GP practices in one region in the north of England have been told they can now vaccinate mordibly obese patients – those with a BMI of 40 or higher – under the national flu vaccination programme, contrary to national specifications, Pulse has learned.
Local GP leaders said NHS England in Yorkshire has confirmed practices will now be paid to vaccinate these patients, despite this being explicitly ruled out under the national enhanced service specification for the flu immunisation programme.
Department of Health advisors previously recommended that morbidly obese patients should get the flu jab, minutes of a meeting held a year ago revealed.
However, NHS England did not include this cohort in the list of clinical risk groups to be offered the flu vaccination under the national programme this year, causing some confusion over whether GPs should offer these patients the vaccination or not.
This year’s winter flu plan states that ‘funding has not been agreed to cover this cohort as part of this enhanced service’, and that ‘practices are able to use clinical judgment to vaccinate patients in this group, but vaccinations for morbidly obese patients with no other risk factor are not eligible for payment under this enhanced service’.
But it has now emerged that immunisation leads in Yorkshire have agreed that GP practices and pharmacists should offer these patients the flu vaccination – and will be paid for this activity.
Dr Dean Eggit, Doncaster LMC medical secretary, told Pulse that the LMC was in the process of writing to practices with confirmation that NHS England would remunerate them for vaccinating this cohort.
He said: ‘We’re sending out an email to our practices that having spoken to [NHS England], they have confirmed that although it does not say this in the enhanced service, they will honour this payment as per the Green Book.’
Dr Eggit said: ‘I don’t think across Doncaster it’s going to be a large number of patients but nationally it may be a significant number – and if you save one patient from having flu and dying from it, isn’t that the whole point?’
Sheffield LMC also said the payments would apply for their practices.
The GPC said its own advice to practices was that ‘there is no obligation to vaccinate patients with BMI over 40 and that no pressure can be applied to practices as this is not about clinical risk, but due to a funding decision by NHS England’.
However, Dr Eggit said he would now ‘be asking GPC to go back to NHS England to reconsider the national position and send out a national line on this’.
Dr Andrew Green, chair of the GPC prescribing committee, said: ’Currently, there is a discrepancy between the groups for whom the influenza vaccine is recommended and those for whom the administration is funded. This is clearly inappropriate and we will endeavour to get all such groups included in the payment scheme for next year.’