Pharmacy-led flu vaccination programme put on hold after GPs object

GPs in Shropshire and Staffordshire have objected to plans to allow pharmacists to deliver an influenza vaccination programme targeting at-risk patients.

Older person receiving flu vaccine

Plans to invite pharmacists to deliver an influenza vaccination programme have been put on hold after protests from GPs.

Pharmacists in Shropshire and Staffordshire were invited by the local NHS England area team to contract for the service — targeting patients aged over 65 years, adults in clinical risk groups and pregnant women — which has traditionally been delivered by GPs.

But, according to a report in Pulse
[1]
, the British Medical Association’s (BMA) local medical committees (LMCs) objected on the grounds that GPs had already placed orders for this winter’s flu vaccines and claimed there was little evidence that a pharmacy-based service improves vaccination uptake.

The move has prompted an angry response from pharmacists.

“This resistance from GPs is particularly frustrating given that we know GP practices are consistently failing to meet the nationally set targets for NHS flu vaccination,” says Alastair Buxton, head of NHS Services at the Pharmaceutical Services Negotiating Committee (PSNC), which represents pharmacy contractors in England.

“Financial pressures and competition within the NHS, combined with the lack of incentives for GPs and pharmacists to work together to improve local care, is at the root of this territorialism,” he adds.

Buxton argues that aligning the community pharmacy and general practice contract would prevent such conflicts.

“All the evidence that we have suggests that pharmacies can and do positively increase NHS vaccination rates where they are commissioned to do so,” he says.

Mimi Lau, director of pharmacy services for the membership organisation Numark, which has members in Staffordshire and Shropshire, said the view of the LMCs “beggars belief”.

“I am appalled by their ignorance,” she says. “They seem to have forgotten the reason why the NHS introduced the service in the first place – which was to enable as many NHS eligible patients as possible to have access to the flu vaccine because of its benefits.”

Elsewhere in the country, GPs and pharmacists have worked well together to deliver flu vaccinations.

“I have also seen area teams holding their ground, not buckling under GP pressure and commissioning the service through both GP and pharmacy,” Lau says. “Both providers operate under the same service level agreement with the same level of funding, thus ensuring equity, fairness and transparency.”

David Dickson, secretary of South Staffordshire LMC, told Pulse that NHS England had not given enough notice for the pharmacy scheme to go ahead and argues that there is no evidence it will improve uptake.

“Practices have already placed their orders for vaccines and they are at financial risk if they are not taken up,” he says. “We are worried pharmacy colleagues don’t have the same recording and reporting duties – they are not going to target the hard-to-reach groups.”

His comments had the support of BMA leaders. “It is those patients who would have always had their flu jabs done in the GP surgery that are being captured by the pharmacies – and they are not actually reaching those who have not been getting it, so it’s not meeting that need,” Charlotte Jones, the chairman of BMA’s General Practitioners Committee (GPC) in Wales, told Pulse.

Richard Vautrey, GPC deputy chairman and its co-lead on immunisation, said pharmacy-based schemes were causing disruption for practices and failing to increase uptake.

“All it does is add complexity and confusion to the process rather than producing any greater benefits in terms of numbers vaccinated,” he told Pulse.

A spokesperson for NHS England in Shropshire and Staffordshire confirmed that the scheme had been proposed earlier in 2014. “We are having ongoing discussions with GP practices, LMCs and local pharmaceutical committees and anticipate the scheme will be available by the end of 2014,” the spokesperson said.

References

 

[1] Price C. LMC forces delay in pharmacy flu vaccination plans. Pulse. Online 22 August 2014. Available from: http://www.pulsetoday.co.uk/clinical/therapy-areas/immunisation/lmc-forces-delay-in-pharmacy-flu-vaccination-plans/20007674.article#.VAXedvldWYI [Accessed 2 September 2014].

Last updated
Citation
The Pharmaceutical Journal, PJ, 13 September 2014, Vol 293, No 7827;293(7827):DOI:10.1211/PJ.2014.20066336