'Host practice' to receive all COVID-19 vaccine payments in each area

A single 'host' practice will receive all COVID-19 enhanced service payments for vaccinating patients in each local area - with practices to agree how these funds will be distributed, NHS England has confirmed.

(Photo: Javier Zayas Photography/Getty Images)
(Photo: Javier Zayas Photography/Getty Images)

The host practice will receive details of how many patients on each practice's list have been vaccinated and will then be expected to transfer payment to the appropriate practice.

However, practices will have to sign a collaboration agreement to deliver the vaccination programme from a designated site - and will need to agree how money is going to be shared between practices within that.

Practices will also be expected to agree how they will share any payments for individuals who are not registered with any practice in the PCN grouping, such as care home workers who may be vaccinated at the same time as patients.

Designated vaccination sites

The details were set out in an NHS England webinar on Thursday 26 November where it also emerged that there has been a delay in confirming designated vaccination sites that are not GP surgeries.

The deadline for confirming vaccination sites was 19 November. However, primary care director Ed Waller said there had been some delays because CCGs needed to establish whether 'it was good value for money' to spend funds on securing non-practice locations. Earlier this week NHS England set out details of a £20m fund to support practices with one-off set up costs, which also covers costs for external sites.

Mr Waller said that the full enhanced service, plus supporting documentation on key aspects of how the vaccination programme will be delivered, would be available 'very, very shortly'.

He said practices would need to 'formally opt into the programme' via the enhanced service and that this step, along with having a designated site in place, will 'turn on that site for vaccine delivery'. He reiterated information set out earlier this week that practices would receive 10 days notice of any vaccine deliveries.

IT solutions

During the webinar officials also revealed that practices involved in the vaccination programme would be using web-based point-of-care IT systems to record details of vaccination. In London this will be the Sonar system, while the rest of England will be using Pinnacle.

The systems will feed data directly into GP IT systems, in the same way that flu vaccinations at pharmacies do, so practices will not have to duplicate data entry. It is understood that training on how to use Pinnacle and Sonar will be provided.

NHS England said it was exploring whether it was feasible to move at some point to use existing GP systems' to record vaccination.

However, the data requirements for the COVID-19 vaccination programme are different from those for flu vaccination, for example data will be sent to the MHRA because the vaccines involved are all new products, and NHS England said it would take time to understand how these requirements could be incorporated into GP IT systems and test them.

The MHRA has also said that all vaccines will need to be scanned before being administered so all vaccination sites will need barcode scanners, which NHS England said it expects to provide.

Payment to practices

The entries on Pinnacle and Sonar will automatically generate payments to the host practice under the enhanced service and provide the data on which practice patients are registered with.The host practice will receive payment after the second dose of the vaccine is administered.

The enhanced service will set out a range of 'limited reasons' where practices will be able to claim payment for administering one dose of the vaccine, such as if a patient fails to attend for their second jab, in which case PCNs will be required to make a manual claim.

During the webinar Mr Waller said that, while NHS England was looking at whether GP practices could deliver vaccinations later in the programme, supply chain logistics meant that NHS England planned to stick with designated sites for the time being.

'We need to take this picture as one that will evolve as the situation evolves,' he said 'But for now we are firmly in the territory of one site per PCN.'

NHS England also reconfirmed that practices will be provided with the required consumables needed to deliver the programme, including all PPE so they will not need to order this from the online portal.

A national list of what will be provided centrally, which will likely include vaccine fridges and cool boxes for taking vaccines into care homes, will be available shortly.

NHS England also said that practices will not be required to offer call and recall to care home staff and health and social care workers, who are expected to be among the first to be vaccinated under the programme. These individuals will be asked to self identify by their employers and a national communications campaign.

Practices will be expected to call and recall patients on their list as the programme moves through the eligible cohorts. While there would be a national booking system, this would not 'understand the groupings of PCNs' and therefore eligibility of patients within the PCN and the GP surgery they belong to.

Eligible cohorts

Final decisions around prioritisation of cohorts rests with the Joint Committee of Vaccination and Immunisation (JCVI) and have yet to be published. Once national guidance was in place to confirm cohorts, practices will be expected to follow this in inviting patients on their list for vaccination, NHS England said.

Slides shown during the webinar said that PCN designated sites 'will need to put in place a local collaborative booking model that enables all practices within the PCN grouping to book patients into clinics at the site'.

GPonline also understands there will be a centrally run consent process for the vaccination programme, but NHS England has yet to provide detail on this.

However, NHS England has confirmed that national materials will be made available about the programme, including information to provide to patients after they have been vaccinated. There will also be information targeted specifically to black, Asian and minority ethnic communities, who have been disproportionately affected by COVID-19. These will be made available soon after any vaccines are approved.

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