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GPs in England will be alone in facing a pay lottery over flu vaccination for new at-risk groups after the Scottish GPC secured an agreement to guarantee payment.

The GPC told Pulse the Department of Health had rebuffed similar attempts for a deal in England and denounced the situation as a 'nonsense'.

Negotiators accused ministers of 'cowardice' for hiding behind the actions of individual PCTs.

The Scottish Executive last month issued a letter instructing health boards they were 'required' to implement local enhanced services to pay GPs for the extra work.

It follows similar guarantees from authorities in Wales and Northern Ireland.

Dr David Love, joint GPC Scotland chair, said it had negotiated the wording of the CMO letter before it was sent out to clinicians. 'We managed to get it sorted out before the letter went out and it was worded so it was quite clear where the responsibility for providing the services lay.'

But the department has said only that it would be 'up to the PCT' to consider local enhanced services after announcing that chronic liver disease patients and carers for the elderly would be added to the flu vaccine at-risk groups.

Dr Hamish Meldrum, GPC chair, said: 'We have not been able to reach an agreement for this year nationally so at the moment it will be down to local negotiations. It's for next year to try to get a resolution for this nonsense.'

Dr Andrew Dearden, a member of the GPC negotiating team, said: 'What we have got is a public health policy that is public in two countries but local in England.

'This is a way of either not doing the policy or of shifting the blame to others like PCTs and GPs. It smacks of cowardice to me.'

LMCs reacted with fury to the news and urged GPs not to do the work for nothing.

Dr John Canning, secretary of Cleveland LMC, said: 'It is wrong that they are doing it this way. It's not the responsibility of the GP, it's the responsibility of the PCT. GPs must not do it for nothing.'

Steve Mercer, chief executive of Avon LMC, said: 'We think that is totally unacceptable. This Government has done it time after time.'

By Emma Wilkinson

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