Plans for a major expansion of the flu campaign this winter were confirmed in details of contract changes unveiled earlier this month by NHS England - and health and social care secretary Matt Hancock has now said the campaign will be the 'biggest in history'.
His comments came as a report commissioned by the government's chief scientific adviser warned that a second spike of COVID-19 infections over the winter could be worse than the peak experienced earlier this year and cause as many as 120,000 deaths in hospitals.
GPs have been warning for weeks that workload in general practice is already back to pre-pandemic levels or beyond - raising concerns that an expanded flu campaign and a damaging second wave of the coronavirus pandemic could push workload to an unmanageable level.
RCGP surveillance data show that clinical administrative workload for GPs is now at its highest point this year and total consultations are almost back to the level seen in the weeks before the UK entered lockdown, analysis by GPonline shows.
Although most consultations continue to be delivered remotely, the college has warned this does not translate to reduced workload for GPs.
Meanwhile, millions of patients have had hospital treatment or appointments cancelled during the pandemic, the BMA has warned. In a paper published on 12 July, the association warned that many of these patients had seen a 'significant worsening of health' - piling stress on GPs forced to manage them in the community and unable to refer them for specialist support.
Practices have hit out in recent weeks over being left 'in the dark' over plans for the 2020 flu campaign - with repeated suggestions that the campaign would be expanded but no detail, leaving GPs unable to plan. Practices are expecting the flu campaign to be complicated by the need for patients to socially distance - meaning that delivering vaccines will take longer than usual, and with demand among existing at-risk groups expected to be high.
Speaking at an online National Pharmacy Association conference on 13 July, Mr Hancock said: 'We want the flu vaccine programme to be the biggest flu vaccine programme in history.
'We have procured enough vaccine to be able to deliver on that. But obviously it is then a big task to actually get the vaccine into people's arms.'
He said the government had been forced to re-evaluate plans for the flu campaign in light of the coronavirus pandemic.
His comments came as a report from the Academy of Medical Sciences, commissioned by the government's chief scientific adviser Professor Sir Patrick Vallance, warned that the UK must prepare for a second wave of COVID-19 infections that could be worse than the first one.
The report warned that a potential second wave posed a 'serious risk to health in the UK' alongside a 'backlog of patients needing NHS assessment and treatment, and the possibility of a flu epidemic'.
It found that hospital deaths from coronavirus between September 2020 and June 2021 'could be as high as 119,900' - although this could be reduced by government action to reduce transmission or improved treatment.
Report chair Professor Stephen Holgate said: 'The modelling suggests that deaths could be higher with a new wave of COVID-19 this winter, but the risk of this happening could be reduced if we take action immediately.
'With relatively low numbers of COVID-19 cases at the moment, this is a critical window of opportunity to help us prepare for the worst that winter can throw at us.'
Dr Layla McCay, a director at the NHS Confederation, warned that GPs needed urgent clarification on the scope of the flu campaign.
'A widespread flu vaccination programme is of paramount importance if we are to keep people who are vulnerable safe and protect the NHS from becoming overwhelmed.
'If this is to be the biggest flu programme we have ever seen, our members across primary care have told us they need to see the details on its scope set out as soon as possible. This is so that sufficient stock can be ordered without delay and plans can be firmed up on how to administer the vaccines safely given the need to protect against COVID-19 transmission.'