The responsibilities for delivering seasonal influenza and COVID-19 vaccinations are set out here:
Primary Care Networks (PCNs)
The Enhanced Service specification requires practices that are members of a PCN to work collaboratively to ensure that all eligible residents of aligned care homes are offered seasonal vaccinations.
Where a practice is not a member of a PCN, or has patients living in care homes outside its PCN footprint, it must work with the relevant PCN to ensure those patients are offered vaccination in line with the Enhanced Service requirements.
Practices should liaise with their PCN to ensure a coordinated and joined-up approach is delivered across all PCN aligned care homes.
Aligned Care Homes
The Network Contract DES places a responsibility on PCNs delivering the Enhanced Health in Care Homes (EHCH) service to ensure that residents of aligned care homes are offered seasonal vaccinations.
Section 8.4.3 states that where one or more practices within the PCN deliver the General Practice COVID-19 and Adult Influenza Vaccination Enhanced Service, the PCN must ensure that residents of its aligned care homes are offered influenza vaccination, or influenza and COVID-19 vaccination where applicable, in accordance with NHS England requirements.
What does this mean in practice?
Where one or more practices participate in the seasonal vaccination Enhanced Service, the PCN is collectively responsible for ensuring residents of aligned care homes are offered vaccination.
However, this does not mean that a single practice must deliver all vaccinations. Delivery may be organised in a number of ways, including through:
- One or more member practices
- Another practice working on behalf of the PCN
- An approved subcontracted provider, such as a community pharmacy or GP federation
Housebound Patients
Definition of housebound
A patient is considered housebound where, in the reasonable opinion of the practice, they are unable to leave their home, or can only do so with significant assistance due to illness, frailty, surgery, mental health needs, or because they are approaching the end of life. The patient should be recorded as housebound within their clinical record.
Eligibility for influenza vaccination
The Enhanced Service specification requires practices to offer influenza vaccination to eligible registered patients, including those who:
- Live in a care home
- Are housebound
This requirement is set out within section 6.17 of the Enhanced Service specification.
Although the additional £10 supplement previously available for vaccinating housebound patients was removed for the 2026/27 programme, the contractual obligation to make all reasonable efforts to vaccinate eligible housebound patients remains unchanged.
Can practices subcontract delivery?
Yes. The Enhanced Service allows practices to subcontract delivery where this is permitted under the underlying contractual arrangements. Examples may include community pharmacy providers or local GP federations.
Subcontracting arrangements will need to be approved by your local commissioner
Are there PCN responsibilities for housebound patients?
Unlike aligned care homes, there is no equivalent PCN contractual responsibility for housebound patients within the Network Contract DES.
Whilst practices may work collaboratively through their PCN, and may establish subcontracting arrangements where appropriate, the explicit contractual responsibility for ensuring eligible housebound patients are offered vaccination rests with the individual practice contractor.
Read more about Aligned Care Homes