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GPs could charge for wider range of travel vaccinations under PHE review

Public Health England is reviewing whether GPs should charge travelling patients for diphtheria, polio and tetanus, typhoid, hepatitis A and cholera vaccinations.

The review into the vaccines, which are currently available to patients free of charge, is separate from a wider consultation on over-the-counter prescribing in the NHS that was launched by NHS England in July.

Responding to a letter from House of Commons Health Committee chair Dr Sarah Wollaston, NHS England chief executive Simon Stevens said that NHS England ‘has asked [PHE] to separately conduct a review of the travel vaccines which you refer to in your letter, and which are currently available on the NHS’.

Dr Wollaston had raised concern that adverse public health consequences may outweigh any financial gains if NHS England would ‘cease to fund vaccines for overseas travel which protect against diphtheria, polio and tetanus, typhoid, hepatitis A and cholera’.

She highlighted that she understood ‘these vaccinations are predominantly provided to people travelling to the Indian sub-continent and Asia’.

But Mr Stevens said that ‘a full assessment of public health consequences of altering the availability of these vaccines’ would be undertaken and would include an assessment of any ‘disproportionate effect on any groups in the population’.

A PHE spokesperson told Pulse: ‘The work is still being scoped out between PHE and NHSE, so we can’t comment on this at this stage. ‘

BMA GP Committee prescribing lead Dr Andrew Green said there needs to be less variation in which vaccinations are offered free on NHS and which ones are charged for.

He told Pulse: ‘The current situation where some travel vaccines can be provided on the NHS and others cannot, is inconsistent and causes confusion for doctors and patients.

‘We would support the introduction of a unified system which is more easily understood providing it aligns with GPs’ contractual obligations.’

GPC chair Dr Richard Vautrey said: ‘There is a degree of confusion over which travel vaccines are free and which have to be paid for privately. It wouldn’t be unreasonable for patients to pay for vaccines as part of a package offered by their GP.

‘I can’t see this would raise significant income but it would clear up confusion and offer patients a one-stop shop which would be more affordable than going to expensive private travel clinics.’

NHS England is carrying out a national consultation on restricting the prescribing of 18 over-the-counter and ‘low value’ items in a bid to save the NHS hundreds of millions.

This brings up hepatitis B, Japanese encephalitis, meningitis ACWY, yellow fever, tick-borne encephalitis, rabies and BCG, depsite these typically not being provided free of charge for the NHS.

The BMA has opposed a blanket ban on OCT prescribing, arguing that GPs would be in breach of their contract if they refused to issue a prescription for treatment that they had recommended.

But local GP leaders renewed their call for the Government to allow GP practices to charge their own patients for non-NHS treatments at the annual LMCs Conference in May.

Which travel vaccinations are free on the NHS?

The following vaccinations tend to be free on NHS as they are considered to present the greater risk to public health:

  • cholera
  • diphtheria, polio and tetanus booster
  • hepatitis A – some combined vaccines, such as combined hepatitis A and B
  • typhoid

However, GP surgeries and private travel clinics alike tend to charge to vaccinate patients against:

  • hepatitis B
  • meningitis C and other meningitis vaccines
  • Japanese encephalitis
  • rabies
  • tick-borne encephalitis
  • tuberculosis
  • yellow fever