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GPs: Pharmacy may share blame for lower flu jab uptake

RCGP: Mild weather and the ineffectiveness of last winter’s vaccine could also have contributed to low uptake

Just 34% of under-65s in at-risk groups have been vaccinated this flu season, 5% less than at the same point last year, according to Public Health England data

Pharmacy is partly to blame for a lower flu vaccination uptake than last year, the Royal College of General Practitioners (RCGP) has said.

Public Health England (PHE) statistics released yesterday (November 13) show that 34% of under-65s in at-risk groups have been vaccinated this flu season, five percentage points less than at the same point last year.

The GP body told C+D that the national pharmacy flu service has “probably played a part” in this decrease, although it has “no way of knowing” for certain. Mild weather and the ineffectiveness of last winter’s vaccine could also have contributed to the low uptake, it added.

PHE also suggested that the pharmacy flu service could be "partly" responsible for the low figures due to the under-reporting of vaccinations. "NHS England has confirmed that 400,000 vaccinations have been given to adults in risk groups through pharmacies so far this season and it's likely that some of these vaccinations have yet to be entered onto patient records," said PHE head of seasonal flu surveillance Dr Richard Pebody.

The Pharmaceutical Services Negotiating Committee (PSNC) said it has “no evidence to suggest pharmacists are not informing GP practices about flu vaccinations”. “Indeed, [we] can think of no reason why they would not – doing so is in everyone’s best interests,” it added.

"Obligation" to record data

NHS England told C+D that GPs have an “obligation” to record information they receive from pharmacists about vaccinated patients in that patient’s clinical record. Decisions about how data is shared between the two professions are made by local teams, it said.

PHE data also showed that vaccination uptake among over-65s has only reached 59%, a three percentage points drop compared with the same point last year. However, the 33% uptake among pregnant women is the same level as last year, according to the data.

The RCGP released its own “alarming” flu statistics yesterday, which revealed that the 101 practices it surveyed over the previous week had given an average of 6% less jabs than at the same period last year. Some family doctors told the RCGP that their surgery fridges are “full of unused vaccines because patients are not turning up in the usual numbers”, it said.

 

How have you built relationships with GPs during the national flu service?

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24 Comments
Question: 
What do you make of the RCGP's comments?

Simon Lawson, Community pharmacist

I have actively encouraged a lot of people to have the NHS flu jab in our pharmacy. Time and time again what I heard was that it was difficult to access a flu jab at a mutually agreeable time with GPs. We have probably increased the uptake. GPs need to look at their own work practice and flexibility. They could learn a lot from us.

Leon The Apothecary, Student

I suspect the delays in starting aforementioned service was a factor.

Lancelot Spratt, Accuracy checking technician

On purely anecdotal evidence only - my local surgery is normally very, very proactive in arranging flu vaccinations, to the point where even if you attend an appointment for a different reason you are asked if you have had your vaccination. Or even if you accompany another person for an appointment! They pester people on the phone and by email and send out letters. This year, nothing. Perhaps that is why the numbers are down. Maybe the doctors have decided the money gained is not worth the energy expended?

Terrie Singleton, Accuracy checking technician

Interesting that most of the people who have walked into Pharmacies are not the over 65's , but all the rest of the population who can't get an appointment at the GP. If this age group is identified as one who isn't getting a vaccine, I would question why , especially when it is widely available. I suspect its more about the GP surgeries finding that their antiquated systems have put patients off as its too many hoops to jump through to get the vaccination done.

N O, Pharmaceutical Adviser

Why all these accusations?? If EPS is deemed fit then why not link it to record all the interventions?? Why you need a separate IT system?? So others can make money? Yet blaming for lack of funds??? Have one national IT system, reduce redtape. Stop, saying we want to be transparent when you are not!!!

N O, Pharmaceutical Adviser

Why all these accusations?? If EPS is deemed fit then why not link it to record all the interventions?? Why you need a separate IT system?? So others can make money? Yet blaming for lack of funds??? Have one national IT system, reduce redtape. Stop, saying we want to be transparent when you are not!!!

London Locum, Locum pharmacist

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Dave Downham, Manager

Is it coming from London that makes you permanently miserable or the fact that you're a locum? A yes to both might explain your general bitterness. Try to get out more, make some friends, perhaps take up a hobby.

Jay Badenhorst, Superintendent Pharmacist

So it is up to pharmacy to change the weather to colder and send more people to surgeries in order for them to use their vaccines left in their fridges...?! A little less finger pointing and central coordination and promotion and the whole National picture may look better! 400k in pharmacy in year one, in my opinion, is brilliant.

Shifakat Ismail, Pharmacist Director

This blame culture does not gain points within any health profession. There needs to be a a synergic effort to achieve targets. Many surgeries have allocated days and locations for flu vaccinations and patient may not find this convienient. From my experience, many patients query why the GP practice have not sent any form of communications for their jab. Furthermore,some local practices went out their trying to get their patients booked for vaccination. All pharmacies and pharmacists work tirelessly to promote any new service, the figure of 400,000 vaccinations speaks for itself. Other factors, such as weather, lack of confidence in the vaccination, convenience any many more are at play. Looking forward to the final figure in a few months time. Well done to all for your hard work

Nat Mitchell, Community pharmacist

I feel that two things would have helped to prevent any decrease in uptake. Firstly, a robust and factual response to the sensationalist reporting of the inadequacies of last years vaccine by the relevant bodies. Secondly, reversion to a centrally run flu vaccine invitation system (LASCA if I remember correctly). Relying on surgeries to inform patients when their policies vary widely has not proven to be successful. Texting, websites and twitter doesn't work well for all patients. We as pharmacists can inform our patients, but a uniform system would be of benefit.It would also make it easier for pharmacies to deal with eligibility issues.

Stephen Eggleston, Community pharmacist

Pharmacy only increases access. Any drop in uptake will be down to 1) GPs not promoting the service and 2) last years publication of details that the vaccine was ineffective (despite the assertion on breakfast TV that, overall, the vaccine at least as effective as any other years vaccine) . Other than that, we are only adding to the provision of service

Karen Samuel-Smith, Pharmacy Area manager/ Operations Manager

Like Rob Darracott I also listened to the R4 "today" interview. A substantial part of the non-story seemed to be based on the observation that "GP surgeries still have a lot of vaccines left in the fridge" rather than doing anything liker, er, looking at records.

London Locum, Locum pharmacist

Sill pathetic little war. Laughable if it wasn't so serious. Pharmacists in the main viewed as minor irritants by GPs.

Simon Mathias, Other healthcare professional

Single data point measurements of success or failure are of little value at best. The real eveidnece will be in the final consolidated figures; and not comparative percentage data - this is just not robust. As to who is to blame? Blame for what? That professionals are not doing their job; taking work from each other or that a patient with free choice has made a decision? This is not about blame but an issue for the whole system, the NHS, the independent contractor, the pharmacy sector, and all teh other providers who have the opportunity to impact on patient health and wellbeing. (Just like the rest of the services we jointly provide and support the patient with). Me, I am not a fan of receiving a letter asking me, I would rather get a phone call or a face to face invite to partake.

Simon MEDLEY, Community pharmacist

maybe it would have been even lower if pharmacy wasn't involved or maybe the gp's don;t know what to do with all these faxesI'm sending them !

Ben Merriman, Community pharmacist

"The GP body told C+D that the national pharmacy flu service has “probably played a part” in this decrease, although it has “no way of knowing” for certain" - any chance of some evidence before inflammatory statements such as this are made?

Z ZZzzzz, Information Technology

Not to worry, in a few years there will be a univeral flu vaccine and after the initial mass rollout in the first year where there will be enough work for both surgeries and pharmacies, I imagine surgeries will then be the only sensible place to have the vaccine as part of the usual childhood regimes. Of course those with vested interests in maintaining the likes of this years' status quo will not want to see that happening as they see the potential loss of future income. As the old saying goes, Turkeys don't vote for Christmas. I do agree with the other comments on here with regards to why the number of flu vaccines have reportedly dropped - combination of informed patients deciding not to bother after last years ineffectiveness along with possible (deliberate?) under-recording by surgeries of the forms sent by pharmacists. Let's be honest how many surgeries bothered enacting on any feedback from pharmacies after an MUR to start with? Most were downright hostile.

Kevin Western, Community pharmacist

Locally, as soon as it became clear that we were doing the service, our local surgeries began phoning their eligible patient database. they have never done this before. they brought forward their flu clinics and began vaccinating people as they walked in to appointments, all new behaviour. All our vaccinations have gone through Pharmoutcomes despite the faff involved. how there are fewer because of our part in the service is beyond me. the reason we got the service is because for years targets havent been met. they didnt jump up and down looking for someone to blame then did they.

Robert Darracott, Community pharmacist

I think your headline goes a bit far. Given the most public platform to voice words consistent with that headline - Radio 4's "Today" programme - Maureen Baker, RCGP Chair, did not point the finger at pharmacy much at all - she talked about the possible effect of reporting last year's ineffectiveness and the mildness, to date, of the weather. She did, of course, urge people eligible for NHS vaccination to attend their GP for their jab.

Anthony Cox, Academic pharmacist

I'd echo Rob's comment about potential over-egging of this story. If asked if one thought the pharmacy scheme probably had an effect, someone might say it probably had some effect, but the RCGP have said they have no way of knowing for certain. I suppose we could also say we have no way of knowing for certain either. What this highlights is the need to ensure that pharmacy vaccination can plug into recording systems, and the need to look at the utilisation of flu vaccine in pharmacy. Are we hitting a different demographic? Are we getting people GPs didn't use to get. Year to year variations, with multiple confounders are not a basis for getting into a bunfight with a professional group that we need to work with as partners.

Dave Downham, Manager

Utter garbage, RCGP. Many factors here, not to mention timing between info sent by pharmacy and being recorded on patient records. Colloquially, ineffectiveness of last year's jab is reason that most people couldn't be bothered - why take the time out of your day to have a jab when it probably won't work? One day, RCGP might take a view that pharmacy is not the great Satan that they make it out to be. In terms of fridges full if unused vaccines, if numbers are down 6%, does that mean that each surgery has at least 32 fridges? Utter garbage.

Nick Hunter, Community pharmacist

How does data compare over the last five or 10 years? Comparing to only last year is not going to give a very realistic comparison

John Alan James Robinson, Superintendent Pharmacist

Interesting. The local surgery which we deal with sends a mailshot to over 65's inviting them to make an appointment. The local surgery where I am registered does not , or at least I have not had a letter. Its easy to deduce how surgeries may or may not react to emails or notifications from pharmacies. NHS England would be able to capture the combined data if the computerisation was in place. Blame games again.

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