Flu Vaccination Advanced Service 2018/19
Changes to the service
- The flu vaccines can now be administered in the home of the patient
- The total service fee has increased to £9.48 which includes £7.98 per administered dose plus £1.50 per vaccination
- Payment claims can now be made electronically
- Pharmacists need only complete the face-to-face training every three years
UPDATES: INADVERTENT ADMINISTRATION OF INCORRECT VACCINE FOR PATIENT AGE GROUP
Public Health England (PHE) has updated its inactivated influenza vaccine guidance for healthcare practitioners with the most significant change being the process to follow when individuals have inadvertently been given a flu vaccine type that is not recommended for their age group.
Advice is as follows:
- inform the patient of the error and its potential implications;- advise the patient that although the quadrivalent influenza vaccine (QIV) and adjuvanted trivalent influenza vaccine (aTIV) will offer some protection to all age groups, individuals aged 65 years and over (particularly those more than 75 years of age) may not respond as well to the QIV as they would to the aTIV, and individuals aged under 65 years will not benefit from the opportunity to make protection against an additional flu strain if they have been given aTIV;
- following a discussion about the risks and benefits, advise the patient that they could, if they wish, be given a second dose of the vaccine they should have had; the clear benefit is the additional protection that may be offered by the correct vaccine, but they should be alerted to the potential increased risk of a local or systemic reaction. Although there is no data available on the safety and effectiveness of administering a second flu vaccine shortly after the first in adults, this advice is based on general principles of vaccination, experience of flu revaccination following cold chain and administration incidents and information about the high dose flu vaccine used in the United States (which contains four times the amount of antigen that is in a single dose of QIV or aTIV);
- if a decision is made to offer the vaccine the patient should have received, it is recommended that this is done as soon as possible after the first dose was given and ideally within a week. This will enable protection to be made as soon as possible. It can, however, still be given if more than a week has elapsed.
This advice also applies to those who have inadvertently been given non-adjuvanted trivalent influenza vaccine (TIV).
A PGD Addenum has been published following the above advice, click here to view or see in the document section below.
National: There is no requirement to register with NHSBSA before providing. However, you MUST to ensure that the NHS section on NHS choices is ticked
London: If you have not already done so, please click here to register with Sonar for the London service.
Note: PPV is currently under review with the aim to become a year-round service. We will send more information when confirmed.
The London SLA has been published, please see the following link.
For the London Vaccination service, you MUST work under a private PGD. If you do not have one, Sonar has a flu and adrenaline PGD, please contact them directly on phone: 020 8743 9440.
Note the following section of the London service spec in relation to the PGD. (August 2018)
3.1) The Service will be known as the London Pharmacy Vaccination Service 2018/19 and is a supplementary service to the National NHS England Flu service under the advanced services of the contractual framework. This local London service can be provided by any pharmacy in London that is also signed up to delivering the National Advanced Flu service. The pharmacy contractor is required to offer eligible patients the opportunity of receiving a flu vaccination at the location. The cost will be met by NHSE London. The vaccine is to be administered by an appropriately trained pharmacist under the authority of a private PGD.
Briefings and Guidance
- NPA – Vaccine type decision making flowchart
- PSNC Briefing- Flu Vaccination Service 2018/19: Adjuvanted trivalent inactivated influenza vaccine (aTIV)
- PSNC Briefing- Pharmacist checklist for the Flu Vaccination Service (September 2018)
- PSNC Briefing- Flu Vaccination: Responsive Lines for LPCs (August 2018)
- PSNC Briefing- Flu vaccination: The benefits of a community pharmacy service (August 2018)
Declaration of Competence from CPPE
2018/19’s Vaccination Services Declaration of Competence has been published by CPPE
The previous two DoC’s for the flu vaccinations, one NHS National vaccination services and the other local vaccination service, have now been merged into one. Therefore, pharmacists intending to provide the flu vaccinations for 2018/19 will only be required to complete one DoC.
Note: If you completed last year’s declarations, you do not have to do another until the 2019/10 vaccination season. If you last completed your declaration of competence in 2016/17 or earlier, you must complete this years DoC.
This year’s declaration of competence documents are published by CPPE, hosted on their site.
Final Guidance on Ordering for 2018/19
NHSE has issued final guidance for ordering vaccine for the 2018/19 flu season.
For the 2018/19 season, all pharmacies participating in the scheme should offer the following.
- The adjuvanted trivalent vaccine (aTIV) for all 65s and over. Given aTIV was only licensed for use in the UK in August 2017, this was not an option for the 2017/18 season. However, the JCVI advice is that this is now the best option for 2018/19 for 65+ age group
- The quadrivalent vaccine (QIV) for 18 – under 65s at risk. In light of an independent cost-effectiveness study into QIV undertaken by Public Health England and considered by
JCVI, the Green Book was updated in October 2017 to provide the advice that QIV is the best option for 18-65 at-risk groups in the 2018/19 season. It is also used for the
The PSNC and NHSE guidance is very clear – Over 65’s cannot be given QIV instead of a-TIV. If a GP or Community Pharmacist does, they would be asked to justify their decision based on the clinical evidence the PHE guidance is based on.
NHSE has also included an FAQ in the updated guidance. If you have any queries, please check here in the first instance.
In light of the updated guidance, you may need to adjust your order accordingly.
If you are having difficulties changing your order, please contact the immunisation team.
For any further queries or concerns, please contact the LPC office.
There is also a new requirement for Registered Healthcare Practitioners for supervised clinical practice following training. The steps below are recommended by CPPE to those who are new to vaccinating:
- Complete the face-to-face training
- Complete the DoC
- Undertake a period of supervised practice with a registered healthcare practitioner who is experienced, up to date and competent in immunisation, and should you identify any additional training need during the supervised practice, undertake the further training and then review your DoC
More advice is available on the PSNC website