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Talks collapse over national swine flu vaccination programme for under-fives

By Lilian Anekwe

Talks over a national agreement for GPs to provide swine flu vaccinations to children under five have collapsed after the BMA refused to sign up to a deal, claiming practices would be swamped.

In a statement released today the Department of Health said it had failed to reach a national payment deal for GPs and so had been left with no option but to ask PCTs to ‘put local plans in place to vaccinate this group', including inviting pharmacies and private providers to offer the jabs.

‘NHS Employers has been in discussion with the British Medical Association's General Practitioners' Committee to seek a national agreement on the vaccination of this group of children through GP practices,' the statement says.

‘This has unfortunately not proved possible. Ministers have today therefore asked PCTs to put local plans in place to vaccinate this group.

‘We hope many GPs will still decide to vaccinate under fives. But where GP practices do not wish to vaccinate this group, PCTs will determine whether vaccinations will be offered through other local GP practices, their directly managed staff or by arranging with alternative providers.'

The GPC claims the Government refused to support measures to free up staff time to stop GPs being overrun.

Lead negotiator on swine flu, Dr Peter Holden, told Pulse general practice was buckling under the pressure of swine flu vaccination workload and hit out at the Government for ‘flogging' GPs to take on an unsustainable workload.

Dr Holden launched an astonishing attack on the Government, accusing it of ‘lacking the balls' to take action to suspend the QOF and relieve GPs of the crushing pressure of swine flu vaccination workload.

‘The DH seems to believe that general practice is infinitely expandable,' he said. 'It thinks it can carry on flogging the staff to deliver everything all the time. That is not the case.'

Dr Holden warned that the workload involved with the under fives would be huge.

The GPC estimate each practice will have to find an additional 40 hours of appointments a week to complete the task.

‘Prevalence has fallen but the issue is we are running a mass vaccination campaign. People need to understand how many hours that takes,' he said.

‘The average practice has 336 children in the age group. When we come to do the under fives, even though it's only one jab, the average practice is going to have to find something of the order of 30-40 hours of time.

‘You'll need two clinicians doing over a week's work and nothing else. There isn't this kind of spare capacity in general practice. We need relief from the routine stuff.'

‘You can't keep flogging the workforce. They need to understand they have a workforce which is at its limits. I personally think its time they recognised that. This has all been communicated to DH and we await ministerial decisions.'

In a letter to all GPs, Dr Laurence Buckman, Chairman of the BMA's GPs Committee, said it had not been possible to reach an agreement with the Government on a national framework but instead said plans should be put in place locally to ensure all eligible children are vaccinated 'as quickly as practically possible'.

Commenting on the announcement Dr Buckman said: 'We sincerely wanted to be able to reach a national agreement with the Government about a process for vaccinating the under fives against swine flu.'

'Unfortunately this has not been possible, because the Government would not support adequate measures to help free up staff time. At the busiest time of the year for general practice, with surgeries already dealing with the additional work of vaccinating the first wave of at-risk groups, we felt this was vital in order to ensure this next phase could be carried out quickly.'

'We would encourage local medical committees and primary care organisations to put in place arrangements that are sensitive to the workload pressures in their area. These should be agreed as soon as possible.'

'We appreciate that parents of young children might be worried when they hear that there will be no national framework and want to assure them that this does not mean their children will not be vaccinated.

'We know many PCOs have already been in contact with GPs in their area to talk about making local arrangements. Given that most practices are also currently working through their vaccination programme for the first wave of at-risk groups, we don't anticipate delays in the vaccination programme for the under fives getting under way.'

Health secretary Andy Burnham said he was ‘disappointed' not to have reached an agreement, but vowed to press on with vaccinating all healthy children aged six months to five years, along with other priority groups, before Christmas.

‘It is disappointing that we have not been able to come to a national agreement with GPs to vaccinate children from six months to five years old. But we are now getting on with the job and asking local health trusts to put local plans in place so that vaccination of these children can begin seamlessly.

‘The supply of vaccine is increasing and we should therefore be able to meet the demand for vaccine and begin vaccinating children before Christmas.'

Vaccination campaign plans for under-fives have collapsed Vaccination campaign plans for under-fives have collapsed

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