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Vaccine delivery workload ‘fell purely onto GPs’, says UKHSA director

Vaccine delivery workload ‘fell purely onto GPs’, says UKHSA director

Workload around vaccine delivery ‘fell purely onto general practice’ in the past decade due to the fragmentation of the NHS, a group of MPs has been told.

MPs in the House of Commons Health and Social Care Committee are analysing the role of vaccination in preventative healthcare, as vaccines are one of 10 themes identified in the committee’s new inquiry into prevention in health and social care.

This morning they heard from pharmaceutical companies and experts including UK Health Security Agency’s director of public health programmes Dr Mary Ramsay and chief executive Professor Dame Jenny Harries, as well as Professor Sir Andrew Pollard from the joint committee on vaccination and immunisation.

Dr Ramsay told the committee that the fragmentation of the public health system, particularly after the 2012 NHS reforms, was ‘one of the weaknesses that we were trying to put back together’, causing the majority of workload to fall onto GPs.

She said: ‘A lot of the workload fell purely onto general practice. I believe general practice do a brilliant job and practice nurses are trusted, and they are experts in immunisation and can deliver to the bulk of the population very effectively.

‘General practice has a registered population they can reach out to, but obviously there are particular populations who don’t access that, and may be less regularly consulting with their general practitioner and may be more marginalised.’

There has been huge controversy around the QOF immunisations indicators, with GP practices in deprived areas especially missing out on payments because they have been unable to exception report patients who refuse to respond to multiple attempts at contact.

It comes after NHS England clarified that GP systems do include codes to exception report in specific circumstances for childhood immunisations QOF indicators, despite the contract stating otherwise.

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Dr Ramsay said that ‘a combined approach’ and ‘strong national coordination and national consistency’ are needed to reach people who might be hesitant to get vaccinated.

She added: ‘It may not be that they have hesitancy towards the vaccines, it may be practical things.

‘It’s quite important that we don’t throw the baby away with the bath water. We know general practice does a brilliant job and we know they have a group of people that they know is their population to serve to, but we need to work together at local level.

‘Hopefully ICSs will see that as an new opportunity but we need something even more local than that and people that know their communities and what the issues are.’

In August last year, as NHS England set out that GP-led sites will be paid a £10.06 item of service (IoS) fee for each vaccine administered – down from £12.58, GPs leaders expressed concerns about the workload and financial implications of the Covid booster programme.

Dr Ramsay added: ‘The lesson from Covid is that strong national coordination and a national vertical programme can deliver but obviously you have to be able to have local delivery as well and locally tailored delivery – I think a campaign is very different to the routine programmes.

‘With the routine programmes, we are protecting people for life and it’s about having a sustainable, consistent offer and following up, and all of those things work better in a joined up system.’

Last summer, London GP leaders expressed ‘substantial concern’ over an urgent polio booster plan and its effect on practice workload, after UKHSA and NHS England had tasked Greater London GP practices with identifying, contacting and delivering a polio booster jab to all children aged 1-9, and those who have not had a primary course.


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Please note, only GPs are permitted to add comments to articles

David jenkins 19 April, 2023 12:09 am

here is a copy of a letter i sent to “the national paper of wales” in december 2021.

AND it was published !

Dear Sir

I absolutely hate Christmas. I would be much, much, happier being in Carmarthen Showground over Xmas giving vaccinations to those who need boosters. I’m willing to do it for nothing.

Unfortunately. even though I am a practicing GP with over 40 years experience, I have been told I cannot do so because “I haven’t been trained”.

So I suppose I shall have to stay at home over the holiday, and have a bad head, and indigestion instead !

Dr David Jenkins, Locum GP, Ferryside

what response did i get ?

you’re right – absolutely none !!

p.s. i know what i would have done if i was a politician – i’d have said “let’s call his bluff – let’s see if he really will do it for nothing”

but i was quite safe – i knew they wouldn’t do that !!

paul cundy 19 April, 2023 1:31 am

Dear All,
Well done Dr Mary Ramsay and I hope chief executive Professor Dame Jenny Harries (to back her up). At last a simple sensible truthful and accurate assessment.
But hey ho lets not encourage the most effective healthcare delivery system in the universe to do this work, lets now outsource it to anyone who has no skin in the game and spies a short term gain.
Excellent, mature long term planning.
Paul C