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GP leaders: Pharmacy flu jabs will fail to boost uptake

The BMA's General Practitioners Committee chair Dr Chaand Nagpaul told C+D the service would "undermine" GP work

Leading doctors including the BMA's Chaand Nagpaul (pictured) have criticised lack of planning for the national scheme, which they say will leave GPs out of pocket and frustrated

EXCLUSIVE

England’s national pharmacy flu vaccination service will confuse “vulnerable” patients, increase GP workload and fail to boost vaccine uptake among at-risk patients, GP representatives have said.

Both the British Medical Association (BMA) and the Royal College of General Practitioners (RCGP) criticised the advanced service announced in the 2015-16 pharmacy funding settlement, saying it would “undermine” GPs and leave practices with vaccines that had been “paid for but cannot be administered”.

Chair of the BMA’s GP committee Chaand Nagpaul lamented the lack of “proper planning” around the service, which had been announced at a “late stage”.

Although GPs worked “constructively” with community pharmacists, he said introducing the service without “ironing out the logistics” could create tension between the two professions.

“It will increase workload and could undermine the targeted population approach that practices currently undertake,” he said. A lack of “seamless” data transfer between pharmacies and GPs could also leave practices in the dark over which patients had been vaccinated, Dr Nagpaul added.

Deputy chair of the BMA’s clinical and prescribing committee Bill Beeby pointed out that practices would have to ensure pharmacy vaccinations were entered onto their own systems, which would create additional work.

GPs may refuse to buy extra vaccine stock next year in protest against the pharmacy service, he warned.

“I think GPs are going to be genuinely frustrated that somebody else gets paid for delivering the vaccine [while] they get paid nothing for doing all the legwork.

“I am not against pharmacists delivering flu vaccines, but the risk is pharmacies will pick up patients who are easy, but have no responsibility whatsoever for chasing the difficult ones,” Dr Beeby told C+D.

"Number of drawbacks"

RCGP chair Maureen Baker said there were a “number of drawbacks” to the new service, including that GPs could be left with unused vaccines.

“[The service] could lead to potential confusion among vulnerable patients and cause unnecessary strain on practice staff, who are already facing intense workload pressures,” she said.

When announcing the new flu service, PSNC warned it could cause “tension” between GPs and pharmacists.

GP support was “encouraged” but “not necessary” for the success of the service, it said – however, pharmacists would need to report the vaccination to the patient’s practice.

PSNC told C+D it would engage with GPs at this year’s RCGP conference, which “may provide an opportunity to talk to them about the service”. It is also due to discuss the flu vaccination scheme at a meeting between itself, NHS Employers and the BMA’s GP committee.

 

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30 Comments

Anonymous Anonymous, Information Technology

So it is all about money then?! Why don't they just openly admit it instead of being so machiavellian and denying it (whilst the general public are still of the belief that doctors are a 'caring' profession)! People assume pharmacists are in it for the money but as an employee I can tell you I couldn't give a hoot whether you buy nurofen at £12 a box or ibuprofen at £3. What I do enjoy hearing, however, is "That's the most painless flu jab I've ever had... Much better than my GP who butchered me!"

Yo Palumeri, Community pharmacist

we try to help by relieving them of the winter burden of providing all those flu vaccines allowing them to focus keeping people out of a&e ,and all they can do is moan,

Gerry Diamond, Primary care pharmacist

Well the NHS is supposed to be about improving access to medicines, so let pharmacists colleagues in the community make a positive contribution to public health. RCGP couldn't be too wrong on their opposition.

Industry Pharmacist, Business Development Manager

I see more patients in a day than a GP therefore I have more exposure to see the at risk groups of patients for the flu vaccine than a GP and have support staff to manage the workload. I am better suited and equipped to deliver this service as I am in the community every day and even on the weekends. So instead of moaning about the workload you put upon yourself by not sharing the work and moaning about the loss of financial gain which when compared to the pharmacy industry is nothing as we are being squeezed year after year, why don't you support a profession who are willing to help decrease your workload and save the NHS money without moaning.

Ashraf Manjothi, Locum pharmacist

Everyone is welcome at the pharmacy for their flu vaccine

Mike Jarrett, Community pharmacist

I remember only too well when the GP's took over the ordering of flu vaccines directly back in the day. It left me with a fridge full of vaccines that had been paid for costing some £800 . Don't remember any sympathy letters from the local GP's at the time !

Ghengis Pharm, Locum pharmacist

I remember it too. Did my usual bulk order with Duphar only to find out the local GPs had ordered their own. Result: money down the drain! So, what comes around, goes around.

Simon MEDLEY, Community pharmacist

might be left with unused vaccines ! _ karma - make up for all the times in the last 20 years i've been left with stock, after having to order them in multiples to fill the few rx's produced when the gps havn't ordered enough to cover their patients demand

Leroy Jackson, Community pharmacist

A student friend of mine was once drafted in with a load of others and quickly trained to help with the huge backlog of passports not getting processed in time in Liverpool. They were to work the evening shift from 5-10 when the regulars went home. After 3 nights they were chastised for doing twice the amount in half the time of the Full time staff. Their numbers were restricted and massaged so as not to make a mockery of the current system. The implication being they couldn't possibly be doing them right. Watch this space.

Stephen Eggleston, Community pharmacist

If GPs were getting the numbers vaccinated, there would be no need for any other provider. The fact that pharmacy has a more patient focused/convenience approach makes it a more attractive proposition than the GP. I have already had patients asking when we will be doing the flu jabs this year, and they appreciate that it is done when it suits them

Lancelot Spratt, Accuracy checking technician

Aw diddums. Flu jabs are a nice little earner for GPs and I guess they don't like the idea of other people getting their hands in the NHS money box.

Chris Pillman, Community pharmacist

Surgery: "I will make an appointment to get my essential flu vaccination at the Drs convenience" Or Pharmacy: "I will make an appointment to get my essential flu vaccination at my convenience"

N O, Pharmaceutical Adviser

How optimism (forced) can change to realism..... 5 things we learned from C+D’s #PharmsInGPs Twitter debate. But RPS England director Howard Duff said “”the collaboration between the two professions could accelerate the “grindingly slow evolution” of community pharmacy’s role.””” ............ So RPS what you have to say now????? I don't care what your other R's have to say

Gareth Rowe, Community pharmacist

What a pile of codswallop. The pharmacy service is there to catch patients who cannot/will not go to a surgery for a designated appointment. We are not in competition with them to take their patients, when the service was launched in Wales three years ago all it took was a discussion with my local practice managers to let them know we are there to mop up those who can't make it to the surgery. We are not supposed to be 'chasing the difficult ones', in fact it's the difficult ones who might turn up in a pharmacy!

Farhat Ahmed, Locum pharmacist

Chand Nagpaul please think before you make childish comments as GP's, Pharmacists, Nurses etc all work extremely hard for the good of all patients. Non of us should be working against each other. Shame on you. What would the public think if they heard us bickering over scraps of NHS money.

SP Ph, Community pharmacist

As I had sked/ commented/ pointed ............. So what is your say on this C&D ?? With all your Tweets and the RPS/ RCGP etc. etc ????

THB _B, Community pharmacist

The GPs leaders are factually wrong. The pilots last year showed that at least 80% of the patients vaccinated did not have a GP vaccine in the previous year. From my own experience about 70 percent of the people I vaccinated had never had a flu vaccine from the GP despite being in the target groups. for example drug addicts who hardly vist the GP and never get flu vaccines. The GP leaders are just getting emotional over loss of income. Sour grapes. get over it.

Margaret O'doherty, Community pharmacist

The experience in Ireland also shows that pharmacists ARE vaccinating those who don't go to a GP for whatever reason, mostly convenience or even phobias. 23% had never been vaccinated before and 83% of those were in the 'at risk' categories. Doctors should looks at facts, not their own pockets.

SP Ph, Community pharmacist

You are absolutely right. When it comes to Money everyone will fight. Lets see how much fight we will have .....

Bal Singh, Locum pharmacist

I wasn't aware that GPs themseleves did the data in putting of patients details and notifications.... Also, pharmacy doesn't have the responsibility of chasing down difficult patients to vaccinate them. OK fine, so what have been the consequences of doctors failing to vaccinate those patients? Pharmacy is taking off some of the work load from doctors. Surely that's what they have been upset about. Surely they should be thanking us?

SP Ph, Community pharmacist

You wish.... They will never thank us for anything. Just imagine they being over-performed by Pharmacists !!

Nat Mitchell, Community pharmacist

Buying in medication (a lot more costly than a flu jab) without any guarantee that patients will turn up is the whole basis on which pharmacies work. This is laughable. Even if there were no other competitors, there is no guarantee that anywhere near all of those who are eligible will turn up.

Brian Austen, Senior Management

When GPs were 'working to rule' under the last Labour Government there was a risk of patients not getting their flu vaccination. One of the potential policies looked at by the DoH was to get pharmacy to fill-in if such problems arose again. Is one of the reasons for the new pharmacy flu service a contingency to show GPs that they cannot use threats about withdrawing services to force a DoH climb-down. GPs don't like it when their lucrative margin on vaccination purchase is threatened. They were never going to support pharmacists giving flu vaccinations because it encroaches an area of their NHS business. This could also explain why there was no national minor-ailments service. It cannot be used as leverage against GPs. Maybe political tactics were influencing negotiations between NHS England and PSNC, and NHS England and GPs.

SP Ph, Community pharmacist

"""They were never going to support pharmacists"" ......... At last you have agreed.

Kevin Western, Community pharmacist

"GPs may refuse to buy extra vaccine stock next year in protest against the pharmacy service, he warned " dont buy any - let us do the lot, is the easy answer to that.

Super Pharmacist, Community pharmacist

Every single year, without fail, I end up with a few stragglers left out to dry when their own GP tells them to wait, wait then wait some more in order to vaccinate risk groups first. Come the end of the flu season, they come to me to have one on private pgd as the gp had ran out & won't order anymore. Efficient service indeed.

SP Ph, Community pharmacist

Absolutely, if they can't buy then there will be someone who can buy. Otherwise, the whole production will go waste (did I hear GSK, Sanofi, etc, etc)

Kevin Western, Community pharmacist

"Although GPs worked “constructively” with community pharmacists, he said introducing the service without “ironing out the logistics” could create tension between the two professions." are you sure he is a GP, not a comedian? How long have GP leaders had to sort this out without trying to undermine it and hope we didnt get it? The only reason we are being considered is that GPs as a whole have consistently failed to reach targets, simply taking the easy to get to that can be done en mass and cheaply, while we have reached people who dont normally turn up. Perhaps now we will get some real co-operation.

London Locum, Locum pharmacist

He may be a comedian but will always be backed up to the hilt by his colleagues. Pharmacy on the other hand........

Anonymous Anonymous, Information Technology

Yes so lets be militant the way doctors are... We hold great might over GP surgeries - imagine what would happen if we referred all OTC sales to GP's just for one day - they would be swamped! Too much is made of our dispensing and checking (activities that even a donkey could perform) and not enough of our responding to symptoms and self-care advice!

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