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NHS England in talks to extend ill-fated pharmacy flu vaccination scheme

Pharmacy leaders are in talks with NHS England about renewing the national pharmacy flu vaccination contract for a second season, despite concerns the scheme has contributed to a fall in uptake of the vaccinations and cost general practice millions of pounds

Pulse has learnt that pharmacy leaders are pushing for a renewal ‘as soon as possible’ and NHS England said arrangements would be announced ’in the next few weeks’.

But GP leaders said the pharmacy scheme should not be renewed if it has not improved uptake, because of the risk it would further destabilise the programme delivered by GP practices.

The national contract, introduced last September, paid community pharmacists across the whole of England to give flu jabs as part of the annual NHS flu vaccination campaign.

NHS England said the scheme would help more people get the flu jab, particularly those considered ‘hard to reach’ such as working-age adults who fall into clinical risk groups.

However, official figures have shown that uptake has fallen across all target cohorts of the population since the scheme was introduced and the GPC has warned it has disrupted established flu clinics and cost practices as much as £4m in lost vaccine payments.

Despite the fall in uptake and criticisms from the GPC, the Pharmaceutical Services Negotiating Committee (PSNC) confirmed to Pulse it is in discussions over renewal of the flu contract with NHS England for the coming flu season.

Alastair Buxton, Director of NHS Services at PSNC said in a statement: ‘We hope that the community pharmacy flu vaccination service will be recommissioned for the 2016/17 flu season.

‘We are pressing for an NHS and Department of Health decision on this as soon as possible.’

Asked about the talks with PSNC, an NHS England spokesperson said: ‘We expect to make an announcement in the next few weeks about the arrangements for the 2016/17 seasonal flu programme.’

Dr Andrew Green, chair of the GPC’s clinical and prescribing subcommittee, said: ’This service should only be recommissioned for next year if it can be demonstrated that there has been a significant increase in overall uptake over the last flu season.

’If this cannot be shown there can be no justification for risking the possible adverse effects of fragmenting the established system.’

Dr Richard Vautrey, deputy chair of the GPC, said: ‘The reality is that expanding the scheme this year has led to an overall fall in flu immunisation uptake which NHS England and Public Health England need to take serious steps to address.’

How the pharmacy flu scheme has impacted on GPs

GP leaders warned that expanding the pharmacy-led scheme last flu season risked leaving GPs out of pocket and disrupting the established flu vaccination campaign, based on results from a series of pilots across England and Wales, including a recently reported London-wide scheme

So far all the evidence suggests they were right. Coverage has fallen in all at-risk groups, with LMC leaders warning pharmacists were merely competing for ‘low-hanging fruit’ – motivated patients who would normally get their flu jab at their GP practice’s flu clinic.

In some areas pharmacists have ‘poached’ patients from their GP, under advice from NHS bosses. The GPC estimated it may have cost practices collectively as much as £4m in lost vaccine payments.

There are also concerns it is adding to practices’ administrative workload in order to keep track of who has been vaccinated, and disrupted other timely check-ups and services usually delivered at the same time as the flu jab – such as shingles vaccinations in the elderly.

Readers' comments (14)

  • fight fight fight. love it

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  • One has to conclude that they are trying to destabilise GP. There can be no other reason for this non joined up thinking.

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  • Evidence? What do you mean we're not commissioning on evidence?!

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  • Other factors that affected uptake negatively are conveniently forgotten. So a single provider that is often not located where the patients are and does not offer vaccinations at patients convenience is 'joined up' thinking? If surgeries offered a 'drop in' service over extended hours then pharmacists wouldn't have a leg to stand on in this argument. They don't!

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  • I have no idea how many of our patients were vaccinated elsewhere. I regularly find ad hoc when seeing patients that they were vaccinated at Boots or some other pharmacy, when I had assumed they had simply declined vaccination after we had asked them to attend.

    Sadly it seems that often we have not been informed which is unsatisfactory and may be an issue of safety if there is no reliable database of who has(n't) been vaccinated. If the system is complex, it risks failing.

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  • Fair point. If pharmacies aren't informing surgeries then they should be informed and reported. But on the other hand I sent a batch of notifications to our surgery and they forgot which email address they gave to our LPC, so din't amend the records.

    There are humans responsible for sending the information from the pharmacy and for entering it onto your system. There will be mistakes, but they won't all be ours.

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  • We opened a pharmacy in October, co-located in our surgery, having previously been a dispensing practice and needing to open up to prevent a potential competitor. Despite the words from the DH wanting to improve access to care, be it GP or pharmacy, they're cutting pharmacy reimbursement by 6% which may force them to close. We should be ok given co-location and rural area, with nearest competitor several miles away. I feel this is part of a drive of divide and rule. Play professions off against each other, keep em busy and distract them whilst the NHS falls apart.

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  • I suggest that the fall in uptake across all groups is much more to do with PHE announcing that the flu vaccine for 2014-15 was only effective in 3% of patients, leading most to think "Why bother?" I am surprised that GPs, when an invited patient declines a flu vaccination, doesn't follow it up to find out why. That would be if most benefit to everybody, especially the patient, as it gives the opportunity to discuss it with them

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  • I am surprised you are surprised Steve.

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  • When a stamp is 64p, I'm not going to chase up a patient via this method when the pharmacist gets to reap the benefit under the current scheme.

    At the very least give me a budget and an incentive to target those who are hard to reach that doesn't eat into the profit we make.

    Alternatively incentivise increases in uptake, 10p uplift for every jab given over the full campaign for every percentage point over 75%, regardless of who gave the flu jab. So a practice is incentivised to make the push and allow others to make the push for one more 1% point from 75% to 76%, a practice giving 1000 jabs would get an extra £100 for every 1% increase, even if the pharmacy took the business via the efforts of the practice communicating to the patient.

    Tell me I'm wrong. It would certainly have an incentive for our eligible under 65s. Might lead to bullying though.

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