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‘Defies logic’: COVID jab fee plummets 25% as service opens to all pharmacies

Community Pharmacy England (CPE) has branded a 25% drop in the fees for COVID vaccinations - which comes at the same time as the service is opened up to more pharmacies - as illogical.

CPE said on Friday (August 4) that NHS England (NHSE) had announced the launch of a new process for pharmacy owners to sign up for the upcoming autumn COVID-19 vaccination service.


The new “expression of interest” process “will mean that more pharmacies will be able to choose to participate than has previously been the case”, according to the negotiator.


Read more: ‘Deeply frustrating’: CPE slams frozen flu funding amid possible delays to service


However, it said that NHSE had decided to reduce the fee paid for vaccinations by 25% to £7.54, “despite the counter-arguments” put forward by CPE and GP representatives.


The vaccination service is “expected” to begin in October and the “expression of interest” process is open from August 4 until 5pm on August 29, it added.



Reduced funding



Aside from the £7.54 COVID vaccination fee, pharmacy owners that vaccinate a housebound patient will be able to claim an additional £10 fee, CPE said.


But it added that there will be “no incentive” for vaccinating patients living in care homes “as has previously been the case”.


The negotiator said that in discussions on fees, NHSE stated it was “reducing the fee as pharmacy owners would have an increased opportunity to co-administer COVID-19 and flu vaccinations”.


Read more: MPs call for greater pharmacy role in vaccine delivery amid uptake concerns


It added that NHSE also argued that “savings” on the fee would allow “continued investment in local commissioning by its regional teams to support outreach work and a more targeted approach in less well served communities, as a way to increase vaccination rates”.


The negotiator said that it had highlighted both the “increased complexity” of the COVID vaccination provess and “related administration workload compared to other vaccinations” to no avail.



“Significant change”



CPE said that the new process “marks a significant change” in the approach used by NHSE.


Previously, pharmacy expressions of interest “were only granted if there was a population need for a new provider to offer the service” - for example, if there was a “perceived gap” in the provision of services offered by other vaccination providers or if there was a “need for additional capacity” - it added.


Read more: Pharmacies should do 'a lot more' vaccinations, says shadow health sec


But this requirement has now been removed for pharmacies wishing to provide the service on the pharmacy premises, it said.


The negotiator added that the new platform hosting the process is also expected to “provide a much improved experience for users”.



Minimum 100 jabs per week



CPE set out that contractors wishing to deliver the service from their pharmacy can opt in as long as they meet the “minimum requirements”.


These include also providing the flu vaccination advanced service from its launch date until March 31 2024, being able to offer “at least” 100 COVID jabs per week and being “in good standing” from a “regulatory perspective”, it said.


However, it stressed that contractors would not be required to administer all vaccinations from the pharmacy site but must also vaccinate eligible housebound and care home patients if requested by NHSE and “may also provide outreach services” if agreed with the commissioner.


Read more: Deliver all adult vaccinations through community pharmacy, think tank urges


Meanwhile, contractors can also express an interest in providing the COVID jab service “solely at an off-site location away from the pharmacy premises”, CPE said.


But in these cases, NHSE “will usually only approve requests to operate services in the vicinity of the pharmacy where there is a population need, for example within the same integrated care system” and where minimum requirements are met, it added.


“These decisions will be taken once the provisional network of pharmacies wanting to vaccinate patients on their premises, primary care network (PCN) sites and other providers such as NHS trusts has been identified”, it said.



“Defies logic”



CPE director of NHS services Alastair Buxton said that the new opt-in process will “bring an opportunity” for some contractors and “may be welcome news for all those businesses that have been frustrated at previous NHS decisions not to include them” in the programme.


He added that the new approach, which is “akin to an advanced service” that contractors can opt into to provide from their premises, “has been a long time coming for the sector and patients”.


But he said that the decision to reduce the vaccination fee “defies logic”, is “incredibly frustrating” and “will inevitably make pharmacy owners think twice about whether the service can be provided in an economically viable way”.


Read more: Pharmacies in England administer 33m COVID-19 jabs

“We cannot understand how they came to reach this decision and we know GP leaders feel the same”, he added, saying that “both resisted it strongly”.

Mr Buxton also raised concerns that the announcement came “much later than was originally planned” by NHSE and “at a time when many pharmacy owners will be taking a well earned break from their business”.

Read more: Pharmacist’s COVID vaccination snap wins NHS photography award

CPE has been “pushing” the commissioner to publish the service specification documents “for a great many weeks” and wrote to ministers earlier this week to raise concerns with the government about the “ongoing delay”, he said.

It warned that the delay “has an adverse consequence for pharmacy owners and their teams, who need time to prepare ahead of the commencement of the service”, he added.


NHSE: “More predictable seasonal offer”


A spokesperson for NHSE told C+D yesterday (August 7) that 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”.

They said that NHSE is confident that £7.54 covers the costs including workforce, administrative and overhead costs, based on an assumption that a typical vaccination takes five minutes.

It comes as CPE also slammed a “deeply frustrating” decision to freeze the level of funding for the flu vaccination service for a further year, as well as possible delays to the start of the service.

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