Seasonal Influenza Vaccination Service
Community pharmacy has been providing flu vaccinations under a nationally commissioned service since September 2015.
Each year from September through to March the NHS runs a seasonal flu vaccination campaign aiming to vaccinate all patients who are at risk of developing more serious complications from the virus. The accessibility of pharmacies, their extended opening hours and the option to walk in without an appointment have proved popular with patients seeking vaccinations.
The Community Pharmacy Seasonal Influenza Vaccination Advanced Service (Flu Vaccination Service) supports NHS England and NHS Improvement (NHSE&I) in providing an effective vaccination programme and it aims:
- to sustain and maximise uptake of flu vaccine in at risk groups by continuing to build the capacity of community pharmacies as an alternative to general practice; and
- to provide more opportunities and improve convenience for eligible patients to access flu vaccinations.
NHSE&I guidance on flu vaccines for 2021/22
On 4th February 2021, NHSE&I issued a letter providing information on the flu vaccines which will be reimbursable under the 2021/22 Flu Vaccination Service.
It is important that all pharmacy contractors that provide the flu vaccination service review the contents of the letter and use the information contained within to inform their ordering of flu vaccine for the season ahead.
It should be noted that the reimbursable vaccines listed in the letter are not the full range of vaccines that the Joint Committee on Vaccination and Immunisation (JCVI) recommended for use in 2021/22 (See below)
The following JCVI-recommended vaccines will be reimbursed as part of the NHS Annual Influenza Vaccination Programme for adults in 2021/22:
Those aged 65 years and over:
- QIVc (where aQIV is not available)
At-risk adults, including pregnant women, aged 18 to less than 65 years:
- QIVe (where QIVc is not available)
The letter notes the JCVI considered the use of QIV-HD in those aged 65, however, because of a significantly higher list price, QIV-HD is not eligible for reimbursement under the NHS Annual Influenza Vaccination programme for 2021/22.
JCVI also considered the use of QIVr in both those aged over 65 and those aged 18 to 64. However, QIVr is not eligible for reimbursement under the NHS Annual Influenza Vaccination programme for 2021/22 at this stage. The letter says further guidance may be issued on this vaccine.
The letter goes on to say community pharmacies should plan their ordering on the basis of meeting at least the numbers of vaccinations they achieved during the 2020/21 season.
Contractors will recognise that the 2020/21 season included additional eligible cohorts, particularly the 50-64 year old group, compared to previous years, but the letter makes no specific reference to the inclusion of this group in the 2021/22 season. The letter does however say:
As with 2020/21, there may be policy developments to extend the eligible cohorts during 2021/22. These developments will be informed by the levels and impact of COVID-19 infection to the population. In this situation, should additional cohorts be introduced, further advice will be communicated as soon as possible.
This consequently provides a lack of clarity on the eligible cohorts and PSNC has raised this issue with NHSE&I and the need for greater clarity to help contractors properly judge the appropriate vaccine numbers to order to meet demand, but also to reduce the risk of wastage.
The National Advanced Service for Seasonal Influenza Vaccination is available to all contractors that are successfully delivering their essential services.
The Service Specification and PGD for the current 2020-21 season can be accessed at https://www.england.nhs.uk/publication/community-pharmacy-seasonal-influenza-vaccine-service/
Key changes negotiated by PSNC for Comunity Pharmacy for the 2020-21 season include:
- Flexibilities to help contractors to offer the service in a COVID-safe way, allowing for vaccinations off-site and outside the consultation room
- Permission for pharmacies to offer flu vaccinations to care home staff at their place of work
- Administrative improvements including a new verbal consent model
Further details and the latest information can be found at https://psnc.org.uk/services-commissioning/advanced-services/flu-vaccination-service and https://psnc.org.uk/our-news/flu-vac-service-spec-published-and-new-flexibilities-agreed/
Additional FAQs have been published by NHSE&I and these can be access here:
There is also guidance for claiming additional costs for the current year, such as those associated with off-site provision or additional fridges. This can be accessed here:
Obtaining further stock of flu vaccines for 2020/21
The increased demand for flu vaccinations this years has resulted in many contractors and GP practices exhausting existing supplies of flu vaccines. The Government worked closely with suppliers to extend production runs and enable additional stock to be available for this season.
The Department of Health and Social Care (DHSC) has published guidance on how community pharmacies will be able to access these supplies of flu vaccines procured centrally by the Government. These communications are available below:
- DHSC guidance for community pharmacy on accessing DHSC centrally supplied flu vaccines
- DHSC guidance for NHS providers on accessing DHSC centrally supplied flu vaccines
2020-21 National Flu Letters
The latest information can be found at https://www.gov.uk/government/publications/national-flu-immunisation-programme-plan
For each flu season:
Contractors need to ensure that they have completed the following steps before they commence flu vaccination under this service:
For each Pharmacist delivering the service:
- Review the Declaration of Competency Assessment for Vaccinations on the CPPE website, if appropriate (see below)
- Print off, complete, sign and date the Declaration of Competency, ensuring you complete the box “Learning and assessment completed from other providers” with the details of the non-CPPE training you have used to achieve competence.
- Keep a copy for your records and submit a copy to each pharmacy premises where you will provide the service.
- Ensure that they have (and retain for their records) a completed and signed authorisation page (page 15) of the PGD for each organisation they are delivering the service for.
On 14 April 2020, NHS England and NHS Improvement issued a statement concerning amendments to the training requirements and resources in preparation for the September 2020 flu vaccination service.
This includes information on face-to-face training, online training and the annual online refresher training. This information supersedes the training requirements in this Declaration of Competence (DoC) framework. Please refer to this updated information before you start to work through this DoC framework and apply it when renewing your DoC statement.
For full details, please refer to the COVID-19 update (April 2020) on the PSNC website:
For each pharmacy premises, the contractor must ensure:
- There is a copy of the PGD that has been signed by someone authorised to do so on behalf of the pharmacy.
- There is a completed Practitioner authorisation sheet 2020-21 (MS Word Version) detailing who will be providing the service at the premises (these documents are extracts from the current PGD)
- There is a copy of each pharmacist’s Declaration of Competence
- The declaration form on the NHSBSA’s website has been completed for each premises.
- They complete and sign the authorisation page (page 16) of the PGD for each pharmacist who is delivering the service in their organisation (not each site).
For each vaccination, the pharmacy must ensure:
- The patient meets the eligibility requirements (see also the current ‘flu letters’ above)
- The patient is given a copy of the manufacturer’s patient information leaflet for the vaccine
- Signed patient consent is obtained and recorded
- The patient questionnaire is completed post-vaccination
- The patient’s GP is notified on the same day as the vaccination (or the following day if this is not possible).
Due to the potential for COVID-19 vaccination and gaps which may be required between receiving a flu vaccination and any COVID-19 vaccination, prompt notifcation of administration of a flu vaccine is critical. The Midlands NHSE&I Team are in the process of finalising funding for the appropriate PharmOutcomes licence to enable this to be done electronically, integrating with GP systems and reducing administration.
- An entry in the POM register (be it paper or electronic) is made for each supply.
At the end of the month, the pharmacy must ensure:
- Completed patient questionnaires are submitted to the NHSBSA in the month end parcel
- Appropriate claims are submitted for payment
- https://ecgtraining.co.uk/product/vaccinationfull/? – Accredited vaccination training provider
- https://www.npa.co.uk/services-and-support/– NPA provides both PGD and training.
- http://www.alliance-healthcare.co.uk/pharmacies/flu-vaccination-service – Alliance Healthcare provides flu vaccination service and you don’t have to be a member.
- http://www.aah.co.uk/shop/en-GB/aahpoint/flubooking – AAH provides flu training
- https://www.buttercupstraining.co.uk/course/vaccination-training-full-practical-online – Buttercups provides flu training
- https://www.flujabtraining.co.uk/courses/ – Flu Jab Training provides flu training and online refresher course
- https://www.locumkey.com/flujabtraining – LocumKey provides flu training in London area
- https://www.cb-training.com/vaccination-training/ – Charles Bloe Training Ltd provides flu training and online refresher course