GPs have been demanding clarity from the government over plans for the 2020/21 flu vaccination campaign, after NHS England suggested in May that additional cohorts could be included in response to the COVID-19 pandemic.
The government has yet to confirm any expansion - but take-up is expected to be high among patients already eligible because of health fears driven by the pandemic.
Senior GPs have warned that social distancing requirements, the need to wear personal protective equipment (PPE) and the potential surge in patient numbers will pose challenges for general practice - in a year when an effective flu campaign is essential to avoid a wave of flu cases at the same time as a potential second spike of coronavirus infection.
BMA GP committee chair Dr Richard Vautrey told GPonline: 'It is going to be a real challenge - this is something we are talking to the government about.
'It will take a lot longer for practices to deliver the flu programme. I think the social distancing will add time, the use of PPE will add time, and potentially increased numbers will add time.
'Some practices will be able to be adapted to have a circuit of patients coming through in a safe way. But it will be more difficult, and many may need to use different venues. It will vary from practice to practice - but practices have a long history of delivering mass vaccinations.
'We need - quickly - clarity from the government on whether the cohort is going to change. We have warned that practices have already ordered vaccines - if we are to increase the cohort, there will be a need for additional supplies. And practices should not be left out of pocket - we will need additional costs covered.'
BMA GP committee member Dr Peter Holden said social distancing would be a 'big issue' for general practice in the delivery of flu vaccines.
Rules around PPE could also more than double the time per jab, he warned. 'One of the issues we have not sorted out is how much PPE you've got to be in. Have you got to change gloves between every patient? If that's the case, it's going to be five minutes per jab, not two - and it's going to mean you need assistance to do that.'
Dr Holden added: 'We still don't know the cohort, and then there are physical restrictions on the buildings.'
The Derbyshire GP told GPonline that practices may need to work together to deliver vaccines, potentially working with local authorities to secure larger facilities that would allow 'multiple streams working in parallel'.
In some areas, primary care networks could be the ideal vehicle for bringing groups of practices together to deliver vaccines en masse - particularly in urban areas, Dr Holden said.
In recent years pharmacies have been allowed to deliver flu vaccines for patients in at-risk groups alongside the service provided by practices. Dr Holden warned that it may be better to let practices run the scheme entirely this year to ensure that key groups were prioritised for vaccination and to ensure that vaccines ordered by GP practices were not left unused.