This resource provides an update on the RSV vaccination programme. NHS England has provided further information on the arrangements in place from 1st September 2024 which covers:
- The programme for older adults aged 75 to 79 years old
- Programme for pregnant women to protect infants
The LMC has received a number of queries related to the programme, guidance to those queries can be found below:
FAQ’s
All adults turning 75 after 31st August 2024 can be invited for vaccination and will remain eligible for an NHS RSV vaccination until reaching 80 years. NHS England recommend invitation occurs as soon as patients are eligible, that is, when they turn 75.
Adults between 75 and 79 are eligible for the adult catch up programme which is initially running until 31st August 2025. This means some 80-year-olds will, exceptionally, be eligible until that date [if they turn 80 between 31st August 2024 and 31st August 2025], otherwise, adults can be included and invited until they become 80.
NHS England is encouraging the older adult catch up programme to commence from 1 st September, with the aim of vaccinating as many as possible during September and October. However, this coincides with the seasonal influenza and Autumn Covid programme, and therefore embarking on this additional exercise (especially noting co-administration advice (below) may not be realistic for many practices given capacity issues.
NHS England’s advice is the RSV vaccination should not be routinely scheduled for older adults at the same time or on the same day as Influenza or Covid Vaccine.
NHS England do advise that “if it is thought an individual is unlikely to return for a second appointment, or if immediate protection is necessary, the RSV vaccine could be administered at the same time as influenza and/or Covid vaccine”.
No specific interval is noted between these vaccines.
This advice now corresponds with the advice given in Chapter 27a of the Green Book
NHS England has commissioned a separate routine programme for pregnant women, who are eligible after 28/40 gestation until delivery (unlicensed after 36/40).
GP practices are commissioned to provide on request or opportunistic vaccinations of pregnant women, for which the usual IoS fee can be claimed [the vaccine is the same for both group] but not the routine RSV vaccination programme.
This means Trusts should be organising an RSV vaccination programme via their midwifery pathway: if GPs become aware of any areas in which this is not being arranged, they should contact the LMC urgently. Thank you for colleagues who have already done so in Sussex where the ICB has confirmed that NHS England Regional colleagues expect all Trusts in South East England to offer the RSV vaccination programme to pregnant women on a routine basis.
Practices are therefore not required to offer a call/recall service for pregnant women.
The Item of Service for the RSV vaccination programme remains £10.06. NHS England is fully aware that GPC England does not accept this is an economically viable fee, and has argued for an increase, even if only to return to 2019/20 inflation linked levels.
Because the RSV programme is delivered as an Essential Service, the LMC cannot recommend practices do not deliver this programme, as this would represent a breach of contract. Seasonal influenza and Covid vaccination programmes are delivered by an Enhanced Service, which is optional. The LMC recommended all practices carefully consider their involvement in these programmes; GPC England’s position to NHS England is that a GP practice-based immunisation programme delivers significant public health benefits, is economically the best option for the NHS, and is convenient and accessible for patients. However, GP practices should not subsidise these programmes.
Para. 10 of the most recent guidance (link above at the start of my letter) provides comprehensive links to all aspects of this new programme.
Supporting Letters
GP practices are not required to deliver the programme (via our usual vaccination call/recall processes) for ante-natal women routinely. Their contractual arrangement is to provide this vaccination “opportunistically and on request”. If given, the vaccination attracts the normal £10.06 Immunisation IoS fee.
Trusts have been commissioned to deliver the routine RSV programme via midwifery antenatal appointments. Unfortunately, the LMC has been advised that in three cases across South-East England, notably:
- Ashford & St Peters Hospitals
- Surrey & Sussex Healthcare
- University Hospitals Sussex
they did not have the necessary arrangements in place to deliver the programme on 1st September. The LMC has been advised this should be the case within the first few weeks of September.
As a result, NHS England South East has advised GP practices local to these Trusts may receive requests for such vaccinations during this time period.
Clearly it is very disappointing and concerning that Trusts did not finalise these arrangements by 1st September, especially given that detailed advice about both the antenatal and adult > 75-year-old programmes was provided by NHS England in June 2024.
Clearly NHS England believe that General Practice will be operationally available to fill this gap; however, the LMC has noted that the childhood seasonal flu vaccination programme also commences on 1st September, and so vaccination appointment capacity will be reduced. For this reason, the LMC recommends practices prioritise those requests received from pregnant women later in the eligible time window (that is 28/40 to 36/40 licensed indication) during the first few weeks of September.
The LMC cannot recommend practices refuse such requests, since RSV vaccination is an essential service within the GMS/PMS Contract, but appointments can be paced to take into account the capacity within the practice.
I hope this update is helpful and the LMC will continue to liaise with NHS England South East to ensure all Trusts are delivering their routinely commissioned RSV (and pertussis) programmes.
Please let the LMC Office know of any requests from local Trusts that isn’t in line with the above information.
With best wishes
Dr Julius Parker Chief Executive