According to some local pharmaceutical committee (LPC) representatives, some GPs have been urging patients to receive their COVID-19 vaccination at their surgery or primary care network (PCN) site instead of a pharmacy-led vaccination hub – in some cases when those patients already had appointments booked or the pharmacy site was closer to their home.

According to one pharmacist, a patient was allegedly “told off” for being vaccinated in a pharmacy-led centre, while another claimed a number of their patients did not attend their vaccination appointments, as they had been persuaded by a GP surgery to go to their site instead.

All those who spoke to C+D about the issue suggested that different local booking systems– separate from the national booking service – was contributing to the problem and creating an “internal market” for patients among vaccinators.

In addition to the national booking service, local systems are in place to enable hospital hubs and PCNs to offer appointments to patients directly.

“Undermining pharmacy service”

Raj Matharu, chair of Pharmacy London, told C+D that he is aware of vaccine patient-poaching in some areas of north-central London. He has escalated the issue to NHS England and Improvement (NHSE&I), he told C+D.

“Some of it seems very systemic and almost designed to undermine the community pharmacy service,” Mr Matharu said. Asked if he was aware of this sort of patient poaching occurring elsewhere, he commented: “To be honest with you, it’s happening across the piece, but I don’t know if the others have escalated like we’ve escalated it.”

NHSE&I was approached for comment.

Similarly, Greater Manchester LPC had received a “fair amount” of complaints from pharmacists in the area, some of whom had witnessed patients requesting to be vaccinated at the nearby pharmacy-led site, but being told they must travel to a PCN site further away, according to vice chair Ifti Khan.

“It’s quite embarrassing, what’s going on,” Mr Khan said. “Patients are being put in difficult positions and what we’re finding is patients are not being given the choice and they’re being told that if they don’t get [the vaccine] from the PCN centre they’ll be wasting NHS resources,” he claimed.

“It’s NHS stock, so it’s misleading the public into thinking they’re wasting NHS resources if they go anywhere else. It’s just bonkers,” Mr Khan added.

He also raised concerns about the added strain that having to travel further to be vaccinated was putting on elderly patients.

“We’ve heard examples of people catching two buses, or spending half the day to go and get the vaccine because they’re having [to] travel miles and miles, and it just seems really strange,” Mr Khan told C+D.

The LPC has raised the issue with Greater Manchester Health and Social Care Partnership (GMHSCP) as well as local PCNs, Mr Khan said.

GMHSCP told C+D that it was not aware of any issues that had been raised by Greater Manchester LPC.

The British Medical Association was also approached for comment.

Pharmacy site “no-shows”

Two pharmacists running vaccination hubs in the Midlands – who both wished to remain anonymous – told C+D they had experienced similar issues at their vaccination sites.

One explained that GPs were contacting patients who had booked through the national vaccination booking service and persuading them to be vaccinated at their surgery or PCN site instead.

“Even to the point that one of our patients, who was vaccinated, got a phone call from the doctor actually telling her off – ‘how dare you go to their vaccination centre. We’re doing the vaccination, we’ve got your record, we know it’s safe,' and so on,” the pharmacist claimed.

Another said that there had been eight no-shows out of 220 bookings on one day. When they had contacted patients  to find out why, they had all been poached by GPs, they claimed.

Greater Manchester LPC’s Mr Khan said: “One of the things that really concerns me [is] particularly with BAME community members, because we know in some areas vaccination levels are low – we know they’re not getting vaccinated, but all of this isn’t helping.

“This should all be about patient choice. Patients choose where they want it, and they get vaccinated. It’s the same vaccine regardless of where you go.”

Deja flu all over again?

Mr Khan speculated that the motivation to take patients away from pharmacy-led centres was “financial”.

“It’s exactly the same as it is with flu; they want to keep control of that money and they want to make sure that money comes into [the] surgery,” he alleged.

There has been a long history of rivalry between pharmacies and GPs over the administering of the seasonal flu jab. In previous years, C+D found that GPs had been “chastising patients” who were considering getting a flu jab at their pharmacy, even threatening to “delist” patients from their practice.

Asked why he thought GPs were resorting to such tactics, Mr Matharu said: “I could give them the benefit of the doubt and think that the vaccine they’ve got they need to use. […] But it does seem that they want to establish themselves as the core COVID vaccine providers.

“The whole point of adding community pharmacy sites was to allow more access capacity geographically, so patients didn’t have to go further away to get the vaccine.”

NHSE&I was contacted with all the above claims, but had not responded by the time this article was published.

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