The government has published plans for a 2021 flu vaccination campaign that will target 35m people - making it the largest flu campaign in history. The campaign will cover all over-50s, people in at risk groups, pregnant women, school-age and pre-school children and health and social care workers.
NHS England said at a primary care briefing last week that publication of a flu enhanced service specification setting out precise requirements for GP practices would come 'in the next few weeks'.
But practices have warned that continuing uncertainty over how the flu campaign will work alongside COVID-19 vaccination - including whether the jabs can be administered at the same time - have left them facing a difficult choice as the 28 July opt-in deadline to deliver COVID-19 booster jabs approaches.
The BMA urged the government and NHS England to publish more details quickly - and reiterated calls for a reduction in other practice workload and a freeze on any new targets, in particular with cases of COVID-19 already rising fast as rules are relaxed from 19 July.
In a letter to NHS staff setting out details of the flu plans, the government said 'planning for influenza vaccination should continue as usual for this autumn'.
But Northumberland LMC medical secretary Dr Jane Lothian told GPonline that if COVID-19 jabs can be delivered at the same time as flu jabs, normal planning for the flu campaign would be 'completely upended'.
NHS England confirmed earlier this month that COVID-19 booster jabs could not be delivered at practice level, despite calls from the profession to support this approach. As a result, if flu jabs can be administered at the same visit, practices will have to plan to deliver many of these at PCN vaccination sites, rather than the usual practice-level operation they carry out annually.
Flu and COVID jabs
Dr Lothian said one PCN in her area was convening a meeting to decide whether or not they could participate in delivering COVID-19 booster vaccinations because of uncertainty over the workload involved and how this would interact with delivering flu jabs.
She said: 'Practices will be very worried [about signing up to deliver COVID-19 boosters]. If you don't have all the details, how can you commit to it?'
One GP commented during the primary care webinar that plans to publish a flu specification in 'the next few weeks' meant practices could not 'make an informed decision about whether we can feasibly deliver Phase 3' of the COVID-19 vaccination campaign.
The JCVI published interim advice last month suggesting that flu and COVID-19 jabs were likely to be able to be co-administered, but has only confirmed that final advice is due 'before September'.
Dr Lothian said that practices faced a 'planning nightmare' as they considered how to set up flu and COVID-19 booster clinics later this year.
She said practices would have to consider the site, the type of COVID-19 vaccine required for each patient, and the type of flu vaccine required for different risk groups, how to transport patients to sites potentially significantly further from where they normally receive a flu jab and booking them in.
Practices will also have to consider limitations around how stocks of flu vaccine ordered by individual practices can be used as part of a larger vaccination operation. 'From a basic planning point of view, there are a lot of variables to consider,' Dr Lothian said.
BMA GP committee chair Dr Richard Vautrey said: 'Practices need to have all the information about different areas of work this winter, so they are able to make informed decisions about what is possible and begin planning.
'Therefore, NHS England should publish the flu specifications as soon as possible, giving practices as much time as they need to consider them alongside the booster programme. As we have already made clear to government, any other additional demands on GP workload must be delayed given the current crisis, and therefore NHS England must also think carefully before introducing any further service specifications in the coming months, in the context of rising COVID-19 cases and the challenges winter will bring.'
NHS England's letter confirming plans for the 2021 flu vaccination campaign warns that 'winter 2021 to 2022 will be the first winter in the UK when seasonal influenza virus (and other respiratory viruses) will co-circulate alongside COVID-19' - and that flu vaccination will be essential to limit pressure on health services.
The letter confirmed that last year saw a record 80.9% of people aged over 65 in England vaccinated against flu, record uptake among frontline healthcare workers, two- and and three-year-olds and in at-risk groups.