Primary Care Networks
7.1. Where the practice is a member of a PCN, it must collaborate with other practices within its PCN to ensure that all patients who are residents of an aligned care home are offered vaccinations in accordance with the commissioner Announcement and terms of this ES and the network contract DES.
7.2. Where the practice:
7.2.1. is not a member of a PCN
or
7.2.2. has a registered patient resident in a care home outside of its PCN’s geographical area,
the practice must co-operate with the PCN responsible for provision of network services to its registered patients resident in care homes to ensure that all those eligible patients are offered vaccinations in accordance with the commissioner announcement and terms of this ES.
7.3. Practices must liaise with their own PCN to ensure that a joined up service is delivered to all PCN linked care homes.
Further information can be found in the Seasonal Vaccination Provider Programme Guide: Spring 2026 version 2.0 and Network Contract DES: Contract specification 2026/27 – PCN requirements and entitlements see sections 8.4.3 to 8.4.4.4
Update letters
We wished to update colleagues regarding the arrangements for vaccinating care home residents with seasonal vaccinations, that is, influenza and COVID-19 vaccinations.
The LMC has become aware that ICBs have circulated an updated version 2.0 guide to the Vaccination Programme taking into account the proposed update to the NHS England’s PCN DES specification for 2026/27. Colleagues should note that GPC England has not yet seen a draft of this specification and does not believe it is appropriate to place a duty or liability on PCNs to have generic responsibility for care home vaccinations created by the decision of one Core Member Practice. Now both COVID-19 and Influenza Enhanced Services are practice based, it is clear that decisions about participating in one or both vaccination programmes are a matter for individual practices, and this should not create a consequential liability for the PCN.
Information:
The LMCs advice is not to respond or confirm arrangements requested by the ICB in relation to this matter.
The LMC has seen an email sent to some PCNs in Sussex (there may be similar requests in other areas within the LMC Confederation) asking PCNs to confirm by Wednesday 11th March:
By close of play Wednesday, 11th March please confirm:
- Who is delivering vaccines to care home resident on behalf of the PCN
- Who is delivering vaccines to the housebound residents of practices not signed up
- If there is a delivery gap, have you contacted the pharmacies in your area, please give names of those contacted.
The LMC will share this letter with the ICB so they are aware; the LMC recommends practices /PCNs do not respond to the ICB on any of these points and instead ask where in the Enhanced Service specifications or current PCN DES specification is there a reference to responding to commissioners with this information by the suggested date of 11th of March. The PCN DES specification for 2026/27 has not even been published yet ICBs are using this as a catalyst for such demands.
The LMC has previously expressed concerns that the planned IoS fees for 2026/27 mean the seasonal vaccination programmes may be uneconomic for GP practices to deliver. If the approach above taken by NHS England, via ICBs, then this is likely to disincentivise participation further.
See news article: LMC update: Seasonal Vaccination Provider Guide: Spring 2026
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
See news article: Further Update: Seasonal Vaccination Arrangements for Patients in Aligned Care Homes