NHS England will launch 12 ‘demonstrator sites’ to test new models for delivering vaccinations, including health visitors taking on catch-up jabs for children.
This builds on the national vaccination strategy, outlined at the end of last year, which signalled a possible end to the current GP practice enhanced services and QOF targets, with ICBs set to take over population-level management.
The 12 sites, which will launch next month, will be testing ‘new and innovative’ models to deliver vaccines, NHS England said, exploring ‘more flexible approaches’ to improving uptake led by ICBs.
‘Specific areas that demonstrators will look to test include using health visitors to perform catch up with children; running MMR pop-up clinics in university spaces; and increasing uptake by people with complex needs, such as learning disabilities,’ according to a slide presented at an NHS England webinar directed to GPs last week.
Pulse has asked NHS England to provide more information about the pilots including what they will test and where they will be located, however the commissioner declined to provide this.
An NHS England spokesperson told Pulse: ‘As outlined in the NHS vaccine strategy, we are working with demonstrator systems across the country who are going further, faster to support access and uptake in innovative ways, and we will be promoting their learning and good practice to support all other systems.’
NHS England has previously said that some of the actions included in the vaccination strategy will begin to be implemented in 2023/24, with ‘as many changes as possible’ to be brought in from 2024/25 and most of the proposals set to be delivered by 2026.
But GPs have warned about the impact of potentially losing vaccination services, saying this could cause a ‘serious loss of income’ for practices.
RCGP chair Professor Kamila Hawthorne said that it will be important for any new vaccination programmes to work closely with local GP practices.
She told Pulse: ‘The recent spikes in cases of measles have brought to the fore the dangers of vaccine complacency and hesitancy – and any initiative that addresses this and extols the importance of vaccination programmes is worth exploring.
‘We’ll be following the progress of NHS England’s plans to launch 12 “demonstrator sites” with interest and look forward to seeing a robust evaluation of them, particularly in terms of effectiveness in increasing uptake both in typically hard to reach groups and generally, as well as any impact they have on established vaccination services.
‘We know that where vaccination programmes are successful, general practice has played a key role in their delivery – so, it will be important for any new programmes to work closely with local GP practices, drawing on the unique experience of GPs and their teams.’
Professor Azeem Majeed, head of the department of primary care and public health at Imperial College London, said he thinks offering vaccination through different providers will turn out to be less cost effective than investing directly in general practice.
He said: ‘I think it’s important to offer flexible access to vaccination services. My view however has always been that this should be done through investing in general practices so that they can work better with their local population to improve vaccine uptake in all groups and particularly those that are more likely to have low vaccination rates.
‘Offering vaccination through a plethora of different providers will turn out to be less cost effective than investing in primary care teams to do this work.’
Tower Hamlets GP Dr Selvaseelan Selvarajah said that he would welcome anything that expands where patients can get vaccinations from, but that this could cause ‘a big issue with integration’.
He told Pulse: ‘GP surgeries are part of the community and should always be at the heart of vaccination delivery, whether that is being run within community pharmacies or schools, by health visitors and so on.
‘What I would call for would be GP surgeries leading and be contracted to deliver the vaccination programmes in collaboration with everyone else. Otherwise, we risk fragmentation of vaccine delivery.
‘There’s a lot of trust being built by GP surgeries with patients and especially in the days of MMR vaccine hesitancy and misinformation, it’s important that patients have access to information coming from someone they trust.’
Dr Zishan Syed, a GP in Rochester, said NHS England needs to engage with practices and explain the rationale behind these proposals and their financial effects.
He told Pulse: ‘Vaccination is an important part of what GPs do and anything that NHS England does needs to be coordinated with GPs, because it has a significant effect on income.
‘The current funding does not match the demand in general practice, so the set up of these vaccination sites could take further funding away from core general practice, and it’s unclear why this is being done.’