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Deliver all adult vaccinations through community pharmacy, think tank urges

Community pharmacy should be commissioned to deliver all adult vaccinations through National Enhanced Services, a think tank has suggested. 

The move should “enhance” the community pharmacy role, a Policy Exchange report published today (December 1) on the future for vaccines policy in England has said.

While pharmacists are only commissioned by NHS England (NHSE) “to deliver more than a small number of vaccines”, the report’s authors – Robert Ede, Dr Sean Phillips and Yu Lin Chou – wrote, there currently remain “barriers to boosting the role” of community pharmacies in England.

It comes as figures released by the National Audit Office reveal that between December 2020 and October 2021, 71% of all first and second doses of the COVID-19 vaccine had been delivered by GPs and community pharmacies.

Of this 71%, 44% were administered by pharmacies.

NHSE had initially only planned for 56% of all first and second COVID-19 doses to be delivered by GPs and community pharmacies, the report said.

There may also “be a role for pharmacy to deliver a greater proportion of ‘out of hours’ or weekend immunisations, where GP practices are unable to”, Policy Exchange suggested.

But, “vaccinations – particularly those for children and of school age – should continue to be delivered within primary care or by School Aged Immunisation Services”, the report noted.

Payment and provider models should be assessed to allow “community pharmacy to collaborate with colleagues in general practice on a greater scale that we have seen in the past for adult programmes”, it added.

 

Student vaccinators

 

Some 12,000 pharmacy students – alongside the 35,000 to 40,000 medical students and 90,000 nursing students – currently enrolled at universities in England, should also be formally asked to volunteer to administer influenza and COVID-19 vaccinations under the professional direction of registered health care professionals, the report recommended.

By deploying them each year to GP surgeries and community pharmacy during seasonal rollout campaigns, students could “support pharmacists, nurses and nursing assistants”, the report said.

In the report’s foreword written by former health secretary Sajid Javid, he acknowledged that “it is clear we should be making better use of our wider workforce”, including students to help support seasonal rollouts.

Read more: ‘It’s a win-win!’: Are pharmacy student vaccinators the future?

“This needs to be planned with care to complement the expertise of our practice nurses, GPs and pharmacists,” he added.

It follows a move by Gurinder Singh – one of the University of Reading’s lecturers in pharmacy medicine – earlier this year to train 20 third-year pharmacy students to become vaccinators, to help pharmacies cope with added flu vaccine demand.

 

Update PGD legislation

 

Amendments should also be made to the Human Medicines Regulations 2012 to allow pharmacy technicians to deliver vaccines through a Patient Group Directive (PGD) and “maximise the vaccination workforce”, the report said.

Under current legislation the list of healthcare professionals who can supply and administer medicines under a PGD includes pharmacists, but not pharmacy technicians.

Read more: ‘Pivotal moment’: Pharmacy technicians set to deliver more clinical services

But within the Community Pharmacy Contractual Framework arrangements for years four and five unveiled in September, the government announced that the Department of Health and Social Care would – subject to the views of the Commission on Human Medicines – launch a public consultation on legislative changes to allow pharmacy technicians to make use of PGDs.

However, it is important to ensure “that any changes are accompanied by strengthened quality assurance measures”, the report noted.

 

“Data is reliable and freely shared across pharmacy and general practice”

 

Other measures recommended by Policy Exchange include sharing data “reliably and freely” across pharmacy and general practice.

Community pharmacy should be able to access patient records in order to support vaccinations in the community, “as a priority”, the report urged.

This move would also be a key component of a wider shift to ‘patient managed’ records” it added.

It follows the publication of the government’s ‘Plan for digital health and social care’ earlier this year, which set out a timeline for increasing the functionality of the NHS App allowing patients to “manage their own health and care”.

Read more: ‘Give us the opportunity’: Pharmacy should take lead on vaccinations, says AIMp

NHS England should also establish “Vaccine Collaboratives” in three pilot areas, the report recommended.

In pilot areas, the item of service payment would be replaced by a “population-based contract to a ‘Vaccination Collaborative’ – bringing together community pharmacy, general practice, local government, the voluntary, community and social enterprise sector and other providers to collectively meet the needs of their citizens”, it added.

 

“Policy Exchange has produced a range of credible ideas”

 

Responding to the report, English Pharmacy Board Chair at the Royal Pharmaceutical Society (RPS), Thorrun Govind, said it was “heartening” to see “proposals which look to encourage the conditions for community pharmacy to do more”.

The RPS hopes “many of these practical proposals are taken forward”, she added.

Meanwhile CEO of the Company Chemists’ Association (CCA), Malcolm Harrison, welcomed “this timely report, which recognises the important – and growing – contribution that community pharmacy plays in delivering national vaccination programmes”.

The CCA has “long campaigned for community pharmacies to be the natural home for all vaccinations”, he added.

The Policy Exchange report “has produced a range of credible ideas here which ought to be taken forward”, he said.

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