Community pharmacies may be forced to provide COVID-19 vaccinations this winter to keep themselves financially afloat, despite a 25% cut in the fee for providing them, local pharmacy representatives have warned.
NHS England announced on 4 August 2023 in the specification for the service that the fee paid per COVID-19 vaccination for the winter 2023/2024 booster programme will be £7.54, compared with £10.06 paid in the previous winter. This itself was a cut from £12.58 per vaccination that community pharmacies had been paid the year prior to that.
Following the publication of the service specification, and expression of interest guidance, for a community pharmacy COVID-19 vaccination service Community Pharmacy England said that the 25% cut in fee “defies logic”.
Local community pharmacy representatives have said that the fall in the vaccination fee will lead pharmacies to question whether it is financially realistic to provide the service but that they may feel forced to sign up.
Adam Irvine, chief executive officer at Community Pharmacy Cheshire and Wirral, said: “I was flabbergasted by the reduction in fee, given the complexity, administrative workload and patient queries around COVID-19 vaccinations. I can only believe that this will cause many pharmacy contractors greater concern as to whether the service is a value to offer for their business.”
Hitesh Patel, chief executive officer at Community Pharmacy London, said: “Contractors yet again have been left with a difficult decision. On one hand, the NHS wants us to provide more patient-facing services, but when the services are rolled out, the fees are derisory.
“COVID vaccinations are more involved than providing flu vaccinations so I fail to see the logic of having a lower fee than flu vaccinations.
“Community pharmacies are in financial peril currently and if they do not take up the COVID vaccination service, many may go under, so many will reluctantly sign up for the service”.
The guidance for expressions of interest in the 2023/2024 community pharmacy COVID-19 vaccination programme introduces a change in eligibility from previous years, which will allow more pharmacies to provide the service if they wish.
Previous guidance said there must be a “population need” for a new provider to offer COVID-19 vaccinations in a particular geographic area. For winter 2023/2024, this is no longer a requirement for pharmacies that want to offer the service from their own pharmacy premises.
Nicola Goodberry Kenneally, chief executive officer at Community Pharmacy West Yorkshire, said: “I do believe there will be many community pharmacies across West Yorkshire who will support the COVID programme, despite the funding cut, to support the patients in being ready for winter.”
But she added: “The NHS decision to reduce the fees paid for the COVID vaccination scheme, and to keep the flu vaccination fees flat despite the uncontrollable cost rises that pharmacies are facing, is yet another blow to pharmacies who are already under extreme operational and financial pressures. Many pharmacies will struggle to survive this winter if additional investment and help is not forthcoming from NHS and government.”
A spokesperson for NHS England said: “The revised fee will sufficiently cover the average cost of vaccinating someone against COVID as part of what is now a more predictable, seasonal offer.
“The NHS is working with vaccine sites to ensure a growing number offer both flu and COVID vaccinations at the same time where possible, to make it more convenient for people to get this life-saving protection ahead of winter, with additional payment available for a double jab in a single visit.”
Pharmacy contractors have until 5 September 2023 to register an expression of interest in providing the winter 2023/24 COVID-19 vaccination service.
Box: NHS England will fund September 2023 flu vaccinations
NHS England (NHSE) has said that pharmacies that have booked patients for flu vaccination in September 2023 will be funded for providing them.
Previously, NHSE had said that the community pharmacy flu vaccination programme would not start until October 2023, prompting the Royal Pharmaceutical Society, Community Pharmacy England (CPE) and other bodies to write to health secretary Steve Barclay, urging “immediate intervention” to allow vaccinations to begin from the usual start date of 1 September.
Many pharmacies said they had ordered vaccines and booked patients in for vaccinations in September, with CPE warning of a “disaster” for patients and pharmacies.
The updated guidance, published on 10 August 2023, says vaccinations that have already been booked in September will be funded by NHSE, but that the care home flu vaccination programme will begin on 2 October 2023, and the programme for all other patient cohorts will start on 7 October.
CPE said the updated guidance will have “huge operational benefits for pharmacy businesses who have already planned to deliver large numbers of vaccinations in September”.
Alastair Buxton, director of NHS services at CPE, said: “While this is not quite the outcome we wanted — we would have preferred a full launch of the service in September, as has always previously been the case — we are delighted and relieved that ministers and the NHS have responded to our calls for common sense to prevail and agreed that pharmacies who have planned vaccinations in September will be able to go ahead with those.
“Pharmacy owners will be relieved by this news and they and their patients should benefit from the avoided disruption which for many businesses could have been significant.”