I am writing to all practices following my recent update on arrangements for care home residents eligible for seasonal vaccinations; that is, influenza and Covid-19 vaccinations.
GPC England has not been successful in reversing the draft wording relating to care home seasonal vaccinations. As currently drafted, the specification places a duty on all PCN member practices to offer seasonal vaccinations to residents of Aligned Care Homes, where one or more practices within the PCN have signed up to deliver adult influenza (and, where applicable, COVID-19) vaccinations under the relevant Enhanced Service. This applies irrespective of whether those individual practices have themselves opted in to the vaccination Enhanced Service.
There will only be exceptional circumstances in which other core practices will be able to step back from this responsibility, including to find an alternative provider. In these circumstances, the PCN (presumably on behalf of other non-participating core member practices) can contact the commissioners for support. It is as yet unclear to the LMC what such exceptional circumstances might be.
The LMC is therefore of the view that the Regulations will mean that if one or more core member practices within a PCN participate in the Enhanced Services, the other core member practices have a collective responsibility in terms of eligible care home residents. NHS England appear to view this new responsibility is part and parcel of the Enhanced Health in Care Homes (EHCH) framework and the creation of personalised care plans for such practice-aligned care home residents.
The LMC believes this approach is coercive and divisive. Essentially it is creating a liability and responsibility for all PCN Core Member practices, based on the decisions of one (or more) Core Member Practices, since signing up to the Enhanced Services for seasonal vaccinations is a practice-based contract. Obviously, if all member practices make the same decision, either all signing up to the Enhanced Services, or all not, this will not create concerns. However, in circumstances in which some practices plan to participate in the Enhanced Services, and others do not, because of the way in which this year’s (2026/27) PCN DES specification is written, the LMC recommends a discussion is held by all member practices before these decisions are made.
As colleagues will know, the LMC does not believe the current £10.06 IoS fee for influenza, nor the adjusted IoS fees for Covid-19 vaccination, are economically viable and instead will result in many practices subsidising their delivery of these NHS public health services with other NHS income. The LMC fully appreciates most GPs would wish to continue providing practice-based immunisation programmes and these are undoubtedly preferrable and effective for patients. However, after some years of requests, once again for 2026/27, NHS England declined to increase this fee.
Clearly this amendment to the coming 2026/27 year’s PCN DES specification increase all practices’ risk:benefit burden in terms of delivery of these programmes
Dr Julius Parker, Chief Executive