Seasonal flu: A decision making framework

The following guidance is intended to be informational and does not constitute legal or financial advice

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Background

We recognise that some GP practices are considering opting out of the Seasonal Flu Vaccination Enhanced Service. Historically, this has been uncommon; however, given the significant challenges currently facing practices, it is an important moment to provide clear guidance. While it is essential to deliver high-quality patient care, practices must carefully assess their financial viability and sustainability. This guidance is designed to support practices in making informed decisions, emphasising the importance of evaluating the overall financial impact of participation.

Key Considerations

Participation in the Seasonal Flu Vaccination Enhanced Service is voluntary and renewed annually. Practices are not contractually obliged to continue providing this service in subsequent years.

If your practice has historically participated, patients may expect flu vaccinations to continue being available through your services. Clear communication will be essential should you decide to discontinue participation.

Practices should focus on a detailed analysis of the financial impact, considering both the revenue generated (top-line) and the overall profit after costs (bottom-line). Given static reimbursement rates for some time, ensure your evaluation accounts for inflation and other rising costs.

Community pharmacists are now delivering vaccinations under the same Enhanced Service, intended to provide patients with broader access. However, data suggests this has not significantly increased overall vaccine uptake. Consider how this affects your local population and your practice’s role.

Contractual and Regulatory Responsibilities

If a practice decides to opt out, the following points should be noted:

Practices must reasonably cooperate with relevant stakeholders (e.g., NHS England, local authorities, and integrated care boards) to:

  • Understand vaccine uptake and barriers.

Assist in strategy development to improve vaccination rates, where applicable.

If requested, practices may need to provide relevant data (e.g., patient eligibility, housebound status, contraindications) to other service providers. However, this does not extend to performing activities beyond the scope of reasonable cooperation.

Should your practice choose to step back from the Enhanced Service, it is advisable to inform the ICB, providing a rationale for your decision. This helps maintain transparency and aids the ICB in planning alternative arrangements.

Next steps

For practices uncertain about their course of action:

  • Conduct a detailed financial review of the programme.
  • Engage with your Local Medical Committee medical director for tailored advice.
  • Inform the ICB of your considerations and seek their perspective on support and delivery options.

We are here to help

Your LMC remains available to assist with queries, including interpreting regulatory obligations or facilitating communication with stakeholders. Please contact the LMC office or reach out directly to your regional medical director.