UPDATED 27 SEPTEMBER 2022
There is a target for 100% of eligible patients to receive an invitation for flu vaccination. At a typical practice of 5,000 patients, achieving 100% coverage of all target patients would provide income of approximately £10,000.
NHS England has confirmed eligibility of the 2022/23 campaign as being:
Primary school age children are also eligible for the NHS vaccine but are now being immunised by the school age immunisation service. Similarly, children aged 2 or 3 on August 31 are eligible but are covered by a separate enhanced services contract.
Practices have been asked to start vaccinating the 50 to 64 year olds (not in clinical risk group) from 15 October 2022.
The complimentary NHS flu vaccination offered to primary care staff has not been extended for the 2022/23 season. So, vaccinations for this group, like other frontline healthcare staff, revert to being an employer’s occupational health responsibility. This includes GPs and their staff.
Under the 1974 Health and Safety at Work Act employers are required to protect employees from risks associated with their work and this could include contracting influenza. Since GPs are not been able to provide occupational health services under the GMS contract (they have to offer it as a private service to employers), it means they cannot claim for an item of service fee or dispensing fee for vaccinating staff. As mentioned, this situation changed last year so practices didn’t suffer any monetary loss but has reverted to the pre-pandemic arrangement this year.
That said, reimbursement can be claimed for members of your frontline patient-facing team who also fall within the eligibility criteria for an NHS jab due to age or clinical risk and are registered with their employing practice.
Meanwhile, locum GPs remain eligible for a an NHS jab from any practice whether they are registered there or not, for which surgeries can be reimbursed, says the 2022/23 Enhanced Service Specification for the flu vaccine programme.
The flu campaign has become increasingly complicated because of the different types of vaccine used for different cohorts. It is important to ensure staff are familiar with the latest guidance and the right vaccine is given to the right patient. The vaccines that will are reimbursable as part of the programme are:
For those 65 and over – aQIV or QIVr. (QIVc may be used if others are unavailable)
For all in at-risk groups, including pregnant women, and those aged 18 to 64 – QIVc or QIVr. (QIVe may be used if others are unavailable).
For 50-64 year olds not in a clinical risk group – QIVe. (QIVc / QIVr can be offered where it’s not needed by the clinical at-risk groups and over-65s. Vulnerable cohorts take priority).
Target coverage has been increasing in recent years. The aim of the flu programme is to demonstrate a 100% offer and to achieve at least the uptake levels of 2021/22 for each cohort (see table below), and ideally exceed them.
|2021 to 2022 flu vaccine uptake
|Aged 65 years and over
|In clinical risk group
|Aged 50 to 64 years not in risk group
|Aged 2 years old
|Aged 3 years old
|Frontline healthcare workers
|Eligible school-aged children
Uptake has been confounded supply chain issues. This can be minimised by ordering ahead and sharing between different suppliers.
It is possible to submit orders a year ahead but changing guidance has made this difficult in recent years.
The fee for administering a seasonal influenza vaccine is £10.06.
The government isn’t procuring central stocks of vaccine for this year’s campaign, so 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.
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.
Authored by Dr John Allingham who is a GP in Leeds
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