GPs could be tasked with vaccinating other PCN practices’ patients under new guidance
The BMA has raised concerns that GP practices who sign up to deliver Covid or flu vaccinations could be held responsible for vaccinating patients registered at other practices within their PCN, who decided not to sign up to deliver the service.
The union’s GP committee said that it has seen new guidance from NHS England which included wording around PCN-wide responsibility for vaccinations.
The guidance refers to a ‘year round pathway patient’ – those patients who are eligible for catch-up or additional dose of vaccination, including outside vaccination seasonal campaign periods – and says that in the event that such patient presents outside of the delivery period the practice must offer the patient a vaccination ‘which could be delivered by another practice in the PCN if agreed by the PCN’.
As part of changes to the GP contract, the Network Contract DES will include ‘explicit requirements’ for PCNs to ensure that eligible care home residents are identified and offered vaccinations.
NHS England said that this means PCNs ‘must ensure arrangements are in place to offer vaccination’, which could be ‘delivered by the registered practice or, if agreed, another practice in the PCN’.
Speaking at a BMA webinar last week, GPC deputy chair Dr Julius Parker said: ‘We’re checking with NHS England as to why they have moved to changing the responsibility to PCN-wide.
‘We know there is some wording in the new contract in terms of PCNs being responsible for ensuring that patients in care homes are offered vaccination, but that doesn’t translate into being responsible for giving it. So this is a quite concerning change in the guidance.’
Surrey and Sussex LMCs, where Dr Parker is chief executive, also put out communication to practices saying that now that both the Covid and flu enhanced services are practice-based, it is ‘clear’ that decisions about participating in one or both vaccination programmes are ‘a matter for individual practices’, and this should not create a consequential liability for PCNs.
The LMCs also said that that ICBs have circulated an updated version 2.0 guide to the
Vaccination Programme taking into account the proposed update to the PCN DES specification for 2026/27.
The LMCs’ advice is not to respond or confirm arrangements requested by ICBs in relation to this matter and await further advice from the BMA.
Their advice said: ‘The LMC recommends practices and PCNs do not respond to the ICB on any of these points and instead ask where in the Enhanced Service specifications or current PCN DES specification is there a reference to responding to commissioners with this information by the suggested date. The PCN DES specification for 2026/27 has not even been published yet ICBs are using this as a catalyst for such demands.
‘The LMC has previously expressed concerns that the planned IoS fees for 2026/27 mean the seasonal vaccination programmes may be uneconomic for GP practices to deliver.
‘If the approach above taken by NHS England, via ICBs, then this is likely to disincentivise participation further.’
NHS England told Pulse that PCNs are ‘collectively responsible’ and that ‘if none of its member practices has capacity’ could make arrangements for another provider to vaccinate these patients under an appropriate arrangement, for example via a subcontracting arrangement or a vaccination agency agreement.
It comes after Pulse revealed exclusively that GP practices across the country are considering not signing up to provide flu vaccinations amid concerns that the programme is ‘no longer financially viable’.
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