Enhanced Services

Flu vaccination enhanced services for 2021/22

flu vaccinations 2021-22

Practices have until next Monday to sign up for this year’s flu vaccination enhanced services. Of note, the main seasonal flu enhanced service for at-risk groups has been modified this year, with a view to running the programme alongside an autumn Covid vaccination booster campaign. Here Pulse Intelligence provides a summary of the key service specification details.

Practices are as usual expected to deliver flu vaccinations to children aged two and three under the childhood flu vaccination enhanced service (ES).

Under the seasonal flu and pneumococcal vaccination ES, the eligible groups are expanded for a second year running in light of the Covid pandemic and expectations of a more severe flu season. Practices are required to give flu jabs to at-risk groups, over 50s, healthcare workers and carers. A complicating factor this year is that they may have to give flu jabs alongside Covid vaccinations, which continue to be delivered at PCN grouping level. As a consequence, NHS England has said practices will be given the option to deliver flu vaccinations in collaboration with their PCN grouping, rather than within their own practice.


Both the childhood flu vaccination and seasonal flu and pneumococcal vaccination ESs will run from 1 September to 31 March 2022.

Practices need to sign up in writing by 23:59 on Monday 16 August 2021, for each of the services.

They must also sign up on CQRS as delivering the service no later than Monday 16 August.

Key changes 2021/22 – Seasonal flu and pneumococcal ES

GP practices can deliver flu vaccinations in collaboration with their PCN grouping, in which case the group will be considered ‘a temporary single medical practice’.

They will also be permitted to sub-contract delivery of the service to another GP practice in the PCN grouping, or to another party, to ensure collaboration across the group.

If a patient is given their flu vaccination by a provider that is not their registered GP practice and the record is not automatically updated electronically, ‘the GP practice must update the patient records on the same day that the vaccine is administered or on the day that notification is received from the other provider’, the ES explains.

Scheduling vaccinations

GP practices are advised to ‘continue as usual’ with plans for the flu vaccine programme this autumn.

However, if co-administration with the Covid vaccine is recommended for some at-risk patients by the JCVI then ‘where possible… vaccines should be given at the same time’.


Practices will be paid £10.06 per dose administered to eligible patients, under both services. Payment should be claimed monthly.

Vaccines for patients aged 6 months to 17 years of age are ordered online from ImmForm as with other centrally supplied children’s vaccines, and practices can’t claim reimbursement for these centrally supplied vaccines.*

For the recommended vaccines for all other patients, GP practices order direct from the manufacturer, and then claim a dispensing fee. See our separate guide on ensuring you claim all your high-volume vaccine fees this year.

*The one exception is any QIVe used for patients aged 2 to 18 unsuitable for LAIV, which practices have to order themselves and can be reimbursed.


For the seasonal flu vaccination programme in at-risk children and adults, practices should use the vaccines detailed in this year’s flu letter.

In summary the recommended vaccines are:

  • for those aged 65 years and over – the adjuvanted quadrivalent influenza vaccine (aQIV), with the cell-based quadrivalent influenza vaccine (QIVc) or the recombinant quadrivalent influenza vaccine (QIVr) offered if aQIV is unavailable
  • for under-65s (including those at risk, pregnant women and 50 to 64 year old cohort) – QIVc or QIVr, or as an alternative if these are not available the egg-grown quadrivalent influenza vaccine (QIVe).
  • Children in clinical risk groups aged 6 months to less than 2 years should be offered QIVe.
  • The live attenuated influenza vaccine (LAIV) should be offered to eligible children aged 2 years and over, unless contraindicated. QIVc can be ordered for children in at-risk groups who are contraindicated to receive LAIV, or for children whose parents object to LAIV on the ground of its porcine gelatine content. QIVe is a second option in 2-18 year olds – but this isn’t supplied centrally.

Source: NHS England – Enhanced service influenza specifications. Published 2 August 2021

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