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NHS England defends flu commissioning restriction

Mimi Lau: "We are very concerned that commissioners are bowing to pressure from GPs"

The North Midlands area team says it listened to LPCs before restricting pharmacy flu vaccinations to under-65s, in response to criticism from Numark's Mimi Lau


An NHS England area team has defended its decision to restrict pharmacy flu vaccinations against criticism from Numark.

Numark said NHS England North Midlands' decision to commission pharmacies to vaccinate only at-risk patients under 65 this winter was reducing “access and awareness” of flu jabs. The independent pharmacies support group was “very concerned” that this was a result of commissioners “bowing to pressure from GPs”, said director of pharmacy services Mimi Lau.

But the commissioning body told C+D it had “considered all information” submitted by Public Health England, local medical committees and LPCs in the area when it reviewed its flu immunisation arrangements. “Uptake for at-risk under-65s is well below recommended levels, which is why this group is being targeted,” a spokesperson said on Wednesday (May 6).

Ms Lau said she had heard “rumours” that other area teams were following NHS England North Midlands’ example. 

Government figures showed 50 per cent of at-risk patients under 65 were vaccinated last flu season. The figure was 73 per cent for over-65s, and Ms Lau stressed that it was "not practical" for all of these patients to visit a GP for their flu jabs. 

“As ever, GP surgeries have picked off the cases [that are] easiest to meet their targets [while] pharmacy has the crumbs,” she added.

NHS England North Midlands is comprised of the two former area teams for Shropshire and Staffordshire, and Derbyshire and Nottinghamshire. Pharmacists in the former area were able to vaccinate patients over 65 last year, but NHS North Midlands told C+D it had decided to implement the Derbyshire and Nottinghamshire model across the whole region this year.

NHS England North Midlands added that it was currently working on further flu initiatives, “particularly to increase immunisation rates for pregnant women”.

Last month, C+D reported that London pharmacists were unsure whether they would be commissioned to deliver the Fluenz nasal vaccine to children this winter.


Has your area team commissioned you to deliver flu vaccinations this winter? 

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Gerry Diamond, Primary care pharmacist

Well, its par for the course......OMG when do I :-)

R A, Community pharmacist

I think secretly most pharmacists would be relieved if this flu jab service was taken off the market one less thing that our employers can harass us about. The only people who will lose out is the good old contractors and companies that own the multiples!

Nick Hunter, Community pharmacist

Who pays your salary?

London Locum, Locum pharmacist

You said it RA. You benefit to the tune of sweet FA.

Robert Severn, Community pharmacist

The Notts/Derbys model was a pilot last year, during which Pharmacy showed some excellent results, in particular with regard to vaccinating patients who had never had the jab before but who were at risk. Being devil's advocate and thinking with a commisioners hat on, would I get better coverage of vaccination by not letting two groups fight over similar population (easy wins)?? and commission those who can reach the hard to get patients a different way? Not saying it's fair, but possibly a way to get a higher vaccination rate.

THB _B, Community pharmacist

In that case Rob the LPC should have argued for HIGHER funding than GPs as we are vaccinating harder to reach patients. So I don't think that argument holds water. Pharmacies did a cracking job last year in nottingham to vaccinate from a standing start and no support from NHS england or the LPC. With a promise that next year we would be able to offer the service to over 65s as well. So really dissapointed that the promises were not followed through and the LPC just nodded the scheme through this year with no significant changes. The LPC needs to re-negoatiate the over 65 exclusion with NHS england!

Nick Hunter, Community pharmacist

Really disappointing you feel like that - please identify yourself and make contact with me or Rob so we can understand your concerns in more depth and explain the situation locally. Contact details if you don't have them on Nottinghamshire LPC website

Robert Severn, Community pharmacist

Valid point re higher funding, and understand pharmacies in Nottingham did a very good job from a standing start, however to say that no support was given from the LPC is just not the case, and I asure you that it was not 'just nodded through'. I'm sure the LPC would be happy to talk to you directly about any concerns you have, and can be contacted via the LPC website.

Nat Mitchell, Community pharmacist

The majority of our patients fall into the over 65's group, so it's a 'no-brainer' that they should included in the service. We are fortunate to be commissioned for all groups as well as primary school children, and in addition to having a private service it gives us comprehensive coverage and decreases confusion. Vaccinating solely 'at risk' groups if difficult and in my opinion, only a relaxation on where the vaccines can be administered by pharmacists (as long as they are safe) will improve uptake. If you don't frequent pharmacies in general then you're not that likely to go there for your vaccination.

Paul Mayberry, Community pharmacist

The only way that pharmacy will be able to really help in reducing the pressure on GP's, A&E and secondary care is if patients know the services are fully available in community pharmacies and that the services provided are consistant. This means all pharmacies should be commissioned to provide the service and ALL pharmacies engage in providing the service.

Stephen Eggleston, Community pharmacist

I am very disappointed that NHS England are only commissioning a partial service from pharmacy. Surely, to get the engagement from the pharmacy team, it is better to enable them to provide a much needed service to all those at risk - especially the over-65's! Do I believe they have bowed to pressure from GP's? - You might think that, I couldn't possibly comment!

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