Under the changes, the childhood immunisation DES will be scrapped and the associated £60m of funding will be moved into the QOF to fund a new immunisation domain that will reward achievement. From April, practices will also be paid a £10.06 item of service fee for every vaccine they deliver.
Providing all routine NHS immunisations will become an essential service under the GP contract, with the exception of the childhood and adult flu jabs, which will continue as separate enhanced services, and COVID-19 vaccination.
The overhaul was agreed as part of the GP contract deal for 2020/21, following a wide-ranging review of vaccinations which concluded payments to practices needed to be simplified.
The BMA has previously said that the reforms should not result in any additional work for practices.
Core contractual standards
A letter to practices from NHS England on 10 March explaining the changes set out five core standards relating to vaccination services that practices will be contractually required to have in place from April.
Practices will need to have a named lead for vaccination services and provide 'sufficient, convenient appointments', which should include appointments during extended hours. The letter said that practices will be able to 'collaborate across their PCN to achieve vaccination coverage', but they must ensure appointment availability suited their practice population.
Patients should be able to book vaccination appointments online 'as these services develop', the letter added.
Practices will also be expected to meet new standards relating to call/recall programmes and opportunistic offers. Patients who do not respond to an initial offer of vaccination should be recalled on a minimum of two additional occasions, the guidance said. On the third contact a healthcare professional will be required to have a face-to-face or telephone conversation with the patient or parent.
The guidance added: 'In most cases, recall activity should continue beyond three contacts until vaccination had been completed – especially for routine childhood immunisations – to ensure maximum individual and population protection'.
Practices will also be require to take part in national agreed catch-up campaigns and follow standards for record keeping and reporting.
From April the QOF will have four new immunisation targets. Practices will be expected to achieve 90-95% uptake of diphtheria, tetanus and pertussis vaccines in 8 month-old infants and for the first dose MMR jab in those aged 12-18 months. Achievement thresholds of 87-95% have been set for 5 year olds to have received a DTaP/IPV booster and two MMR doses.
A further indicator targets practices to achieve 50-60% uptake of the shingles vaccine in those aged 70-79. In total 64 points will be available for immunisations.