NHS England has said it is seeking MHRA approval for GPs to deliver Covid booster vaccines at an individual practice level.
The specification for the enhanced service, published last month, said that GPs wishing to participate in the booster programme must do so in PCN groupings as it is ‘not operationally feasible’ to offer the vaccinations at an individual practice level.
However, NHS England told GPs at a webinar about the programme the following day that it is ‘working with the MHRA’ to allow this.
NHS England medical director for primary care Dr Nikki Kanani said: ‘The requirement around primary care networks as recipients of delivery is just so that we can use that logistical supply chain in a sensible way. Rather than delivering to 6,700 practices we need to do that at a little bit of scale.
‘But providing the MHRA supports us and all of you in the system and the supply allows, we really want to get down to practice level.’
And NHS England director of primary care vaccination Caroline Temmink added that NHS England is ‘working with the MHRA to make sure that PCNs will be permitted to transport and administer vaccines at a practice level’.
NHS England is ‘hopeful’ that vaccine movement arrangements will be ‘as flexible as possible to allow people to deliver this in the best way for their population’, she said.
However, it remains unclear what exactly MHRA approval is needed for and what more it will permit above the arrangements in phases one and two of the programme.
NHS England has been approached for clarification.
Dr Kanani later added that while vaccine stock will be delivered to PCNs, GPs ‘will be able to move the vaccine in the way that we’ve already been able to’ where ‘equitable uptake’ needs to be ensured.
She said: ‘We are certainly not sitting here wanting vaccine to be stuck in one place, in fact, we want to get it out into every bit of the community as quickly and as safely as possible because that’s our best chance of getting people protected.’
And Dr Kanani reassured GPs there is ‘absolutely not’ a ‘deliberate move to reduce GP PCN involvement in phase three by restricting the number of sites but opening the doors to all community pharmacies’.
She said: ‘We know that general practice and community pharmacy have been placed under a huge amount of pressure already – let alone us heading into winter.
‘We’re trying to get that balance right to look after the service rather than to restrict it’.
In a recent GP Committee bulletin, the BMA said that local community delivery of both Covid and flu vaccines is ‘essential to the success of [the] programme’ and that local systems ‘must support practices to do this’.
It said: ‘It is very disappointing that NHSE/I is not listening to practices and has not done more to enable local groups to safely transfer vaccines delivered to PCN sites onto member practice sites should they choose to do so.
‘Yet at the same time, we have seen vaccines safely delivered in care homes, through buses, pop-up sites and smaller pharmacies. Moreover, vaccines have been provided to practices to deliver to their patients elsewhere in the UK.’
It added: ‘We will continue to challenge this unnecessary restriction which could lead to poorer uptake.’
The Pulse survey of GP partners also found that 5% of practices that were taking part in phase one of the Covid vaccination programme opted out of phase two because they were unable to administer the jabs themselves.
And former health secretary Matt Hancock previously said that he would investigate the possibility of Covid vaccinations being administered from individual GP practices.
Meanwhile, Dr Kanani also suggested in the webinar that the 15-minute observation period for the Pfizer vaccine is under review and that GP practices should still be able to deliver flu jabs even if they don’t sign up to give Covid booster vaccines.
Unveiling the 2021/22 flu vaccination enhanced service specification for GP practices earlier this week, NHS England said it was inviting ‘all practices’ to opt in to the programme over the next two weeks.
And the flu programme specification reiterated that a GP practice which is a member of a PCN grouping ‘may choose to work together with the GP practices in that PCN grouping to deliver [flu] vaccinations in accordance with this ES’.
A GP practice ‘may require the ability to sub-contract the delivery of the required clinical services to another GP practice in the PCN grouping or another party,’ it added.
Final guidance on whether flu and Covid booster jabs will be co-administered will be issued following JCVI advice, which is awaiting the results of a clinical trial.