DHSC guidance for community pharmacies in England providing seasonal flu vaccination as part of NHS Pharmaceutical Services on accessing DHSC centrally supplied flu vaccines
Updated 25 March 2021
Applies to England
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Summary
As you will be aware, the Department of Health and Social Care (DHSC) has announced its intention to run the largest flu programme ever in the 2020 to 2021 flu season. Part of this includes a drive to increase uptake in existing cohorts eligible for a free vaccine under the NHS programme, and expansion to new groups. In order to support the expanded vaccination programme, DHSC has secured an additional supply of influenza vaccines, which are available for pharmacies to purchase from wholesalers.
Guidance for GP practices and other NHS providers has been released separately.
Initially, additional flu vaccines that community pharmacies purchased could only be used to vaccinate patients and frontline social care workers, as set out in appendix A of the community pharmacy seasonal influenza vaccination advanced service specification document, and those using a community pharmacy as part of an occupational health scheme for frontline health and social care workers only.
From 1 December 2020 the eligible groups were extended to include 50 to 64 year olds and from 15 January 2021 they were extended further to include any private patients and any others as part of occupational health schemes. In the case of vaccines offered to private patients, pharmacies are not be able to claim reimbursement or payment for this service from the NHS.
Pharmacies should consider retaining some vaccines specifically for NHS eligible cohorts, as some may come forward later in the season, such as newly pregnant women or others that have not received their vaccine yet.
How to order additional stock
This guidance covers community pharmacies in England. Guidance for GP practices and other NHS providers has been issued separately.
Assess if there is a need for further flu vaccines by assessing current and expected uptake rates in eligible cohorts compared with your current vaccine supply (including ensuring that you have received all of the vaccines you have ordered from suppliers for each eligible cohort). You should only access additional stock if you have allocated or used all of your locally ordered stock.
Place an order for additional stock with your wholesaler.
Wholesalers are no longer required to ensure that pharmacies complete and sign a self-certification declaration prior to ordering stock. This is to help ensure that as much of the stock as possible is utilised and reflects that pharmacies are now able to use the vaccine to vaccinate private patients. Wholesalers will be updating their systems accordingly.
NHS Business Services Authority Provider Assurance (NHSBSA) team will be conducting post payment verification (PPV) on flu service claims, as they have in the past, on behalf of NHS England and NHS Improvement (NHSEI). This will also include any vaccinations offered under the NHS service using the additional stock. Any anomalies identified will be dealt with via the NHSBA's usual PPV processes, with cases that cannot be resolved with the contractor escalated, with full support and information, to the NHSEI regional team for resolution.
Community pharmacies are advised to keep appropriate records to support their claims so if requested by NHSEI or NHSBSA information is available.
Contractors found as part of the NHSBSA Provider Assurance PPV processes to have used the additional vaccine stock outside these conditions or claimed inappropriately through the NHS service when administered as a private service may be subject to further action.
Table 1: additional vaccines available to order from wholesalers
| Manufacturer | Product | Vaccine type | Ovalbumin content micrograms per dose |
|---|---|---|---|
| GlaxoSmithKline (GSK) | Fluarix Tetra | QIVe (standard egg-grown quadrivalent influenza vaccine), split virion, inactivated | Equal to or less than 0.05 micrograms per |
| Seqirus | Adjuvanted Trivalent Influenza Vaccine | aTIV (egg-grown trivalent influenza vaccine), surface antigen, inactivated, adjuvanted with MF59C.1 | Equal to or less than 0.2 micrograms per 0.5 ml dose |
| Seqirus | Flucelvax® Tetra | QIVc (cell-grown quadrivalent influenza vaccine), surface antigen, inactivated | Egg-free |
| Mylan | Quadrivalent Influvac® sub-unit Tetra | QIVe (standard egg-grown quadrivalent influenza vaccine), surface antigen, inactivated | Equal to or less than 0.1 micrograms per 0.5 ml dose |
Wholesalers can provide pharmacies with information on which products they have available to order, and will advise on delivery times, ordering limits and pricing information. Deliveries will be made as part of the usual deliveries to community pharmacy from wholesalers.
Wholesaler contact details
Alliance Healthcare
Contact customer services for standard orders, enquiries and general support:
-
telephone 0330 100 0448
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fax 01773 819 321 (retail customers) or 01773 813 196 (hospital customers)
Alternatively, customers set up on Alliance Healthcare Direct (AH Direct) will be able to access the flu vaccines there too.
Lexon UK
Call 0800 614 242 or 0800 612 770.
McKesson UK
Go to the AAH website or the AAH flu portal.
Contact customer services on 0344 561 8899.
PHOENIX Healthcare Distribution
Log into Numarknet using member details.
The order form can be found at the DHSC England centrally supplied flu vaccines hub.
For non-Numark members, email sales@phoenixmedical.co.uk.
Frequently asked questions
What stock is available?
See table 1. Sufficient stock is available for eligible groups. DHSC has worked with all manufacturers of adult flu vaccines to increase supply for use in England. There are a range of products available to cover eligible cohorts.
Which wholesalers will stock be available from?
Additional stock can be accessed from Alliance Healthcare, Lexon UK, McKesson UK and PHOENIX Healthcare Distribution.
Are there restrictions on the volume of vaccines a pharmacy is able to order at one time or in total?
No additional restrictions have been put in place for ordering limits by DHSC. However, wholesalers may apply demand management approaches.
Am I limited in ordering from my main wholesaler?
You should use your main wholesaler in the first instance, and you should have used or allocated all of your existing stock before placing an order.
Who can be immunised with vaccine with the additional stock?
See the summary section above.
What identification do I need to request to see to prove someone is a frontline health or social care worker?
Eligible frontline health and social care staff can be vaccinated using additional vaccines (under the NHS Advanced service or occupational health services) by presenting at a community pharmacy and self-identifying as a frontline health or social care worker. These staff do not need to present ID. However, employers have been advised that it may be helpful for these groups to present a letter stating they are a frontline health or social care worker.
What are the requirements for recording the use of vaccines?
Recording of vaccinations should be undertaken using your normal IT system as with your other NHS flu vaccinations. Claims will be submitted as normal via the NHSBSA MYS platform.
Can I use additional stock to vaccinate social care workers who are eligible for a free vaccine?
Yes. Furthermore, from 15 January 2021 additional stock has been made available to private patients or for occupational health schemes. You may wish to retain some stock for NHS eligible patients, and you should still vaccinate them under the NHS programme if they come forward for a vaccination.
I have currently used up all of my stock of aTIV, but am expecting another delivery of aTIV from my normal order. Can I order aTIV from the additional stock so I don't have a temporary shortage?
No. Additional stock can only be used once a community pharmacy's locally procured stock supplies have been exhausted or fully allocated and cannot be used to fill temporary shortfalls in the availability of locally procured vaccines.
Can I order additional vaccines if I have run out of vaccine for one cohort but not another? For example, running out of QIVe but not aTIV, if I am not expecting to receive any more QIVe.
Yes. If you have run out of a vaccine for a particular cohort, you can access the additional stock even if you have stock or further deliveries pending of another vaccine for use on a separate cohort. For example if you have run out of QIVe to vaccinate at-risk individuals aged 18 to 64 and aren't going to receive any more, but still have a local order of aTIV to vaccinate individuals aged over 65 yet to arrive, you can place an order for QIVe from the additional stock.
Which brands of vaccine are available from DHSC? Are they suitable for all ages and clinical needs?
Vaccines have been ordered by DHSC from several manufacturers. See table 1. This was done to reduce the likelihood of the additional stock being seriously affected should a problem occur with a single manufacturer.
Health professionals accessing additional stock will have a choice of flu vaccines and should order the vaccine(s) best suited to their patient population, in line with Joint Committee on Vaccination and Immunisation (JCVI) guidance as set out in the national flu immunisation programme 2020 to 2021 letter and green book advice on the suitability of each product for different age groups and clinical needs such as severe egg allergy (anaphylaxis). More detailed information is available from the manufacturers' summaries of product characteristics.
Can multiple orders for additional stock be placed at the same time?
Stock is available to order from wholesalers and is subject to their delivery schedules. This has been done to match current arrangements many community pharmacies have when ordering their own flu vaccines. Wholesalers will advise on available stock, delivery times, ordering limits and pricing information. Deliveries will be made as part of the usual deliveries to community pharmacy from wholesalers. DHSC will collect data on orders placed with wholesalers and will monitor ordering by individual community pharmacies.
Do I have to pay for additional stock?
Yes. Additional stock for community pharmacies has been made available via wholesalers in order to match arrangements that community pharmacies currently have to purchase flu vaccines. Any of these vaccines offered under the NHS Advanced Service for flu vaccinations can be claimed for reimbursement (and remuneration of the service fee) in line with normal flu vaccinations. This approach also allows for the use of additional stock for occupational health schemes and other private use from 15 January 2021, in line with the restrictions detailed above.
How will payments for vaccinations administered under the NHS Advanced service work?
Payments for additional flu vaccines administered under the NHS Advanced service will work in the same way as other locally procured vaccines. You should submit your claim via the NHSBSA MYS flu platform as normal, and you will receive a fee for providing the service and a reimbursement value for the vaccine.
This does not apply to vaccines administered to frontline health and social care workers through occupational health schemes or any other private services.
What if, even after purchasing additional stock, I do not have enough stock to meet demand?
Where possible you should signpost patients to other providers in your area that still do have stock available.
Further Information
If you have any further queries, please contact england.fluops@nhs.net.