Public Health England to consider removing travel vaccinations from NHS prescriptions

NHS England has asked the public health agency to look at whether the NHS should charge for more vaccines, when they are requested solely for the purposes of travel.

Simon Stevens, chief executive of NHS England

A review by Public Health England (PHE) on whether travel vaccinations should be removed from NHS prescriptions has been requested by the chief executive of NHS England, in addition to an ongoing review of low-value prescription items, which already includes some vaccines given to travellers including yellow fever and rabies. 

In a letter to the House of Commons Health Select Committee chair Sarah Wollaston, NHS England chief executive Simon Stevens said PHE had been asked to conduct a review into vaccinations for diphtheria, polio, tetanus, typhoid, hepatitis A and cholera, when they are requested for travel purposes, to “assess their appropriateness for prescribing on the NHS”. These vaccinations are currently provided free on the NHS.

Stevens said a “full assessment of the public health consequences of altering the availability of these vaccinations” would be carried out, and will include “assessment of any disproportionate effect on any groups in the population”.

He added that “any changes to availability, if proposed, will be subject to further consultation by NHS England”.

NHS England is already conducting a review of low-value prescription items, including some travel vaccinations, which could result in many of the drugs being effectively removed from primary care prescribing lists.

The travel vaccines included in this review are not technically available on the NHS but are “sometimes inappropriately administered for the purposes of travel”

Wollaston, MP for Totnes and a GP, wrote to Stevens (8 August 2017) to ask for clarification on the impact that this national review of low-value prescribing would have on the NHS’s provision of free travel vaccines.

She expressed concern that “the public health consequences of altering the availability of travel vaccines may outweigh any financial savings”. She also asked Stevens to confirm “whether the provision of free travel vaccines is under review, and, this being the case, which vaccines are being reviewed and the timeframe for implementing any potential changes”.

In response, Stevens confirmed that the low-value prescriptions items consultation was currently only considering hepatitis B, Japanese encephalitis, meningitis ACWY, yellow fever, tick-borne encephalitis, rabies and BCG. And he confirmed that the most recently requested PHE review would be looking at the prescribing on the NHS of vaccines for diphtheria, polio, tetanus, typhoid, hepatitis A and cholera, when requested solely for the purposes of travel.

Royal Pharmaceutical Society English pharmacy board chair Sandra Gidley said: “For people to fund their own travel health at a time when the NHS is struggling to fund all that is required of it, it seems entirely reasonable for people going on holiday to fund their vaccinations.

“I would ask why the NHS and taxpayers should be funding those vaccinations. Vaccinations are holiday basics.”

A PHE spokesperson said it was still “scoping” the request from NHS England and could not comment further at this stage.

Last updated
The Pharmaceutical Journal, PJ, October 2017, Vol 299, No 7906;299(7906):DOI:10.1211/PJ.2017.20203744

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