This season’s flu vaccination scheme has been plagued by difficulties. The Government’s new pharmacy flu vaccination programme aimed to vaccinate hard-to-reach patients, but has meant that fewer were vaccinated in GP practices. Many GP practices have been left with surplus vaccine, which the GPC has suggested could lead to a combined £4m loss to practices in flu payments. As GPs prepare to put in their orders for next season, Dr Andrew Green advises on whether it’s worth you offering the same scheme next season.
Will the next season be any different to last year’s?
I would be amazed if there was any significant change. The pharmacy flu scheme is unlikely to change next year, even if there is no evidence of increased overall uptake, as the Government remains wedded to increasing choice for patients even when services are fragmented as a result.
Should I consider scrapping the service next season?
Even with reduced numbers of patients attending general practice, GPs will probably find this a worthwhile service to provide, as it should remain profitable providing the above factors are taken into consideration.
How many vaccines should I order?
Practices will find it very hard to predict how many vaccines they will need next year, and every practice will be different so I can’t offer specific advice on whether practices should order the same number of vaccines as used last season. However, whatever you do, I would advise ensuring that you are not left with unused stock. You may do this by reducing the total number ordered, which might leave patients unprotected, or by ordering more on a sale-or-return basis, which will be more expensive so reduce practice profitability. Obviously neither option is ideal.
If I decide to order fewer vaccines, do I have to inform anyone?
Providing practices are genuinely trying to match ordering with expected demand, this remains a matter for the practice. Only if a practice is anticipating altering their previous arrangements significantly should they notify their commissioning body as soon as possible so that they can make alternative plans. This was, of course, exactly what didn’t happen in reverse last year, but that is no reason for us not to uphold basic professional standards.
How can I ensure I deliver more vaccines next season?
I would recommend practices ensure that their services next year are as patient-friendly as possible, for example looking into evening or weekend dedicated flu clinics. Practices do vary greatly in their arrangements and it might be worthwhile liaising with other practices to see what works well in your own area. Effective advertising is vital, and try targeting early those patients who went to a pharmacy this year. Having a ‘flu day’ when all the practice gets together – GPs, nurses, receptionists and bacon-butties – can be a team-building experience. Also consider talking to your patient participation group to see if they have any ideas as to how to make your service as convenient as possible.
Is it worth liaising with nearby pharmacies to ensure there is no overlap next year?
The statement from NHS England last year that they expected GPs and community pharmacies to cooperate over provision simply illustrates that they have no idea as to the financial pressures that GPs are under. The PSNC and NHSE have set up a competitive environment and the resulting difficulties are not our responsibility to address. I think it would be more beneficial to liaise with local practices to share good practice and to consider joint advertising. Care must be taken to ensure that any publicity concentrates on informing patients about the benefits of immunisation, and informs them as to the services available in GP practices, rather than criticising pharmacies or implying that visiting pharmacies will result in reduced level of other GP services.
Dr Andrew Green is chair of the GPC’s clinical and prescribing subcommittee and a GP in Hedon, Yorkshire