Eligibility
Patients eligible for vaccination under this ES are those patients who are included within the cohorts below:
9.1.1 those aged 6 months to under 50 years in clinical risk groups;
9.1.2 pregnant women;
9.1.3 those aged 50 years and over;
9.1.4 those in long–stay residential care homes;
9.1.5 carers;
9.1.6 locum GPs;
9.1.7 close contacts of immunocompromised individuals;
9.1.8 frontline health and social care staff employed by:
9.1.8.1 registered residential care or nursing home;
9.1.8.2 registered domiciliary care provider;
9.1.8.3 a voluntary managed hospice provider;
9.1.8.4 Direct Payment (personal budgets) and/or Personal Health Budgets, such as Personal Assistants; and who are registered with the GP practice; or
9.1.9 frontline health and social care staff employed by:
9.1.9.1 a registered residential care or nursing home; or
9.1.9.2 a voluntary managed hospice provider; that are not registered with the GP practice but who elect to receive their vaccination from the GP practice
9.1.10 those living in:
9.1.10.1 long–stay facilities;
9.1.10.2 nursing homes;
9.1.10.3 other long–stay health or social care facilities; or
9.1.10.4 a housebound Patient as described in paragraph 11.16. that are not registered with the GP practice.
9.2 All frontline health and social care workers are expected to have influenza vaccination to protect those they care for.
Service Specification
11.1 The GP practice shall offer seasonal influenza vaccination to all eligible Patients unless contra–indicated. Vaccinations must only be administered to eligible Patients.
11.2 Immunisation is contra–indicated where the Patient has previously had a confirmed anaphylactic reaction to a previous dose of the vaccine, or to any component of the vaccine.
11.3 Where the eligible Patient is a registered patient of the GP practice the GP practice shall undertake:
11.3.1 a proactive call/recall if the Patient is considered at–risk;
11.3.2 a proactive call basis if the Patient is not considered at–risk with the aim of maximising uptake;
11.3.3 reasonable co–operation with any national call/recall service; and
11.3.4 shall maintain clear records detailing how they have called/recalled eligible Patients.
11.4 In calling Patients in accordance with paragraph 11.3, GP practices must use at least one written communication (to include letters/SMS text messages) offering vaccination to eligible Patients. GP practices must request details of the Patient’s ethnicity status if they have not previously provided this information to the GP practice and where provided by the Patient or their carer, the GP practice must record the ethnicity information in the Patient record.
11.5 Vaccinations must only be delivered during the term of this ES.
11.6 The vaccines reimbursed as part of the NHS Seasonal Influenza Immunisation Programme 2021/22 are outlined in the letter6 published on 1 April 2021. During the influenza season there may be additional advice from the Commissioner or Public Health England if there are issues with vaccine supply,
11.7 GP practices should ensure that the correct number of doses of vaccine are administered. Where two doses of vaccine are required (see 11.8 below), a failure to give both doses may leave a child incompletely protected. Conversely, where only one dose of vaccine is indicated, payment will not be made for any second doses that are inadvertently given.
11.8 Patients aged six months to under nine years at the time of vaccination, who are in clinical risk groups and who have not received influenza vaccination previously, will require a second dose of the appropriate vaccine at least four weeks after the first dose
11.9 GP practices must adhere to defined standards of record keeping ensuring that the vaccination event is recorded in the medical record of the Patient on the same day that it is administered where possible and shall include:
11.9.1 any refusal of an offer of a vaccination;
11.9.2 where an offer of vaccination was accepted:
11.9.2.1 details of the informed consent to the vaccination;
11.9.2.2 the batch number, expiry date and title of the vaccine;
11.9.2.3 the date of administration of the vaccination;
11.9.2.4 when two or more vaccines are administered in close succession the route of administration and the injection site of each vaccine;
11.9.2.5 any contra–indication to the vaccination or immunisation;
11.9.2.6 any adverse reactions to the vaccination; and
11.9.2.7 record within the Patient record any vaccinations that have been administered using centrally supplied stock
if this stock has been supplied.
11.10 Where a vaccination is administered to a registered patient of the GP practice by a provider other than the GP practice and the Patient’s record is not automatically updated electronically, the GP practice must update the Patient records on the same day that the vaccine is administered or on the day that notification is received from the other provider.
11.11 Practices should record vaccination events relating to Patients specified in paragraphs 9.2 and 9.3 and who are not registered with the GP practice in line with national guidance.
11.12 GP practices must ensure that all healthcare professionals who are involved in administering the vaccine have:
11.12.1 referred to the clinical guidance available including the Influenza Chapter of the Green Book8 and Inactivated influenza vaccine information for healthcare practitioners9; and
11.12.2 the necessary experience, skills and training, including training with regard to the recognition and initial treatment of anaphylaxis.
11.13 GP practices must ensure that all vaccines are received, stored, prepared and subsequently transported (where appropriate) in accordance with the manufacturer’s instructions and the guidance set out in the ‘Storage, distribution and disposal of vaccines’ chapter of the Green Book’. All refrigerators in which vaccines are stored should have a maximum/minimum thermometer, temperature readings should be taken and recorded from that thermometer on all working days and appropriate action must be taken if any readings are outside the recommended temperature range of +2°C to +8°C.
11.14 GP practices must have the ability and capacity to deliver this ES. Appointments should provide maximum flexibility for Patients and should be available at a range of times across the week including during extended hours, such as evenings and weekends to maximise vaccinations to eligible cohorts.
11.15 GP practices must ensure that services delivered under this ES are accessible, appropriate and sensitive to the needs of all Patients. No eligible Patient shall be excluded or experience particular difficulty in accessing and
effectively using this ES due to a protected characteristic, as outlined in the Equality Act (2010) – this includes Age, Disability, Gender Reassignment, Marriage and Civil Partnership, Pregnancy and Maternity, Race, Religion or
Belief, Sex or Sexual Orientation.
11.16 GP practices will monitor and report all activity information via ImmForm on a monthly basis. As in previous years the activity information shall include a monthly count of all eligible Patients who received a seasonal influenza
vaccination in the relevant month. This information will be used by NHS England and NHS Improvement and PHE for monitoring uptake achievement and national reporting. These figures are used for official statistics.
11.17 Where the Patient or parent/guardian has indicated they wish to receive the vaccination but they are unable to attend at the practice (for example because the medical condition of the Patient is such that, in the reasonable opinion of the GP practice attendance on the Patient is required and it would be inappropriate for the Patient to attend at the practice) the GP practice must make all reasonable efforts to ensure the Patient is vaccinated.
11.18 GP practices will be responsible for recording adverse events and providing the Patient with information on the process to follow if they experience an adverse event in the future after leaving the vaccination site, including
signposting the Yellow Card service. GP practices will be expected to follow MHRA incident management processes in the case of a severe reaction.