This enhanced service requires GPs to vaccinate vulnerable groups of patients and over-65s.
At our practice of 5,000 patients, with a relatively young population, achieving 100% coverage of all target patients would provide a total income of approximately £7,000. This is non-recurrent funding as most people only need a single vaccine.
This programme aims to protect vulnerable groups against pneumococcal infection due to Streptococcus pneumoniae, a common cause of pneumonia that can also lead to meningitis and septicaemia.
It comes under a directed enhanced service (DES) – which also covers seasonal flu vaccinations – and requires GPs to vaccinate those aged 65 years and over, and patients aged 2 years up to 65 years who are considered ‘at risk’, with pneumococcal polysaccharide vaccine (PPV23).1
Patients with no spleen or splenic dysfunction need to be vaccinated every 5 years, while everyone else only needs the vaccine administered once.
Target groups for PPV23 are listed in full in Annex A of the DES1 and include:
The fee for administering the pneumococcal vaccine is £10.06. It needs to be pre-ordered directly from the pharmaceutical company – this means practices can cut their costs if they negotiate decent discounts. Bulk buying can bring discounts, through buyer groups such as those run by LMCs. This should be done throughout the year, not just in flu season, due to ongoing vaccine shortages.
The vaccine reimbursement is claimed back from NHS prescription services (NHS Business Services Authority). With careful negotiation and swift claiming it is possible to get the reimbursement before paying the original invoice.
Practices must be signed up as delivering the service or ‘accepting a quality service’ on CQRS (Calculating Quality Reporting System) in order for payments to be made. Data for first doses are extracted automatically via GPES (General Practice Extraction Service) run by NHS Digital.
Updated business rules for 2020/21 including SNOMED codes are published on the NHS Digital website.
Payments are made monthly. Check the Open Exeter statement every month to ensure all the claims made correspond with monies received and make sure that any errors are chased up swiftly. Any problems should be addressed initially with the commissioner. CQRS and GPES errors can also be pursued via NHS Digital.
For patients requiring a PPV vaccination every five years, your practice should make arrangements for payment with the commissioner – payment is only automatic for the first dose. See ‘Claiming for a 5-yearly dose’ in NHS Digital’s guidance on this programme.
Dr Farzana Hussain is a GP Principal in East London
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