Swine flu deal lets GPs plan ahead

Uncertainty about swine flu funding has ended, but concerns about storage remain. Sanjay Tanday reports.

Multi-dose vials mean that each jab will take time to prepare
Multi-dose vials mean that each jab will take time to prepare

Frantic negotiations between the DoH and the GPC over funding for the swine flu vaccination campaign finally ended last week, with the announcement that UK GPs will receive £5.25 for every dose of vaccine they administer.

With the programme expected to begin within weeks, the deal is a welcome boost to practices planning additional clinics to deliver the jabs.

CMO for England Sir Liam Donaldson has already set GPs an ambitious target of vaccinating all nine million at-risk patients by the end of the year.

Currently, it is expected that patients will be given two doses of the vaccine, which would mean that GPs would earn £10.50 per patient.

However, early studies have shown that one dose may be sufficient to provide immunity.

Central funding welcomed
GPs will welcome the news that the deal will be centrally funded, allaying fears that it would force cuts to existing services such as local enhanced services (LESs).

Practices that perform well may be able to boost their income beyond the £5.25 fee per jab. GPs who hit target uptake levels in the swine flu programme will see thresholds for QOF indicators on patient experience lowered.

In addition, the collection date for their data on childhood immunisations will be put back by six weeks to mid-February.

Dr George Kassianos, RCGP immunisation spokesman and a GP in Berkshire, says the agreement enables practices to proceed with plans to immunise at-risk groups.

'The amount negotiated and agreed is not as important as the fact that we have an agreement and the campaign can now start,' he says. 'If vaccinations take place in normal working hours, extra clinical staff may need to be drafted in.'

RCGP vice-chairman Dr Clare Gerada, a south London GP who helped tackle one of the first outbreaks of swine flu at Alleyn's school in Dulwich, says her practice will use the money to take on extra staff and run a vaccination clinic on Saturdays.

'We usually have to do this when it comes to the seasonal flu programme,' she says.

Dr Trefor Roscoe, a GP in Sheffield, an area heavily hit by the first wave of swine flu, says the deal is welcome and will help to fund the overtime GPs will have to put in.

'We are seeing if we can hire out a local school sports hall to carry out a vaccination clinic in the evenings and at weekends.

'This is extra work that we cannot fit into the normal day. There are no longer any quiet times to deliver the jabs.'

What was negotiated?
  • £5.25 per dose of vaccine.
  • No changes to QOF for 2010/11.
  • No cuts to LES funding
  • Thresholds for achievement of QOF indicators on patient experience lowered.
  • Collection date for data on childhood immunisations to be delayed by six weeks.

Fridge space worries
But Dr Roscoe warns that despite the additional funding the problems of fridge space are still to be resolved.

'We do not know when the vaccine will arrive. At the moment we are running down the stocks of other vaccines to make room, but the first batches of the seasonal flu jab will be arriving next week.'

Dr Kassianos agrees that there are still problems: 'GPs purchasing additional pharmacy fridges may not be the answer. There may be a problem with space in the surgery premises. They may also become surplus to requirements after the end of the campaign.'

Some GPs have expressed concern that the swine flu fee is lower than the £7.51 fee for seasonal flu jabs.

'Why this is considered a "cheaper" option than seasonal flu eludes me,' says Coventry GP Dr George Paige.

'The main problem is that the vaccine will be in multi-dose vials so it will take a long time to sterilise, draw up and prepare the syringe,' he says.

Elsewhere, the GPC has agreed that no changes will be made to the QOF for 2010/11, a move strongly supported by GPs across the UK.

A GP poll this month found 74 per cent of GPs wanted QOF changes delayed to let them focus on swine flu. But with doubts over whether vaccination is necessary, GPs' biggest challenge may be persuading patients to have the jabs.

 

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