GP practices can administer the quadrivalent (QIV) flu vaccine to patients over 65 as a ‘last resort’ and still be reimbursed in the usual way, the BMA has said.
But the new guidance said practices should, in the first instance, advise patients to return for their vaccination when the aTIV vaccine is in stock or signpost them to another provider such as pharmacies.
The advice comes amid warnings that practices may lose out on funding to pharmacies this season due to a supply issue the new adjuvanted trivalent vaccine (aTIV) that has been recommended for over-65s.
Practices which choose to administer the QIV vaccine to over-65s must first gain patient consent, and those found to have given the QIV vaccine ‘inappropriately’ face having their funding reclaimed.
Due to the aTIV supply issue, practices will receive their stock in a phased manner over three months, raising concerns they may run out between deliveries and have to turn patients away.
BMA GP committee chair Dr Richard Vautrey told Pulse: ‘Provision of QIV to over-65s is an option of last resort and should only be offered in exceptional circumstances, and when aTIV is not available and is highly unlikely to become available locally.
‘While practices will be reimbursed for delivering the clinically appropriate vaccine, we understand that consideration will be given to special circumstances related to availability.’
However, he warned that practices ‘found to have inappropriately provided the incorrect vaccine’, will have their payments recovered by commissioners.
Doncaster LMC medical secretary Dr Dean Eggitt, who is also on the BMA’s GP Committee, said the new advice had been issued because giving practices the option to administer QIV with patient consent ‘is better than nothing’.
He said: ‘We can’t signpost [patients] to another practice because we can’t vaccinate our non-registered patients, so essentially we’ll be signposting to pharmacy.’
He also said there was a risk patients would end up not getting vaccinated at all if they were sent to find their own provider.
He said: ‘It introduces a new element of risk if you say to a patient “you need a flu vaccine, can you go find it”. The risk is that they won’t go find it and then they’ll never get it.’
NHS England confirmed that GP practices can be reimbursed for administering QIV after first making attempts to direct patients over 65 to other providers.
But it added that practices seeking reimbursement for the use of vaccines in a way that does not adhere to guidance will be asked by to prove that their decision ‘was an exercise of reasonable care and skill as required by the GMS/PMS contracts’.
An NHS England spokesperson said: ‘In line with recommendations from the Joint Committee on Vaccination and Immunisation, GPs were informed in February this year that for the first time, people over 65 will be offered the newly-licensed boosted vaccine offering the best possible protection from flu.
‘The vaccination supplier has confirmed sufficient supply of the jab, and we expect CCGs to work with surgeries and pharmacists in their region, to ensure everyone is able to get vaccinated ahead of winter.’
Patients aged 18-65 should still receive the QIV flu vaccination.