Clarification of Legal Position re Flu Vaccine Sharing

The Department of Health (DH) have now advised regarding the legalities of practices (in England) sharing spare stock of flu vaccines with other practices. Normally, a wholesale dealers licence is required (by medicines legislation) for someone to supply a medicine to a person who is not the end user, i.e. the patient. Given the circumstances the MHRA have agreed the following response, which mirrors the position adopted during the swine flu pandemic: “The transfer of vials of flu vaccines between GP practices is not normally accepted practice. However, if for a specific patient need, it proved necessary for inter-practice transfers to take place, health professionals should ensure the maintenance of the cold chain, traceability, and provision of current patient information leaflets and summaries of product characteristics.” So in this situation GP practices can transfer vaccine stock to another practice.

Flu Vaccination (Pandemrix) and QOF Changes

On 6 January the interim CMO for England, announced that practices would be able to use the monovalent Pandemrix H1N1 vaccine where there is a localised shortage of the trivalent seasonal flu vaccine for their eligible patient population. Following this announcement, the GPC and NHS Employers have agreed that for the purpose of QOF, for 2010/11 only, eligible patients who have received Pandemrix in place of the seasonal flu vaccine should count towards their achievement for the relevant QOF indicators.

Technical information: Codes to allow this to be calculated automatically as part of the 2010/11 QOF achievement have been requested and are expected to be available by the end of January 2011 and published on the PCC website.

The relevant clusters are FLU_COD and TXFLU_COD and relate to:

• The chronic heart disease (CHD) Ruleset
• The chronic obstructive pulmonary disease (COPD) ruleset
• The Diabetes ruleset
• The Stroke ruleset

Please note that these changes apply to the 2010/11 QOF only and as such from April 2011, coding for the seasonal flu indicators will revert to seasonal flu only.

Flu Vaccine Payment Arrangements

Practices should be paid using local arrangements set up under the seasonal flu and pneumococcal DES, not the national Pandemic Influenza (H1N1) DES. However, in England where practices have ‘shared’ vaccines then the receiving practice should not be reimbursed or paid a PA fee for Pandemrix as the vaccine is centrally procured and provided free of charge. In relation to those practices, with a surplus of trivalent seasonal flu vaccines that redistribute their stocks to other practices, subject to agreement locally, can claim the following in terms of costs:

• PA and vaccine costs for vaccines procured and administered to their own practice population
• An Item of service fee for vaccines administered to their own practice population
• PA and vaccine costs for those vaccines procured and passed to another practice – IOS fees should only be claimed by the practice that administers the vaccine

In relation to the practice in receipt of another practices surplus of trivalent seasonal flu vaccines, subject to agreement locally, can claim the following in terms of costs:

• An Item of service fee for vaccines administered to their own patient population
• PA and vaccine costs can only be claimed for the vaccines procured directly from the supplier and administered to their own practice population. PA and vaccine costs for vaccines procured from another practice cannot be claimed.

Any stocks remaining after the vaccination programme must be returned to the relevant suppliers and PA and vaccine costs for these vaccines cannot be claimed. Practices that have procured their vaccines from a neighbouring practice should return any unused vaccines to that practice in order for them to return the surplus stock to their supplier. The GPC and NHSE agreed this joint statement.

Template Letters covering Short Term Certification and Letters/Reports/Certificate Requests Outwith NHS Responsibilities

The LMC has updated the following template letters which can be found on the guidance page for your use:
Short Term Certification, Students/Pupils Letter
Short Term Certification, Employees/Employers Letter
Payment for requests for reports/letters/certificates outwith NHS Responsibilities Letter

GP Earning and Expenses Final Report 2008/9

The GP Earnings and Expenses 2008/09 Final Report has been published here.

While the key figures were released in the provisional report published in September, the final report provides more detailed background information. The commentary the GPC prepared on the provisional report is available here for ease of reference.

Sessional GP Newsletter

The Sessional GPs Newsletter, Winter 2011, is available here.