NHS England might ‘take action’ if a pharmacy contractor delivers the inappropriate flu vaccine to certain patient groups, the Pharmaceutical Services Negotiating Committee (PSNC) has confirmed.

The negotiator said that contractors who provide the adjuvanted trivalent inactivated flu vaccine (aTIV) and the quadrivalent vaccine (QIV) to the wrong patient groups might face action from NHS England for a ‘breach’ of the service’s terms.

PSNC highlighted that the over-65s should not be offered any other vaccine than aTIV (Fluad) ‘at this point in the season’, unless they are allergic to eggs.

The comments come after NHS England published guidance last month on the 2018/19 flu vaccination programme delivery, which said a contractor will ‘not be reimbursed or remunerated for vaccines administered to patients outside of the eligibility criteria.’


‘Serious contractual breach’


The NHS England guidance said: ‘Any community pharmacy contractor providing the advanced service must work strictly within the terms of the patient group direction (PGD) and the pharmaceutical services (advanced and enhanced services) (England) directions, covering the advanced service, published in the drug tariff.

‘Any deviation will be treated as a serious contractual breach.’

Non-eligible patients include:

  • The under-18s.
  • People who had an anaphylactic reaction following a previous dose of the vaccine
  • People who had an anaphylactic reaction due to any component of the vaccine or residues from the manufacturing process – such as barium sulphate and polymyxin.
  • People who had a severe anaphylactic reaction to egg and were in intensive care
  • Those who have already received the vaccine for this season.
  • Individuals suffering from acute severe febrile illness. These should be temporary excluded.

According to NHS England, GPs and pharmacists who have aTIV stock shortage issues should tell patients to ‘return later in the season’.


Fee increase


Under the flu vaccination service, contractors will receive a £9.48 fee for each flu vaccination delivered – a 34p increase to £7.98 per administered dose plus an additional £1.50 fee per vaccination – a payment rise recently negotiated by PSNC.

In addition, they will be reimbursed for the cost of the vaccine and be paid an allowance ‘at the applicable VAT rate’, NHS England said.


New flu jab requirements


PSNC said it is the first time this year (2018/19) that different vaccines are ‘recommended’ for different eligible groups’, which include hospice care workers.

‘There is also an added complexity this year, due to the fact that contractors will receive a phased delivery of Fluad and that there is a recommended priority order for patients in the 65 years and above eligible group,’ the negotiator added.

According to NHS England guidance, GP surgeries and pharmacies will receive ‘three batches’ of aTIV over three months – 40% in September, 20% in October and 40% in November.