Guidance

DHSC guidance for primary care in England on accessing DHSC centrally supplied flu vaccines

Updated 11 October 2021

Applies to England

Summary

Following the success of the 2020 to 2021 seasonal flu immunisation programme, the Department of Health and Social Care (DHSC) has announced its intention to continue with the expanded flu programme in the 2021 to 2022 flu season as part of its continued response to the COVID-19 pandemic. This includes a drive to increase uptake in existing cohorts eligible for a free vaccine under the NHS programme, and also expansion to new groups, such as secondary school children up to year 11.

In order to achieve even higher vaccine uptake rates compared to last year, DHSC has secured an additional supply of influenza vaccines, as a temporary measure for this year only. These vaccines will be available for NHS providers, general practices and community pharmacies, to top up local supplies once they run low and will be deployed to areas where it is most needed to maximise uptake. Providers should work with commissioners to ensure stock is prioritised to where it is needed most, in eligible cohorts under the NHS programme where uptake is lower. Additional supply arrives later in the season and is intended to complement existing supply. We are now able to confirm the process by which community pharmacies and general practices will be able to access this additional stock. A proportion of this additional stock will also be made available to trusts and the arrangements for them to order against this stock has been detailed separately.

Please note that the stock will arrive from early November onwards. General practices will be able to place orders for this stock from 18 October through NHS England and NHS Improvement (NHSEI) commissioners. Community pharmacies can purchase additional stock directly through wholesalers, and so should continue to order stock via wholesalers throughout the season as they typically do. Community pharmacies should contact their wholesaler for details on what stock is available.

In designing the process for accessing DSHC stock, consideration has been given to how contractors currently source and administer flu vaccinations. It has been purposefully designed to limit the impact on business as usual vaccinations and supply chains. We also have a responsibility to balance this with the need to protect and mitigate risks of unintended use, as this is a taxpayer funded programme, whilst acknowledging the exceptional circumstances that has warranted the programme's expansion. The additional stock will only be available for this season (2021 to 2022) and providers will be expected to order their own supplies for future seasons as they normally do.

Further control has been given to regional NHSEI commissioners to be able to direct and sign off vaccine orders for general practices, enabling regional systems to further support increases in uptake to meet the ambitious aspirational targets for each cohort this season. Practices will be provided with the DHSC vaccines free of charge so will only be able to claim an item of service (IoS) fee for each DHSC supplied vaccine that is administered. Community pharmacies will be able to continue to purchase stock via wholesalers but should keep in regular contact with regional NHSEI commissioners.

The majority of the additional DHSC stock will arrive from early November onwards. The DHSC supply is being made available to support and encourage providers in increasing uptake amongst their registered eligible cohorts with the support of the NHSEI regional commissioning teams. In addition, providers will want to ensure they are working creatively with other providers in the local system to ensure opportunities to utilise all available vaccines are maximised and wastage is minimised.

Pharmacy contractors and general practices should follow MHRA guidelines on the movement of vaccine. We recognise that some primary care network (PCN) groupings will wish to co-administer the flu and COVID-19 vaccination to eligible patients at their designated PCN site for COVID-19 vaccination where it is clinically appropriate and in line with JCVI guidance to do so. The template Collaboration Agreement has been updated to enable synergistic delivery and/or co-administration of the seasonal influenza vaccine arrangements, where it is operationally expedient and clinically appropriate to do so, under the Enhanced Service specification: Seasonal influenza vaccination programme 2021 to 2022.

Pharmacy contractors and general practices who are working within vaccination centres may use centrally supplied vaccines for these centres. PCN groupings cannot order vaccines themselves however providers within the grouping can. This stock can also be used to support co-administration and synergistic delivery with the COVID-19 vaccine in line with the JCVI statement regarding a COVID-19 booster vaccine programme for winter 2021 to 2022 . Where this is possible, centrally supplied vaccines can be used for this, however patients should be offered whichever vaccines are recommended for them and available at the time rather than waiting for coadministration. Vaccines used in this way must have their delivery taken by someone acting on behalf of the pharmacy contractor or general practice, and must be stored correctly, remaining under the pharmacy contractor's or general practice's control.

Providers must follow JCVI guidance and use the recommended vaccines for each cohort as set out in the annual flu letter.

The community pharmacy Local Enhanced Service specification – phase 3 coronavirus vaccination (LES) will also be updated to support co-administration where eligibility for both programmes, supply, and regulation allow.

How to order additional DHSC stock

These sections cover community pharmacy and general practices, and vaccination sites for COVID-19 in England. Guidance for trusts and NHS providers has been issued separately.

Community pharmacy only

Community pharmacies should determine if there is a need for further flu vaccines by assessing current uptake rates in eligible cohorts (taking into account booked clinics) and calculating any additional vaccines required. Community pharmacies should then get in contact with their regular wholesaler in order to access additional stock, and follow the wholesalers process for ordering stock.

Community pharmacies should keep in regular contact with their local NHSEI Regional Public Health Commissioning Team to assess the populations that still need to come forward for a flu vaccination, and the strategy for offering them a vaccine. Information may also be included in the weekly NHSEI primary care bulletin. Community pharmacies can sign up to receive the bulletin.

DHSC has boosted supply to the community pharmacies by working with manufacturers to ensure more stock is available for wholesalers. Stock ordered by pharmacies will not be distinguishable from other stock they may order.

General practice only

Practices should determine if there is a need for further flu vaccines by assessing current uptake rates in eligible cohorts (taking into account booked clinics) including registered patients vaccinated elsewhere, and calculating the amount required to vaccinate those outstanding patients compared with the practice's current vaccine supply and orders yet to be delivered.

Only order vaccines for approved cohorts who are eligible as part of the public programme. Minimum order quantity is 50 doses.

Once you are sure of the number of vaccines required, contact the appropriate NHSEI Regional Public Health Commissioning Team providing advice on your current levels of stock and any additional stock you may need. Include all other relevant details to support the order for instance your delivery model or potential vaccination of unregistered eligible populations in care homes or hard to reach groups as orders may need to be prioritised by commissioners.

Your Regional NHSEI Public Health Commissioning Team will coordinate across your local area on what stock is needed to meet demand. This is to ensure that vaccines are distributed equitably and according to need. The central stock is limited, so allocations have been made for each region based on population sizes.

After placing an order with your Regional NHSEI Public Health Commissioning Team, they will pass on these details to manufacturers, who will then confirm your order including the delivery address. Manufacturers will advise you on expected delivery times. This may be an estimate at first, but will be confirmed sooner to the expected delivery date.

Information will also be shared with NHSEI counter fraud and NHSBSA Provider Assurance teams who will work with regional teams.

DHSC will provide periodic updates on central stock levels available from suppliers to the Regional NHSEI Public Health Commissioning teams, so you should keep in regular contact with your regional team. Information may also be included in the weekly NHSEI primary care bulletin. Practices can sign up to receive the bulletin.

By accessing stock, practices are agreeing to follow the rules on the use of these vaccines. These have been purchased by the DHSC and provided free of charge, so these measures are in place to support practices in achieving higher uptake, ensure proper use of vaccines and minimise vaccine wastage.

By accessing stock, general practices agree:

• to not return any of their locally procured stock to manufacturers (entral stock is intended to be used as additional stock to boost supply and not as a replacement for local stock)
• that they will only use DHSC stock to vaccinate those patients who fall into eligible groups included in the national flu immunisation programme, as set out in the Seasonal Influenza Vaccination Programme Enhanced Service Specification 2021 to 2022 and to claim only the correct fees for DHSC flu vaccines, which is only the specified Item of Service fee and not additionally claim reimbursement of the vaccine cost for those ordered free of charge under this agreement
• this stock is a safety net to ensure the expanded flu programme can be delivered in response to the COVID-19 pandemic – it is not a guarantee of DHSC vaccine and must not affect your ordering for future seasons
• that a GP partner of the practice, another appropriate signatory of the practice's NHS contract or GP team member with appropriate authority, is aware of the requirements and will sign any declarations required as a condition of accessing DHSC vaccine
• that they have read, understand and agree to comply with the conditions set out in this guidance

The claiming process for fees for administering DHSC vaccines is set out in Appendix A, and the declaration to be submitted to NHSBSA is set out in Appendix B.

Table 1 below sets out the different types of vaccines available from each manufacturer and when each one becomes available. Orders will be placed via NHSEI commissioners, so you should only contact manufacturers to discuss confirmed orders. Please note that the majority of stock arrives from November.

Practices should only order enough vaccines to cover your expected demand as you will not be able to return unused DHSC flu vaccines but you should be ambitious – the national programme is aiming to reach 85% vaccine uptake for those over 65 years and 75% for those eligible under 65 years as per the flu letter. As stock is limited you should aim not to place more than 2 DHSC stock orders. Ordering more frequently may limit the availability of delivery slots and may require the department to alter the ordering policy to ensure all practices have access to stock.

Practices should have systems in place to store and administer locally and DHSC supplied stock in such a way to support accurate record keeping and financial claims. Stock does not have to be kept in separate locations, but practices should be able to keep track of stock. These records may be required at a later date as part of a post-payment verification process.

You will not be able to return any unused stock to manufacturers. Towards the end of the season, if you find yourself with an excess of DHSC stock that you will not use you are required to contact your regional NHSEI commissioner so they can support the re-distribution of the stock to another local provider.

In light of high demand for flu vaccine this season and the significant expansion of the programme – along with the ability to redistribute stock locally in line with MHRA guidelines – it is not expected that any DHSC stock will go unused, although any given batch of vaccine ought not to be moved more than once under these mutual aid provisions. However, in the very unlikely circumstance that a practice finds itself with a small amount of unused DHSC stock and only after notifying your regional NHSEI commissioner and making every effort to redistribute the stock, practices will be required to dispose of any unused DHSC stock themselves. Disposal should be done in conjunction with the practice keeping clear records as to the amount, type of vaccines and batch numbers redistributed or disposed of. Practices will be required to submit this information as part of a post-payment verification exercise.

Surplus DHSC supplied vaccines should under no circumstances be used to vaccinate private patients who are not eligible to receive a free NHS vaccination as set out in the Seasonal Influenza Vaccination Programme Enhanced Service Specification 2021 to 2022. Practices are also prohibited from supplying DHSC supplied stock to a third party in exchange for payment.

The steps for claiming fees for administering DHSC flu vaccines and the post payment verification process are included within Appendix A and B.

COVID-19 vaccination sites

Providers acting together in a PCN grouping at a vaccination site may use additional vaccines to vaccinate for flu, alongside or separately from COVID-19 vaccine co-administration, following JCVI advice.

It is not possible for PCNs or PCN groupings to order vaccines themselves. Providers within PCN groupings should order any additional flu vaccines following the guidance for the type of organisation they are. If they are a community pharmacy they should purchase additional vaccines through wholesalers. If they are a general practice, they should place an order via their NHSEI regional commission team. If they are a trust, they should follow the separate advice detailed on GOV.UK.

Pharmacy contractors and general practices should follow MHRA guidelines on the movement of vaccine. Some PCN groupings may wish to co-administer the flu and COVID-19 vaccination to eligible patients at their designated PCN site for COVID-19 vaccination where it is clinically appropriate and in line with JCVI guidance to do so. The template collaboration agreement has been updated to enable synergistic delivery and/or co-administration of the seasonal influenza vaccine arrangements, where it is operationally expedient and clinically appropriate to do so, under the Enhanced service specification: seasonal influenza vaccination programme 2021 to 2022.

Pharmacy contractors and general practices who are working within vaccination centres may use centrally supplied vaccines for these centres. PCN groupings cannot order vaccines themselves, however providers within the grouping can. This stock can also be used to support co-administration and synergistic delivery with the COVID-19 vaccine in line with the JCVI statement regarding a COVID-19 booster vaccine programme for winter 2021 to 2022. Where this is possible, centrally supplied vaccines can be used for this, however patients should be offered whichever vaccines are recommended for them and available at the time rather than waiting for coadministration. Vaccines used in this way must have their delivery taken by someone acting on behalf of the pharmacy contractor or general practice, and must be stored correctly, remaining under the pharmacy contractor's or general practice's control.

Table 1: additional vaccines available to order

Manufacturer	Product	Vaccine type	Ovalbumin content micrograms per dose	Availability
Viatris (Formerly Mylan)	QuadrivalentInfluvac®sub-unit Tetra	QIVe (standard egg-grown quadrivalentinfluenza vaccine), surface antigen, inactivated	Equal to or less than 0.1 micrograms per 0.5 ml dose	From mid November
Sanofi Pasteur	Supemtek®	QIVr (recombinantquadrivalent influenza vaccine)	Egg-free	From early November
Seqirus	Flucelvax®Tetra	QIVc (cell-grown quadrivalent influenza vaccine), surface antigen, inactivated	Egg-free	From mid November

Note Supemtek® does not come with needles and you will be required to provide your own needles.

Chapter 4 of the Green Book on immunisation procedures recommends a 25mm 23G (blue) or 25mm 25G (orange) needle should be used for intramuscular injections in infants, children and adults. The syringe Supemtek® is provided in has a luer-lock adapter: these luer-lock syringes can accommodate either a luer-lock or luer-slip needle.

Appendix A: claiming fees for DHSC stock and post payment verification (GP only)

For registered patients, practices must record vaccinations using DHSC stock within the patient record (PCR) as they do currently for all influenza vaccinations (both for UK Health Security Agency (UKHSA) centrally supplied childhood flu vaccines as well as locally procured vaccines). The practice will receive a £10.06 Item of Service (IoS) fee for each vaccination recorded on the clinical system and extracted via GPES for payment.

Practices should continue to claim in the usual way for locally procured (for example, not UKHSA or DHSC centrally supplied) flu vaccines which also attract a PA fee and reimbursement of the cost of the vaccine. Practices cannot claim reimbursement of the cost of the vaccine for DHSC stock.

Practices are required, as part of the process for accessing DHSC centrally supplied stock, to complete and return to the NHS Business Services Authority (NHSBSA) by the end of April 2022 (that is, at the end of the flu vaccination season) a template which will include:

• information on how many locally procured vaccines of each type the practice has purchased, administered, redistributed or returned to manufacturers during the season
• a declaration that DHSC vaccines supplied to the practice have not been used to vaccinate private patients or have not been passed to a third party in exchange for payment
• information on how many DHSC-supplied vaccines of each type the practice has sourced from each manufacturer during the season and of these, how many have been administered, redistributed or destroyed
• a declaration signed by a GP partner of the practice, or GP team member with appropriate authority, confirming that to their knowledge, the information provided is accurate and the practice has claimed appropriately for both locally procured and centrally supplied vaccines (the declaration is included within Appendix B)

Practices are advised to set up a records management system that collects the relevant data throughout the flu season to support the prompt submission of the PPV form at the end of the season.

The NHSBSA will use the information in the PPV form, as well as information on historic claims (from 2019 to 2020 and 2020 to 2021), CQRS claims for the 2021 to 20 22 flu season and information provided by manufacturers on practice drawdown of DHSC stock, to undertake a comprehensive post-payment verification process. Any anomalies identified are dealt with via the NHSBA's usual post-payment verification processes. Cases that cannot be resolved with the practice will be escalated, with full support and information, to the regional team for resolution.

We advise practices within this guidance that submitting the post-payment verification form is a condition of accessing DHSC stock and that NHSEI reserve the right to withhold the practice's March 2022 final flu payment until forms have been submitted.

Appendix B: self-certification declaration to NHSEI as part of post-payment verification process (GP only)

Practices will be required to sign this declaration as part of the post-payment verification process.

I declare that I have accessed the DHSC additional flu stock and:

When ordering DHSC stock, I had received, used or allocated all of the flu vaccines I had ordered locally, for the cohort(s) that I required additional DHSC vaccine for and all orders were endorsed prior to submission by the regional NHSEI Commissioner of the flu vaccination programme.

I have only used DHSC stock to vaccinate those patients eligible for a free NHS flu vaccination and who fall into the groups included in the National Flu Immunisation Programme Plan.

I am only claiming the item of service fee for patients vaccinated with the DHSC stock as set out in the Seasonal Influenza Vaccination Programme Enhanced Service Specification 2021-22.

DHSC vaccines supplied to the practice have not been used to vaccinate private patients or have not been passed to a third party in exchange for payment.

I agree that the practice will provide any and all evidence to support claims if required as part of the pre and post payment verification processes, including evidence of vaccination uptake rates, and details of what vaccine was used, to the regional NHS England and NHS Improvement (NHSEI) Public Health Commissioning Team (and NHSBSA and NHSCFA acting on behalf of NHSEI) as part of the verification processes or investigation as required. This includes consenting to share data on existing local orders for flu vaccines. Information on if a practice has accessed stock may also be shared with flu vaccine manufacturers. I agree that NHSEI may require an appropriate portion of claims to be repaid if use of the DHSC vaccines was outside the terms of this guidance or it is considered by NHSEI that there were inaccuracies or inconsistencies in the claim.

I declare that the information given on this form is correct and complete. I understand that if I withhold information or provide false or misleading information, disciplinary action may be taken against me and I may be liable to prosecution and or civil proceedings.

Name of individual making the declaration:

Job title or role within the practice (must be GP partner or GP team member with appropriate authority):

Signature (in signing this, you are confirming that you as a contract holder are signing for and on behalf of the practice and that you have authority to make the declaration on behalf of the practice):

Date of declaration:

Appendix C: frequently asked questions (community pharmacy only)

What stock is available?

Enough stock is available for eligible groups. The department has worked with all manufacturers of adult flu vaccines to increase supply for use in England. The department has ordered additional stocks of QIVc, QIVe and QIVr to boost supply. Community pharmacies should contact their wholesaler on which products they have available.

Who can be immunised with vaccine from DHSC stock?

Community pharmacies that access stock from wholesalers can use them for any patients, as they would with any stock they purchase.

In line with the aim of the national flu immunisation programme, DHSC's objectives are to vaccinate patients eligible for a free NHS flu vaccination to the uptake ambitions set out in the national flu immunisation programme 2021 to 2022 letter. These detail which vaccines are suitable for use on each cohort.

Can I use DHSC stock to vaccinate primary care staff?

Yes. As outlined in the letter published on 29 September 2021, community pharmacy are able, for this influenza season (1 September 2021 to 31 March 2022), to vaccinate all eligible primary care contractors (general practices, pharmaceutical services, dentists and general ophthalmic services) and their frontline staff, including locums. This is for contractors and clinical staff involved in patient-facing frontline provision of NHS primary care services and non-clinical reception and counter staff who play an integral part in patient-facing care on a day-to-day basis in primary care settings.

Can I use DHSC stock to vaccinate social care workers who are eligible for a free vaccine?

Frontline social care staff are eligible for a free vaccine under the national flu immunisation programme. Frontline social care staff can be vaccinated at a community pharmacy and self-identifying as a frontline social care worker. These staff do not need to present ID.

You should refer to guidance on flu immunisation for social care staff.

Which brand of vaccine are available from DHSC? Are they suitable for all ages and clinical needs?

Additional flu vaccines for community pharmacies have been made available to them to purchase via wholesalers. Community pharmacies should contact their wholesaler on which vaccines are available.

Health professionals administering flu vaccines should follow JCVI guidance as set out in the National flu immunisation programme 2021 to 2022 letter and in the Green Book on 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.

Do I have to pay for DHSC stock?

Community pharmacies that are in need of additional stock should contact their wholesaler to purchase stock. This will be under the terms and conditions set by the wholesaler. This is necessary due to legislative barriers on providing free stock to community pharmacies.

How will payments for vaccines work for vaccines?

Community pharmacies can continue to claim payments using their usual process for flu vaccines.

What do I do with unused stock at the end of the season?

Community pharmacies should only purchase vaccines to meet the needs of their local population. DHSC has boosted supply to the community pharmacy sector, and these vaccines are intended to be used after local stocks are exhausted as they are coming later in the season. Whilst this is not a strict requirement, it is expected to ensure that wastage is minimised. It is therefore not anticipated that providers will have any unused local stock if you have purchased DHSC stock. Community pharmacies will be required to follow any processes on disposal or return as set out by their supplier of flu vaccines.

Can a PCN access DHSC stock?

Due to the need to reconcile orders with financial claims as part of the post-payment verification process, it is not possible for PCNs to order DHSC stock on behalf of multiple practices.

What if, even after accessing DHSC stock, I still have insufficient stock to meet demand?

Community pharmacies should contact their wholesalers on making additional orders. You should speak to your local Regional NHSEI Commissioning Team to understand the vaccination strategy in your area. You may also wish to re-direct patients to other local providers and community pharmacies if they have stock available.

Appendix D: frequently asked questions (GP only)

What stock is available?

Enough stock is available for eligible groups. The department has worked with all manufacturers of adult flu vaccines to increase supply for use in England. The department has ordered additional stocks of QIVc, QIVe and QIVr to boost supply.

Who can be immunised with vaccine from DHSC stock?

In line with the aim of the national flu immunisation programme, the DHSC stock can be used to vaccinate patients eligible for a free NHS flu vaccination as set out in the national flu immunisation programme 2021 to 2022 letter and seasonal Influenza Vaccination Programme Enhanced Service Specification 2021-22. These detail which vaccines are suitable for use on each cohort. DHSC flu vaccines must not be used to vaccinate anyone not covered in the groups set in these documents.

Can I use DHSC stock to vaccinate primary care staff?

Yes. As outlined in the letter published on 29 September 2021, practices are able, for this influenza season (1 September 2021 to 31 March 2022), to vaccinate all eligible primary care contractors (general practices, pharmaceutical services, dentists and general ophthalmic services) and their frontline staff, including locums. This is for contractors and clinical staff involved in patient-facing frontline provision of NHS primary care services and non-clinical reception and counter staff who play an integral part in patient-facing care on a day-to-day basis in primary care settings.

Can I use DHSC stock to vaccinate social care workers who are eligible for a free vaccine?

Frontline social care staff can be vaccinated using additional vaccines for those presenting at a general practice and self-identifying as a frontline social care worker. These staff do not need to present ID.

You should refer to guidance on flu immunisation for social care staff.

Which brand of vaccine are available from DHSC? Are they suitable for all ages and clinical needs?

Vaccines have been ordered by DHSC from a number of manufacturers. This was done to reduce the likelihood of the DHSC stock being seriously affected should a problem occur with a single manufacturer. Details of the vaccines procured can be found in table 1.

Health professionals administering flu vaccines should follow JCVI guidance as set out in the national flu immunisation programme 2021 to 2022 letter and in the Green Book on 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.

Do I have to pay for DHSC stock?

No payment is needed by general practice as stock has been paid for by DHSC and will be provided to practices free of charge. For patients immunised with DHSC stock, you will only be able to claim the Item of Service fee and not a reimbursement for the cost of the vaccine, as it was provided for free.

How will payments for vaccines work for vaccines?

This is detailed in Appendix A for general practices.

What do I do with unused stock at the end of the season?

If you have accessed DHSC stock you should have exhausted all of your local stock first. Whilst this is not a strict requirement, it is expected to ensure that wastage is minimised. It is therefore not anticipated that providers will have any unused local stock if you have accessed DHSC stock. Manufacturers will also require you to agree not to return any local stock as a condition of ordering DHSC stock. In light of high demand for flu vaccine this season and the significant expansion of the programme – along with the ability to redistribute stock locally – it is not expected that any DHSC stock will go unused. However, in the very unlikely circumstance that a provider finds itself with a small amount of unused DHSC stock and only after notifying the relevant Regional NHSEI Commissioning Team and making every effort to redistribute the stock, providers will be required to dispose of any unused DHSC stock themselves. Disposal should be done in conjunction with the provider keeping clear records as to the amount, type of vaccines and batch numbers redistributed or disposed of. Providers may be required to submit this information as part of a post-payment verification exercise.

Can a PCN access DHSC stock?

Due to the need to reconcile orders with financial claims as part of the post-payment verification process, it is not possible for PCNs to order DHSC stock on behalf of multiple practices.

What if, even after accessing DHSC stock, I still have insufficient stock to meet demand?

Practices should speak to your local Regional NHSEI Commissioning Team to place an additional order or ask them to determine if any other providers have surplus stock that you can access, adhering to MHRA guidelines. Alternatively, you could re-direct patients to other local providers and community pharmacies if they have stock available.

Will I easily be able to distinguish between locally procured stock and DHSC centrally procured stock so I can ensure I claim the correct payment?

In most (but not all cases), the DHSC centrally procured stock will have different batch numbers to locally procured stock. Practices should put in place arrangements to clearly label and if possible, store DHSC stock separately to locally procured stock to ensure accurate financial claims are made. Practices should be accessing DHSC stock only when they are no longer expecting to receive any more locally procured stock for that particular vaccine.

Further information

Throughout the season, information and updates will be shared with Regional NHSEI Commissioning Teams for dissemination to practices. Information may also be included in the weekly NHSEI primary care bulletin. Practices can sign up to receive the bulletin. In addition, if there are further questions not addressed in this document, please contact your Regional NHSEI Commissioning Team in the first instance.