BMA confirms COVID-19 vaccination deal will not be a directed enhanced service

GP practices will not deliver the COVID-19 vaccination programme under a directed enhanced service (DES) agreement as previously expected, the BMA has said.

BMA House (Photo: Malcolm Case-Green)
BMA House (Photo: Malcolm Case-Green)

GP leaders have made clear that despite initial discussions on the basis that the deal - which will see a designated practice in each primary care network area in England deliver vaccinations - would be rolled out as a DES, a different form of enhanced service will be used to allow greater flexibility.

Instead of a DES, the COVID-19 vaccination programme will operate under an enhanced service commissioned by NHS England under section 7a of the NHS Act.

BMA leaders say the change will not allow terms and conditions to vary across the country, that the 'content of the specification is no different' due to the change of contractual vehicle - and that it will be 'offered to all practices under the same terms' in much the same way as a DES.

COVID-19 specification

Changes to the specification will only be possible by agreement between NHS England and the BMA's GP committee - although using the section 7a provisions means the deal can be updated 'swiftly' if any amendments are necessary, potentially as new vaccines become available or as further practices are brought into the campaign.

BMA GP committee chair Dr Richard Vautrey said: 'While initial discussions had been on the basis of a DES, we have now been advised that section 7a arrangement would provide the most appropriate contractual vehicle for the programme.

'This will provide the flexibility for necessary changes – only with agreement between NHS England and Improvement and GPC England – that is crucial in such a fast moving environment where we will need to add in new information without delay as more vaccines are supplied with different requirements.

'An enhanced service such as this is already used for other public health immunisation programmes delivered by general practice.

Vaccine plans

'While we understand there has been unnecessary confusion, practices and patients will experience no differences resulting from the technical change, and the requirements of the programme remain the same.'

Final guidance released earlier this week by NHS England confirmed draft details of the plans revealed last week by GPonline, which made clear that practices will receive a £12.58 item of service payment for each jab administered. Two doses of the vaccine are required - meaning practices will receive £25.16 in total per patient vaccinated.

The final plans also confirm that most of England's 1,250 PCNs will be expected to designate a single practice to administer vaccines in their area - although exceptions could be made for networks covering patient populations of more than 100,000.

PCNs are expected to nominate a designated practice by 17 November, with CCGs to assess and make recommendations to NHS England regional teams by 19 November and NHS England to confirm approval of vaccination sites on 23 November.

Documents published by NHS England suggest a full service specification for the COVID-19 vaccination enhanced service deal will be published in 'late November'.

Details of the GP-led COVID-19 vaccination plan came after a early findings from a phase 3 trial of a vaccine developed by Pfizer and BioNTech found 'a vaccine efficacy rate above 90%'.

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