One LMC leader told GPonline that local practices felt they had been ‘strong-armed’ into participating in phase 3 COVID-19 vaccinations between 6 September and 17 December 2021 - fearing ‘substantial financial losses’ if they opted out.
Others said practices simply felt it made sense to continue with vaccinations after PCN-led sites delivered the vast majority of COVID-19 jabs rolled out in the UK to date - and reports from GP leaders suggest most practices across the country plan to sign up to deliver booster jabs.
Clinical directors leading PCNs have argued that safeguards needed to be created around workload, specifically QOF, with the vaccination campaign continuing to present practices with a considerable workload challenge.
COVID booster vaccinations
North Staffordshire LMC secretary Dr Chandra Kanneganti said PCNs in his area would be opting in. He said practices in Stoke-on-Trent had worked well as a PCN during the pandemic, and it made sense to continue.
‘We are doing it because it’s crucial - we’re waiting for the guidance around whether we can do the flu vaccines at the same time - but we've been doing COVID-19 jabs from the beginning. This has been a huge achievement for general practice, and played a key role in reducing hospital admissions,’ he said.
Dr Kanneganti admitted that there should have been local variation to allow practices in certain areas the flexibility to vaccinate at an individual practice level, with the BMA saying earlier this month that plans for vaccination at PCN-level only ‘ignored’ the voice of GPs.
Clinical director at Whitewater Loddon PCN in Hampshire Dr Tim Cooper said the six PCNs in his area, who had come together as one team for phases 1 and 2, were signing up to deliver booster jabs, but warned there could be workload issues.
Dr Cooper said: ‘I think it might be challenging if we can’t co-administer [COVID-19 jabs] with flu jabs. But ultimately, as we’ve worked at scale, we have the benefit of shared resources across six PCNs. The item of service is enough to cover what we need to do.
‘I think there needs to be understanding that this is taking practice and PCN time. The safeguards around QOF and workload need to be considered, without this we have simply created another big workstream.’
He added: ‘I don’t think it would be enough for us to pull back but I do think greater consideration needs to be given to the overall pressure primary care is under.’
One LMC chair in the Midlands argued that practices in the area had not been left with much of a choice about whether to sign up. They said: ‘Most practices in our PCN feel as though they are being strong-armed to sign up or potentially make a substantial financial loss.
‘The design of the enhanced service seems to be at odds with how most practices and PCNs would have liked to have rolled out this phase of the COVID-19 vaccine.’
NHS England ruled out administration of COVID-19 booster jabs at individual practice level in an enhanced service document for phase 3 of the vaccination campaign. It also said that flu vaccinations should be co-administered in a single appointment where possible.
However, final advice from the JCVI, due ‘before September’, could yet change this. GPs have warned this could leave them facing a potential 'planning nightmare' - threatening to ‘upend plans’ and leave many unable to deliver booster jabs.
LMC leaders have also warned that even if practices sign up now to indicate willingness to deliver COVID-19 boosters as part of phase 3 of the vaccination campaign, they could yet choose to pull out at a later stage.
Liverpool LMC medical secretary Dr Rob Barnett said: 'It's a two-stage process. If you don't sign up and therefore give an indication of interest now, you won't be part of it at all. If you do sign up then you can withdraw - one thing is you have to have a signed collaboration agreement by 6 September, and if you don't sign up [for that], by default you're out.
'Until we see the flu enhanced service I don't think practices will be in a proper position to make an informed decision. So there may be some changes.'
GPs at Wessex LMC also highlighted that practices faced 'potential issues' with 'unknown variables' around the flu campaign. They said: ‘We would suggest that this is not the same as signing an agreement to provide the service.
'In fact [the agreement] goes on to say in the same paragraph that “GP practices and the Commissioner (NHS England) must record their agreement to participate in the enhanced service in writing. It does not say how and when the recording of the agreement is to take place.’