The debate comes after the Pharmaceutical Services Negotiating Committee (PSNC) announced yesterday (August 20) that contractors can administer the flu vaccination in patients’ homes, as part of changes to the 2018-19 national flu service.

NHS England has also agreed to increase the fee for each administered dose from its 2017-18 level of £7.64, to £7.98 for the 2018-19 flu season. Combined with the additional fee – which will remain at £1.50 – it means each pharmacy will now receive £9.48 per vaccination.

However, no specific funding has been announced for the proposed off-site vaccinations.

Community pharmacist David Gallier-Harris said the proposal is “opening up a new unfunded level of service”, which is “again relying on the goodwill and professionalism of pharmacists”.

“Pharmacies are already located at the heart of the community, ideally suited to providing flu vaccination close to home, and funded as such,” he said.

“Domiciliary supply is a different service altogether and should go ahead if funded”, and if needed, he added.

Domiciliary jab “makes no economic sense”

Amish Patel, director of Hodgson Pharmacy in Longfield, Kent, told C+D delivering the vaccination in patients' homes would be “loss leading”.

“We would have to employ a second pharmacist or maybe a nurse to go out and do [it]. I’m not sure if it is viable at this stage,” he said.

Mike Hewitson, superintendent and managing director of Beaminster Pharmacy in Dorset, said it would “make no economic sense” to offer domiciliary flu vaccines.

After pharmacies factored in the costs of training, pharmacists’ time, waste disposal and administration, profit from the service would be “at best marginal”, Mr Hewitson argued.

“Flu is already a loss-making service,” he said. “We need a level playing field with general practice in terms of staff qualification level and criteria.”

A “golden” option

However, Nat Mitchell, pharmacist and director of JWW Allison & Sons Ltd in Cockermouth, Cumbria, said his pharmacy will “definitely” offer housebound and elderly patients the flu vaccination in their own home, albeit “outside of [business] hours”.

“Every year I’ve had to apologise to patients who genuinely need this service,” he told C+D. “I’m currently pretty much forced to dispense at a loss at times, which I detest. Being given the option to go out and vaccinate a housebound patient for roughly £15 seems golden in comparison,” Mr Mitchell added.