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BMA slams ‘rushed’ flu service implementation

Chaand Nagpaul: Never a good idea to implement a national scheme with a few weeks' notice

The "fragmented" IT systems being used across England could cause confusion about which patients have been vaccinated, says BMA GP committee chair Chaand Nagpaul

EXCLUSIVE

The “rushed” implementation of England's national pharmacy flu service could increase GPs’ workload, the British Medical Association (BMA) has warned.

PSNC announced the scheme two months before its planned September launch, and BMA GP committee chair Chaand Nagpaul told C+D it is “never a good idea to implement a national scheme with a few weeks' notice”.

NHS England revealed last month that it had not been able to implement a national IT service for pharmacists to update GPs about vaccinated patients in time for winter, and Dr Nagpaul said a “fragmented” IT approach could cause confusion about which patients have been targeted.

The scheme should have been “thought through” before it was announced, with a national IT system put in place to ensure the two professions could coordinate their vaccination strategies, he said at NHS England’s Health and Care conference in Manchester last week (September 3).

Further bureaucracy

Using "parallel" IT systems will create further bureaucracy unless they are able to correctly record which patients have been vaccinated, he stressed. "We need to make sure we are true to the principles of population coverage and have systems in place to target the right patients," he said.

“Without the [national] IT, it could be a case of GPs sending reminders to patients [who have already been vaccinated] and that could add a lot to the workload,” Dr Nagpaul said. “If we are to see co-operation between GPs and pharmacies, we must have the technology.”

GPs had “geared themselves” to vaccinate most of the population and ordered their vaccinations based on last year’s vaccination rates, Dr Nagpaul said. They had only found out about the national pharmacy scheme “at the last minute”, he added.

PSNC told C+D today (September 8) that it still hopes NHS England will publish the full details of the flu service – including the service specification, the GP notification forms and details of how contractors will be paid – "very soon".

Local pharmaceutical committees told C+D last week that they are intending to use existing IT service PharmaOutcomes to implement the flu service, because resorting to a paper-based system would be a “nightmare”. 
 


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14 Comments

Nat Mitchell, Community pharmacist

Graham I read your article and I commend your stance. I also read the comment below the article which I fear illustrates the challenges we will face.

Graham Phillips, Superintendent Pharmacist

I wrote an article for GP Online arguing that what we need is GP/CP collaboration and that this divide-and-rule approach from Commissioners and PSNC is deeply unhelpful. Chaand Nagpaul has been a great advocate for community pharmacy. Having met him I respect him greatly. This obsession with forcing GPs and CPs to compete is completely wrong. More here: http://www.gponline.com/viewpoint-community-pharmacists-gps-natural-alli...

Kevin Western, Community pharmacist

Graham unfortunately, most of the roles that Pharmacy is eyeing up are currently done by GPs and the money for them currently goes with the role. Any service we do is going to result in some loss to GPs and they use their influence to block them. If there is a positive from this service it is that that resistance has been overcome. What is required is for other services to be handed to surgeries to make up for the loss. It is fascinating to see how the politically correct "all we do is care for patients" goes out the window when their income is threatened.

Jay Badenhorst, Superintendent Pharmacist

GPs had “geared themselves” to vaccinate most of the population and ordered their vaccinations based on last year’s vaccination rates, Dr Nagpaul said..... You mean that you got a good discount on your vaccines and want to profiteer. Let us not forget you are not the NHS. You are a contracto to the NHS like pharmacy. And what if patients get reminders twice?! They may actually get vaccinated which could help the GPs reach their targets this year!

Matthew Edwards, Community pharmacist

What a farce. Doctors trying to protect their income. The IT exists with pharmoutcomes or other providers that the LPC can use. Pharmoutcomes even emails direct to surgeries the vaccination details of every entry. From personal experience the only time a patient is "double-dosed" is when the surgery doesnt update their own records from the information given to them - and it is in their contract to keep their records up to date so there is no argument about an increased workload as they are already getting paid

Nat Mitchell, Community pharmacist

It's a bit of a joke that I have to ask patients what their ethnicity is and a GP doesn't even have to ask if a patient has already been vaccinated. It appears that Dr Nagpaul is putting forward a strong argument for EVERYONE using a consent form like pharmacists currently use.

Kevin Western, Community pharmacist

I suspect the reason it is so rushed is the determined opposition by the BMA and its lobbyists - to say they were unaware it was happening is disingenuous at best. As Stephen says they could always , as a last resort, actually ask the patient before sticking the needle in. How long has the BMA etc been resisting Pharmacist access to records and preventing joined up healthcare - stop whingeing and get on with it.

Kevin Western, Community pharmacist

oops how did that happen?

Kevin Western, Community pharmacist

I suspect the reason it is so rushed is the determined opposition by the BMA and its lobbyists - to say they were unaware it was happening is disingenuous at best. As Stephen says they could always , as a last resort, actually ask the patient before sticking the needle in. How long has the BMA etc been resisting Pharmacist access to records and preventing joined up healthcare - stop whingeing and get on with it.

A C, Locum pharmacist

the roll out of this service was rushed for political reasons. There were 2 main objectives: 1) the doH could demonstrate they were actively modernising health care by improving accessibility to the service and at the same time reducing GP workload 2) a reminder to GPs that they have no God given right to provide healthcare services. This coupled with the current 7 day working has sent a very clear message that the current system is unsustainable and the DoH is undermining it so that future " improvements can be more easily implemented."

Christopher Donaldson, Community pharmacist

Always happens, 't'was ever thus',GP's object to pharmacists encroaching on 'their' territory.

Stephen Eggleston, Community pharmacist

Surely, all they have to do to avoid duplication of vaccination is ..... Ask the patient!

Dilip Shah, Community pharmacist

Apologise Dr Nagpaul for pointing this out that you need to read the PGD specification regarding Vaccinations given and the reporting criterion to GPs .The IT infra structure set up for this service has worked well previous e g last year with increase in flexibility of Flu Vac in London and increased in uptake. I am sure that National IT structure and reporting either manually or Via IT systems would work well. I think we should put patients first and commend the service which would prevent the complication of influenza in high risk and vulnerable adults and children .

They had only found out about the national pharmacy scheme “at the last minute - See more at: http://www.chemistanddruggist.co.uk/news/bma-flu-scheme-must-have-techno... I'm amazed that they were told about it at all!! At a recent contractor event I attended, a member of the NHS area team said that it was up to pharmacists to inform their GPs about the service!?!

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