is of deep regret that these practices have been deprived of the resources they need to provide patient care by the introduction of this scheme without any notice period or negotiation, and it provides a good example of the adverse consequences that can happen when care is fragmented.

‘Hopefully these practices will have been able to adjust their orders for this year, though as we have previously said this will make full patient protection in the event of an epidemic harder to achieve.’

NHS England declined to respond to Pulse's query on whether it would pay compensation to GP practices for the wasted vaccines.

However, an NHS England spokesperson said: 'We expect our early announcement on the recommissioning of the Community Pharmacy Seasonal Influenza Vaccination programme for 2016/17 will benefit GP practices when it comes to preparing stocks, placing orders and help to avoid any unnecessary costs. We will continue to review and evaluate the scheme.

'GPs and pharmacies can also arrange "sale or return" arrangements independently or utilise group purchasing schemes to save costs.'

Survey results in full

Has your practice been left with unused flu vaccine after this year’s campaign? (Partners only)

Yes: 56% (284)

No: 35% (175)

Don’t know: 9% (45)

Has your practice lost money as a result of unused flu vaccine? (Only those who answed yes to the first question)

Yes: 59% (168)

No: 22% (64)

Don’t know: 19% (52)

The survey was launched on 28 April 2016, collating responses using the SurveyMonkey tool. The 24 questions asked covered a wide range of GP topics, to avoid selection bias on one issue. The survey was advertised to readers via our website and email newsletter, with a prize draw for a Samsung HD TV as an incentive to complete the survey. A total of 504 GPs answered the first question, and 285 answered the follow-up question.



Readers' comments (16)

  • Let's be honest It's all about the ££££. Nice to to see also the case with junior doctors. The leaked emails finally revealed they just wanted a pay rise, though it had to be presented to the public as 'patient safety'.

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  • Need a bit more data to drawn the conclusions in the article. How representative was the sample, what were the comparative figures for the previous year and how did overall take up rates change?

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  • "Let's be honest It's all about the ££££"

    It is all about the £££ when you have a service to run. Are you suggesting that practices should run this service for less than the government pays for it - ie are you suggesting that GPs should pay out of their own pockets to vaccinate people?

    Bit rich coming from the shop owners that sell linctus / homeopathy / herbal remedies that we all know do very little....

    And the JD leaks don't show that - have you ACTUALLY read them?

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  • Yes of course it all about money even with junior doctors, nothing to do with impossible working conditions. Read this Pharmacist 10:28 -

    Just hope you haven't got any children that fall seriously ill.

    And of course pharmacist are all about saving the world.

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  • I have to say that I'm ashamed at my fellow pharmacist's comment about junior doctors. They have my full support and, even so, why mention it in a discussion about flu vaccinations? My hubby is a junior doctor and the sacrifice and time he has given to his job is admirable. In fact, we're now living in Canada for a few years for his fellowship so that he can bring back the skills he has learned to benefit our patients back home.

    It's a pity that money was lost in GP practices but perhaps this should be lesson for the next flu season, i.e. supply the vaccines where there is the demand. The pharmacist is the most accessible health professional on the high street and it is important that we use this to the advantage of ensuring patients get the appropriate treatment at the appropriate time, in this case flu vaccinations. I administered many vaccines to people at high risk for flu who simply didn't get it in previous years from their GP because it was too inconvenient and didn't work around their work schedule.

    With regards to the comment about homeopathy and the likes, not all pharmacists sell this nonsense. Most of us have high standards of ethics and evidence based practice.

    Bottom line, we need to support each other to the benefit of our patients.

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  • Early announcement? When?

    NHS England have a habit of ignoring the rule, that it is better to be quiet and look ignorant than to open your mouth and confirm it.

    The best discounts and therefore best ordering time for Flu Vaccine is before Jan 1st each year. Confirming the continuation of the scheme over 4 months after that date and just 2 months earlier than the previous year shows just how little NHSE understand about how General Practice works.

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  • @ Pharmacist 10:28

    So in three years time you won't mind having a 30% pay cut if money is not important to you and your family.

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  • How about GP practices being allowed to sell OTC medication or even dispense FP10s. A one stop shop for patients.

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  • I have no objection as long as we have a level playing field. Why can we not offer private vaccines which would generate much needed income at no cost to HMG?

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  • Why not let pharmacies do them all, including the housebound.
    Let's see how that pans out.

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