Published 3 August 2020
Please note this guide refers to the core 2020/21 seasonal flu DES – the newly expanded flu campaign due to COVID-19 includes additional cohorts, as detailed separately here.
This enhanced service requires GPs to vaccinate vulnerable groups of patients and certain health and social care staff.
This directed enhanced service requires GPs to vaccinate those aged 65 years and over, pregnant women, patients aged six months up to 65 years who are considered ‘at risk’, carers and locum GPs.
GP practices are also contracted separately to vaccinate two- and three-year-olds under the childhood flu vaccination enhanced service.
For 2020/21, the adjuvanted trivalent influenza vaccine (aTIV) is recommended for those aged 65 and over, while at-risk infants aged 6 months to 2 years should receive the egg-grown quadrivalent influenza vaccine (QIVe), at-risk 2-9-year-olds should be given the live attenuated influenza vaccine (LAIV) unless contraindicated, and a newer, cell-based quadrivalent vaccine – QIVc – is recommended in at-risk groups aged 9-18 years. (See box)
Vaccine ordering varies. It is possible to submit orders a year ahead but last-minute changes to vaccines in recent years have caught practices out.
The target groups for seasonal influenza vaccination are:
See Annex B of the service specification for a full description of the eligible cohorts.
Note that under the expanded flu vaccination campaign for 2020/21, set up to protect those also vulnerable to COVID-19, the following groups will also be eligible for vaccination by GPs:
The fee for administering a seasonal influenza vaccine is £10.06. The vaccine needs to be pre-ordered directly from the pharmaceutical company – this means practices can cut their costs if they negotiate decent discounts. This involves liaising with drugs reps as early as January for the following winter. Bulk buying can attract discounts and there are buyer groups, such as those run by LMCs, which can help.
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.
NHS England/Improvement will reimburse the following vaccines in 2020/21:
• aTIV for those aged 65 years and over
• QIVc for those aged 65 years and over (where aTIV is not available)
• QIVc and QIVe for at-risk adults aged 18 to less than 65 years (including pregnant women) and at-risk children aged 9 to 17 years for whom LAIV is unsuitable and where locally procured vaccine stock has been used.
The LAIV for children should be ordered through ImmForm from centrally purchased supplies, with QIVe available to order for children in at risk groups aged less than 9 years old who are contraindicated to receive LAIV.
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. These data are extracted via GPES (General Practice Extraction Service) run by NHS Digital.
Payments will be made monthly. Check the Open Exeter statement every month to ensure all the claims made correspond to monies received and make sure that any errors are chased up swiftly. Any problems should be addressed initially with the commissioner (which is the CCG if delegated co-commissioning or NHS England otherwise), and CQRS and GPES errors can also be pursued via NHS Digital.
Dr John Allingham is medical secretary at Kent LMC
Vaccines recommend for 2020/21 Seasonal influenza vaccination programme (as defined in the annual flu letter)
|At risk children aged from 6 months to less than 2 years||Offer standard QIVe||1 dose unless first influenza vaccination in which case a second dose is recommended at least 4 weeks after the first|
|At risk children aged 2 years to less than 9 years||Offer LAIV unless contraindicated, then offer QIVe||1 dose unless first influenza vaccination in which case a second dose is recommended at least 4 weeks after the first|
|At risk children aged 9 years to less than 18 years in clinical risk groups||Offer LAIV unless contraindicated then QIVc is recommended. If QIVc is unavailable, QIVe should be offered as an alternative.||1 dose|
|At risk adults 18-64 years (including pregnant women)||Offer QIVc or QIVe as an alternative to QIVc||1 dose|
|65 years and over||Offer aTIV or QIVc if aTIV is not available.||1 dose|
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