Last year, only 50% of eligible, at-risk people took up the ’flu vaccination. In a bid to drive up numbers, pharmacists have been asked to assist ensuring more choice for patients. Dr Mike Townend asks if such a move is well thought through?

The ’flu vaccination season is almost upon us, and this year pharmacists are being invited to join the national vaccination campaign on a fee per item of service basis.

NHS England has stated that this move should help to reach those who would not otherwise receive the vaccine. They have said that ‘Primary care is not achievinghigh enough vaccination rates for clinical at-risk groups. During the 2012/13 ’flu vaccination campaign in England only around 50% of at risk patients were vaccinated’, and that: ‘Over three years, one PCT raised their vaccination levels in the over 65 year olds from 59% to 76% by the introduction of a community pharmacy service.’1

Pharmacy staff will be expected to identify eligible patients and encourage them to be vaccinated. There will be a payment of £7.64 per vaccination administered, with an additional £1.50 payment in recognition of costs incurred such as training, revalidation and disposal of clinical waste.

At first sight this appears to be a sensible move; patients may be able to be vaccinated at a pharmacy near their place of work or at a time more suited to them, though some GP practices may offer ’flu vaccination sessions outside their normal surgery hours.

However, there are drawbacks that will be obvious to most GPs.

Firstly, there is no recognised method of sharing records between GPs and pharmacists, making it difficult for GPs to know if their at-risk patients have been vaccinated or who they would need to vaccinate to reach their targets. There is clearly a need to ensure pharmacists keep adequate records of patients receiving the ’flu vaccine and that there is a suitable mechanism put in place for sharing vaccination records between GPs and pharmacists.

Secondly, GPs are likely to have ordered their supplies of ’flu vaccine in advance based on previous uptakes of vaccine. If large numbers of their patients are vaccinated elsewhere they will suffer financial loss from unused stocks of vaccine. This has led to the BMA’s General Practitioners Committee2 calling for compensation for GPs left out of pocket in this way.

Additionally, they have called for a review of the GP fee for the ’flu vaccination in view of the GP’s added responsibility for record keeping and call and recall systems – tasks we’re not sure if pharmacists will have to carry out at present.

Making the ’flu vaccination freely available at pharmacies may be seen as increasing patient choice, an important aspect of NHS care in the 21st century, and increasing ’flu vaccination cover of those at risk is a laudable objective, but this initiative appears to have been ill-planned and announced too late for GPs to order appropriate stocks of ’flu vaccine.

Insufficient thought has been given to record-keeping and sharing of records, and GPs should not be expected to suffer financial loss in its execution.

References
1. http://www.england.nhs.uk/wp-content/uploads/2013/12/winterpressures_community-pharmacy-services.pdf. Accessed 29/07/2015
2. http://www.bma.org.uk/practical-support-at-work/gp-practices/service-provision/vaccination/pharmacist-flu-vaccines  Accessed 29/07/2015