NHS England is working on aligning payments for flu and Covid vaccinations paid to GP practices but will not achieve this goal before 2025/26 at the earliest.
As it stands, NHS England flu vaccination payments are made directly to GP practices while Covid vaccination payments are made to PCNs.
At the NHS Confed Expo conference in Manchester this week, NHS England national director for vaccination Steve Russell was told this ‘remains a real sticking point’ for people working in general practice because it makes it ‘very difficult to join together flu and Covid campaigns’.
Admitting that the system is ‘an utter pain’, Mr Russell explained that aligning the two payment streams is difficult due to supply chain issues.
‘To align it in the way that you describe needs some changes. Some of those will be less popular than others, he said.
‘Our intention is – partly through the [upcoming national vaccination] strategy – to look to align more firmly in 2025/26. But that again still requires quite a lot of work around supply chain, contractual arrangements and so on, and that may be a little bit overambitious.
‘There is a general perception that 2026/27 looks possible and plausible but we think that feels like a long way off so we’re going to have a go at doing it for 2025/26.’
Among complications are the UK Government’s strategic partnership with Moderna, whereby it is committed to buying respiratory vaccines from the company, he revealed.
‘Moderna have, as well as other vaccine manufacturers, a desire to see whether it is possible to combine Covid and flu in time, also pending RSV – so there are things coming down the line and we have to organise ourselves now for it.’
During his talk, Mr Russell also revealed that NHS England’s expected new national vaccination strategy is likely to be published in the next few months, and that it would see some vaccination commissioning responsibilities delegated to ICBs.
Also during the session, Mr Russell admitted that vaccinations payments mechanisms within QOF and IIF have ‘quirks’ and said these were being looked at by NHS England.
Told by a delegate that item-of-service fees GP are paid for vaccinations are ‘not sufficient’, especially to target vaccine hesitancy, Mr Russell said: ‘We recognise that there are problems in the way that the funding currently works.
‘Some of the incentives in QOF and IIF are a bit funny and don’t always help people do what they want to. The Covid programme funding is non-recurrent, comes down in sort of six-month packets which doesn’t really allow people to plan. And the stuff that we’ve been talking about this morning on outreach – item of service doesn’t cover the cost of that.
‘So we have clocked all of that, and there are a set of proposals around that, and as we implement the strategy we will engage and consult on changes to the financial framework.’
He also said ICBs are encouraged to use their public health grant to help fund GPs to target vaccine outreach.
GPs had previously criticised childhood immunisation programme thresholds which were seen as punitive to practices in areas with high levels of vaccine hesitancy although there were some concessions to QOF reporting this year.