Practices with low uptake of seasonal flu jabs may miss out on thousands of pounds in funding because they will struggle to hit targets for swine flu jabs.
Under the deal struck last week, practices receive a basic £5.25 per swine flu jab administered. But to trigger extra benefits, GPs must give the jabs to at least 3 per cent more at-risk patients than last year's UK average uptake of seasonal flu jabs.
The 2008 uptake rate was 73.5 per cent in over-65s and 47.2 per cent in at-risk groups.
Only practices whose swine flu uptake is at least 3 per cent ahead of these levels will have their PE7 and PE8 patient experience QOF targets lowered.
Practices that achieve this level of uptake earn a 10 per cent drop in the upper thresholds and 20 per cent in the lower thresholds for PE7 and PE8.
If practices perform the same as last year, lowering the upper threshold of the PE8 indicator by 10 per cent will more than double the number of practices scoring top marks, worth £4,437 to an average-sized surgery.
But RCGP immunisation spokesman Dr George Kassianos warned the swine flu vaccination was far tougher to deliver than seasonal flu jabs.
It is time-consuming to administer, and practices will struggle to get patients in for both doses, especially in areas with traditionally low uptake of flu jabs, he said.
'Don't expect your nurses and doctors to be able to do as many as the annual influenza vaccination,' Dr Kassianos warned.
'Many inner-city practices have difficulty with uptake and there needs to be a national campaign to tell people to get immunised,' he said.
GPC chairman Dr Laurence Buckman estimated that an average-sized practice's vaccination workload would take one nurse four to six weeks.
He also accused the DoH of spreading rumours about GPs demanding large fees to deliver the vaccine, to weaken the GPC's negotiating position.
GPs have also expressed concern that details of criteria for QOF suspension and payments for practices unable to maintain services are yet to emerge.
Negotiations to help practices overburdened by swine flu are ongoing, said GPC swine flu lead Dr Peter Holden. 'The first thing to do was get the vaccine sorted.'