GP practices considering stopping flu vaccinations due to financial viability
Exclusive GP practices across the country are considering not signing up to provide flu vaccinations amid concerns that the programme is ‘no longer financially viable’, the BMA has told England’s chief medical officer.
In a letter to Professor Chris Whitty, seen by Pulse, the union’s GP committee raised serious concerns around vaccination funding for practices.
It said that funding for provision of routine immunisation programmes is ‘contributing to the general decline in funding’ for practices, pointing out that item of service payments were last uplifted in 2019/20.
The GPC also warned that many practices feel that participation in the annual flu programme is ‘no longer a financially viable option’, with costs of providing flu clinics (including additional staff, and clinical time) ‘having risen substantially in recent years’, while funding for the programme ‘has remained static’.
The letter said: ‘We are already hearing from practices across the country that they do not intend to sign up for next year’s flu programme and consequently are not planning on ordering vaccine stock.’
It added that these concerns have been raised with NHS England during discussions on proposals for the annual flu programme ‘to no avail’, and GPC England is concerned that any action to address the situation will only come once practices ‘actively start to pull out of the programme’ for financial reasons.
It also added that despite an agreement from NHS England to uplift the payments for routine childhood vaccinations by £2 per dose, funding for GP vaccination programmes has ‘fallen significantly behind inflation’ since the last uplift.
The letter, signed by GPC deputy chair Dr Julius Parker, said: ‘We believe that safeguarding and increasing uptake for these programmes should be a priority for the Government and the NHS, especially in light of the risks we’ve seen in recent years from infectious diseases alongside falling rates of vaccination.
‘Delivery of vaccinations remains a core aspect of general practice and something that our members see as a key part of the service that they provide to their communities.’
It added that the consequences of the ‘real term decline in funding’ for vaccination programmes ‘can be severe’ for both GP practices and patients.
The letter said: ‘The reduction in funding for provision of routine immunisation programmes is contributing to the general decline in funding for general practices, with practices needing to make difficult financial choices on things like their clinical workforce and non-contractual services that they would otherwise like to be able to offer.’
At the end of last year, NHS England announced that the item of service fee for the adult influenza vaccination service will be £10.06 in 2026/27.
Sign up for the adult flu services ‘will be announced in due course’, the commissioner said, and practices will be invited to sign up by 31 July 2026.
If practices have signed up to deliver the COVID-19 vaccination service, they will also be required to deliver the flu vaccination service, which requires a separate sign up.
NHS England also announced that there will no longer be an additional £10 payment for the administration of Covid-19 vaccinations to housebound people.
Practices will be able to claim £8.70 per vaccine administered between 1 September 2026 and 31 January 2027 while the flu campaign is underway; and £10.06 outside the flu campaign.
However, GPs have raised concerns that the removal of the housebound fee will make the programme ‘unviable’ for practices.
In an update to practices, Kernow LMC said: ‘There are fears NHS England’s decision will render that aspect of any future campaign unviable for GP practices, taken in conjunction with a general lack of uplift across influenza and Covid vaccination payments.
‘This is a vulnerable patient cohort and the decision seems likely to increase inequity, rather than contributing to a measurable improvement in their healthcare.’
A Department of Health and Social Care spokesperson said: ‘We are investing an additional £1.1bn in general practice to reinforce the front door of the NHS, bringing total spend on the GP contract to £13.4bn in 2025/26 — the biggest cash increase in over a decade.
‘After years of decline, we are rebuilding general practice — recruiting an extra 2000 GPs and giving GPs more time to spend caring for patients.
‘GPs and their teams play a vital role in delivering vaccinations to their communities and we are grateful for their continued efforts. We will continue to work closely with the profession to ensure patients can access the vaccines they need.’
Pulse has contacted NHS England for comment.
In his annual report – looking at infectious diseases – Professor Whitty had warned there is a need to be more ‘systematic’ about preventing infections in older age groups who can ‘suffer significant harms’.
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READERS' COMMENTS [7]
Please note, only GPs are permitted to add comments to articles
But it isn’t just the IOS fee. The Flu vaccine cost reimbursement is opaque at best. Large manufacturers charged around £18/vaccine 25/26 with reimbursement from NHSE and by extension our ICB only a paltry £12.50/vaccine with no coherent explanation as to why this is, meaning the vaccine cost is subsidised by the IOS fee. So for all the effort and work vaccinating some 1600 eligible patients for my paractice, we have ended up with around £3000 ‘profit’ which does not even cover staff costs and amounts to a net practice loss. We have cancelled our Flu vaccine order for this year as a result. I urge England wide practices to take a close look at not only their poor IOS fee but also the cost reimbursement which is likely to leave them out of pocket.
1600 vaccinated patients generates £16,000 in IOS fees plus vaccine purchase profit. How do you make only £3000 before staff costs and end up with a net practice loss?
1600 vaccinated patients brings in £16,000 (and change) in IOS fees.
Purchase of 1600 vaccinations costs about £ 31,000; of which about £20,000 is reimbursed.
16,000+20,000 minus £ 31,000 leaves about £5,000.
Approx, in gross terms.
Cost of consumables = ?
Cost of staff time, at 5 minutes per patient – assuming they undress themselves and dress up again elsewhere, would be 8,000 minutes, or over 130 hours.
If Nurse time costs only £20 per hour, this is still £ 2,600 minimum for the 1600 patients.
Then there is admin staff to manage the WIS, etc
It adds up to a net profit in the minus figures, possibly substantially.
I did not include any home visit costs. And I think I included a good deal on purchase price in bulk!
Exactly DC, if you were reimbursed the whole vaccine cost KM, it demonstrates a variable aproach to reimbursement that is grossly inequitable. Vaccine cost £18 v reimbursement £12.50. Maybe check your figures?
Pharmacies and other private providers seem to be be able to buy at profit and undertake all manner of services from immunisations to huge profits from weight loss injections etc. with a fraction of the oversight in respect of training , quality checks for staff or infrastructure and it is increasingly an uneven playing field. Why in this case are not GP practices allowed to supply, stock and administer these other hundreds products if pharmacists are ??
Purchase price is £15.25 after discount from Seqiris. Reimbursement is almost £17.50 if you include the PA allowance aka dispensing fee.
Overall profit for Flu as other’s say is very borderline -and not without financial risk.
If we overpurchase (> 10% sale or return) we end up bearing a loss which can easily wipe out profit. More so now flu jabs are more expensive (£18 vs £5-6 from previous years).
£10.06 needs to be uplifted annually at least by inflation too. Pharamacy fridges are expensive -£1500 plus and require lots of man hours documenting temp, Staff costs going up