Community Pharmacy London Vaccination Service
These are all the necessary documents that are needed for the London Pharmacy Vaccination Service until the National Advanced Service is launched.
For further details please contact Raj Matharu on 020 8650 6604 or 07914 769 218 or bbglpc@gmail.com
V1.1FinalSLA.ServiceSpecLondPhcyImms LES2015-16 copy Update onTrainingnAccreditationLondonServ 30hAug2015 copy Service Operation Guidance_LondonPcyImmsService 2015_03092015v1.5 copy PPVrecordform2015londonservicev1.0 copy PatientExperienceSurvey2015-16Final copy patient consent form15-16 copy NHS England (London region) Immunisation Incident Reporting Form copy LOCALflurecordform2015londonservicev1.0 copy FAQs LondonImms&NationalAdv Flu2015V1.2 copy COMBINEDflurecordform2015londonservicev1.0 copy 2015v2-Sonar Login User Guide- copy
Latest update: July 2015
A new Advanced Service for 2015/16 — a national flu vaccination service — was announced on Monday 20 July 2015 by NHSE and the Pharmaceutical Services Negotiating Committee (PSNC). From September 2015, community pharmacists in England will be able to provide flu vaccinations under the NHS to eligible adult patients. The national flu vaccination service will be underpinned by a national Patient Group Direction (PGD), which will be issued by NHS England. This will be the first Advanced Service to include a PGD and pharmacies providing the service will have to comply with the terms of the PGD.
This is extremely exciting for community pharmacy teams in England. Across London, pharmacies have been providing flu and pneumococcal vaccinations over last two years. The groups of patients covered in the national flu service will now be covered via the national specification and agreement for flu. However we have agreed with NHSE (London) that they will commission through a Local Enhanced Service (LES), an additional service to cover the additional groups of patients and a lower age bracket of 2yr – 18yr’s (in whom Fluenz cannot be used), and pneumococcal polysaccharide (PPV23) vaccine for eligible cohorts. This will be underpinned by London specific PGD’s for Flu and PPV23.
It might be helpful to see Patients’ eligibility – groups covered under each of the two services
Summary of Groups of Patients likely to be included in the National Flu Service and those in the London Vaccination Service
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National Pharmacy Advanced Service for Immunisations 2015/16
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London Enhanced Vaccination Service 2015/16 |
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In 2015/16, flu vaccinations will be offered at NHS expense to the following groups: • people aged 65 years or over (including those becoming age 65 years by 31 March 2016) • people aged from 18 years to less than 65 years of age with a serious medical condition such as: – chronic (long-term) respiratory disease, such as severe asthma, chronic obstructive pulmonary disease (COPD) or bronchitis – chronic heart disease, such as heart failure – chronic kidney disease at stage three, four or five – chronic liver disease – chronic neurological disease, such as Parkinson’s disease or motor neurone disease, or learning disability – diabetes – splenic dysfunction – a weakened immune system due to disease (such as HIV/AIDS) or treatment (such as cancer treatment) • all pregnant women (including those women who become pregnant during the flu season) • people living in long-stay residential care homes or other long-stay care facilities where rapid spread is likely to follow introduction of infection and cause high morbidity and mortality. (This does not include, for instance, prisons, young offender institutions, or university halls of residence) • people who are in receipt of a carer’s allowance, or those who are the main carer of an older or disabled person whose welfare may be at risk if the carer falls ill • consideration should also be given to the individuals who expect to share living accommodation on most days over the winter continuing vaccination of household contacts of immunocompromised individuals, specifically close contact is unavoidable and, therefore, for whom (to be confirmed by national team)
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In 2015/16, flu vaccinations will be offered at NHS expense to the following groups: · people aged from 2 years to less than 18 years of age, using Fluarix Tetra, in whom Fluenz Tetra is contraindicated and have a serious medical condition such as: – chronic (long-term) respiratory disease, such as severe asthma, chronic obstructive pulmonary disease (COPD) or bronchitis – chronic heart disease, such as heart failure – chronic kidney disease at stage three, four or five – chronic liver disease – chronic neurological disease, such as Parkinson’s disease or motor neurone disease, or learning disability – diabetes – splenic dysfunction – a weakened immune system due to disease (such as HIV/AIDS) or treatment (such as cancer treatment) · front line health care workers · Additional groups identified in the NHS England London Region service specification (these are to be defined but will include NHSE and PHE staff as well as staff in Prisons and Special Needs Schools)
In 2015/16, Pneumococcal Polysaccharide Vaccine (PPV) will be offered at NHS expense to the following groups:
· People over 65 years of age, not previously been immunised with PPV · People aged 2 to 64 years with the following conditions: · Chronic respiratory disease · Chronic heart disease · Chronic kidney disease · Chronic liver disease · Diabetes · Immunosuppression & asplenia or dysfunction of the spleen · Individuals with cochlear implants
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Some of the specifics of the two separate services are listed below – bear in mind that much of the details for the national service have yet to be confirmed and for the London LES, some details have not been agreed as yet due to the revisions required following the announcement of a national service
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National Flu Vaccination Service 2015/16
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London LES for Vaccination Service 2015/16 |
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Criteria for providing the National service
The national flu vaccination service can be offered by any community pharmacy in England which: · Has a consultation room (a pre-requisite for provision) · Has suitably trained staff (see below) · Is able to procure the flu vaccines. Vaccines will not be procured centrally so pharmacies will have to source their own · Meets data recording requirements, details of which are not yet known · There will be a requirement to report to the patient’s GP practice · It is not known yet if patient experience data is to be collected It is not yet known whether data collection and payment claims will involve an electronic or paper-based system
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Criteria for providing the London Vaccination service via LES The London vaccination service can be offered by any community pharmacy in London which: · Has a consultation room roo (also a pre-requisite for provision) · Has suitably trained staff (see below) · Is able to procure the flu & PPV23 vaccines. Vaccines will not be procured centrally so pharmacies will have to source their own · Meets data recording requirements via Sonar IT platform · There will be a requirement to report to the patient’s GP practice via Sonar IT platform · Patient Experience information will need to be collected and uploaded on IT platform Data collection and payment claims will involve an electronic process via Sonar IT platform
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Vaccination training — Whilst requirements have not been made known pharmacies will wish to start getting ready in the interim. Our advice: Pharmacies wishing to provide the service will have to demonstrate that pharmacists administering the flu vaccinations have been appropriately trained. Training will not be provided centrally and pharmacies can choose the training they require to satisfy themselves that they have the necessary skills to provide the service. Pharmacist are reminded to seek confirmation from their training providers that their training meets the National Minimum Standards for Immunisation Training incorporates the Core Curriculum
For those pharmacists who are new to the service, a full practical vaccination training will be required most probably – Must cover vaccination techniques, anaphylaxis management and basic life support; these sessions are usually supported by a series of online training modules.
For those pharmacists who participated in the Flu service last year, Refresher vaccination training will be required most probably – Can be via online training modules covering information on vaccination techniques, anaphylaxis management and basic life support
Accreditation requirements are likely to include completion of a declaration of competency via CPPE but as yet the full details for this is not available
Other training (not necessary but useful to better equip individuals for delivery of this service) includes consultation skills, marketing & time management
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Vaccination training requirements are known – see Training & Accreditation Briefing circulated 17th July Pharmacies wishing to provide the service will have to demonstrate that pharmacists administering the flu vaccinations have been appropriately trained. Training will not be provided centrally and pharmacies can choose the training they require to satisfy themselves that they have the necessary skills to provide the service. Pharmacists are reminded to seek confirmation from their training providers that their training meets the National Minimum Standards for Immunisation Training and incorporates the core curriculum
For those pharmacist who are new to the service, a full vaccination training will be required – Must cover multiple vaccination techniques (intramuscular, subcutaneous and intranasal), anaphylaxis management and basic life support; these sessions are supported by a series of online training modules.
For those pharmacist who participated in the Flu service last year, Refresher vaccination training may be useful – Can be via online training modules covering information on multiple vaccination techniques (intramuscular, subcutaneous and intranasal); Refreshers will be needed on anaphylaxis management and basic life support
Accreditation requirements include completion (or re-completion) of a declaration of competency via CPPE including a new Step 5 this year Please see the Training & Accreditation Briefing dated 17th July
Other training (not necessary but useful to better equip individuals for delivery of this service) includes consultation skills, marketing & time management
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| As an Advanced Service, providing the national flu vaccination service will be optional for pharmacy contractors but bear in mind the implications of provision on Pharmaceutical Needs assessments of localities |
As a Pharmaceutical Enhanced Service, providing the London vaccination service will be optional for pharmacy contractors but London LPCs encourage all pharmacies to sign up to provide as a top up to the national service.
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Many pharmacies already provide flu vaccinations as a private service and they will be able to continue to offer this.
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Many pharmacies already provide flu vaccinations as a private service and they will be able to continue to offer this.
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Pharmacies will be reimbursed the cost of the vaccine (list price), and receive remuneration of £7.64 plus an additional fee of £1.50 to cover the costs of providing the service) per vaccination. There will be no separate funding for set-up and running costs e.g. training, clinical waste management & anaphylaxis kits etc., as the £1.50 per dose is intended to cover these.
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Details to be confirmed soon in light of the different arrangements for the national service. |
| The service specification, guidance and PGD for the national flu vaccination service are still being developed. The Pharmacy London Vaccination Team will keep contractors updated via their LPCs, once full details are available | The service specification, guidance and PGD’s for the London Pharmacy Vaccination service are still being developed and or reviewed. The Pharmacy London Vaccination Team will keep contractors & pharmacists in London updated via their LPCs, once details are agreed & available |
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Start of service 1st September 2015 – so as soon as vaccines are available in September It is likely the service provision will end 31st December 2015 but this is yet to be confirmed
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Start of service 1st September 2015 – so as soon as vaccines are available in September Service is likely to end 31st March 2016 as in previous years |
| The national Flu service is an Advanced service and like MURs and NMS, GP support would be helpful and should be encouraged; However, GP support is NOT NECESSARY in order to successfully provide the service. If you experience any negative pressures from your local GP practices, contact your LPC for support | The London Pharmacy Vaccination service is commissioned by NHSE (London) to meet its obligations to Londoners. GP support would be helpful and should be encouraged; However, GP support is NOT NECESSARY in order to successfully provide the service. If you experience any negative pressures from your local GP practices, contact your LPC / or Commissioner for support. |
Contractors and pharmacy leads are urged to consider the following points in the build up to September and the next vaccination season:
- Pharmacy vaccination services and in particular flu vaccination, is increasingly being viewed as the norm as a service offer from community pharmacies and this is seen even more clearly by its addition into the Advanced service category. This is turn has implications on Pharmaceutical Needs in each area and so we urge pharmacy contractors to view engagement in light of this for their future.
- The Pharmacy London Vaccination team urge contractors to sign up to the London Vaccination service alongside the national flu service and put in place a structure through which you can produce good activity – besides a good source of income, you are strengthening your own position within the primary care structure in your own localities
- Review your work practices and try and see how this service can be built in alongside all the other regular work in practice such that you maximise the potential for your pharmacy
- There are many providers of vaccination training – if in any doubt, please contact your LPC for help
- Ensure you are signed up to receiving regular updates from your LPC so that you get information in a timely manner.
- Once service specs, PGDs etc. are received make the time to get fully familiar with the documents such that you know what needs to be done and plan effectively to deliver on the service
- Make the arrangements for stock availability – talk to your LPC if in any doubt
- Start informing your patients that you will be vaccinating from September – use all the means available to you and your team to build up awareness early
We hope you find this briefing useful and we welcome any feedback, please feel free to email bbglpc@gmail.com with your comments.
TRAINING REQUIRMENTS. To be eligible to provide the service a pharmacist must have completed a training course that meets the National Minimum Standards for Immunisation, which includes the essential topics, set out in the Core Curriculum 3. This includes how to manage an anaphylaxis. There are a range of different providers of these courses, and it is the responsibility of the pharmacist to confirm with the course provider that the training meets these requirements. NHS England does not accredit training providers, nor does it hold a list of them. If any pharmacist is having difficulty identifying a provider they should contact their LPC. As a minimum a pharmacist should attend face to face training at least once every three years. The National Minimum Standards recommends as a minimum, all immunisers who have completed a basic immunisation course should receive an annual update. Where a pharmacist wishes to administer a vaccine by a route that they have not previously been trained (e.g. previous training was to administer vaccines via intramuscular route, but the pharmacist intends to administer via intradermal or sub-cutaneous) they are required to undertake face to face training. With the introduction of the PPV vaccination in 2014/15, a number of pharmacists requested additional support with respect to the need to draw up into a syringe as this vaccine is not available in a pre-filled syringe. The vaccine manufacturer is currently producing a training video which will be made available to pharmacists in the next few weeks. Pharmacists are also required to hold a valid a Basic Life Support (BLS) certificate, which includes providing basic life support to children from 2 years of age. A number of immunisation training providers include BLS training as part of their course. Pharmacists may be asked to provide evidence of any training attended, including certificates.
Assessment of knowledge. CPPE have developed a two-part e-assessment of knowledge. For this service it is mandatory that any pharmacist has completed and passed “Immunisation in pharmacies – developing your service (Part 1).”
Assessment of competence. The National Minimum Standards recommends that all new vaccinators should spend a minimum amount of time with a practitioner who has attended a comprehensive immunisation course and is experienced in giving vaccines and advising about immunisation before starting to give immunisations themselves. There should be an assessment that involves observation of the pharmacist during a number of vaccinations to demonstrate that they have attained specified clinical competencies such as those included in the Core Curriculum document. A number of immunisation training providers offer an assessment of competence as part of their course. If any pharmacist who has not previously administered vaccinates is unable to arrange an assessment of competence through the training provider, they should contact their LPC. In 2014/15 approximately 2000 pharmacists in London delivered the vaccination service, and therefore it should be relatively straight forward to arrange.
Pharmacists who are new vaccinators may be asked to provide evidence of such an assessment of competence.
Accreditation In order to provide the Vaccination service you must work through the DoC system on Vaccination services. This involves accessing the DoC framework from the CPPE website5 and visiting the competence framework to assess and meet any gaps in your knowledge and skills. Once you are satisfied that you meet all the competencies within the framework you must print and sign your statement of declaration and also complete step 5 to confirm your declaration and enable access to your CPPE viewer This step 5 is a new feature, and pharmacists who have already fully completed the previous 4 steps, including printing and signing their certificate, are still required to complete step 5. CPPE has confirmed that it should go live on their website by 25th July 2015, and that they will be sending an email to everyone who has previously completed a DoC to ask them to return to step 5 and add in the date of when they completed their DoC retrospectively so it appears on the CPPE viewer page. Pharmacists are responsible for reassessing their competence to deliver the service at least once every 3 years. Those pharmacists who have already fully completed a DoC in 2014/15 are therefore not required to complete this again (apart from completing step 5). However it is recommended that pharmacists review their declaration statements to satisfy themselves that each statement is still valid. Patient Group Directions (PGDs) as all vaccines are prescription only medicines, NHS England London Region has authorised a suite of PGDs to enable any eligible healthcare professional to be able to administer an immunisation as part of a programme commissioned by the organisation. These include those that community pharmacists will be asked to administer. They are published on the NHS England website at http://www.england.nhs.uk/london/immunis-team/ .The PGDs for the seasonal flu programme are currently being reviewed and will be uploaded once they have been approved – this is likely to be in late August 2015. Every pharmacist who wishes to administer a vaccine as part of this service must have downloaded and signed a copy of the relevant PGD(s) prior to vaccination.
Service Level Agreement. A Service Level Agreement, including a service specification, is currently being finalised. Once it is available it is important that all pharmacists providing the service, including locum pharmacists, familiarise themselves with the content.
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London Vaccination Service 2015/16 Provider Briefing 15/01
This is a brief update on behalf of the Vaccination team at Pharmacy London regarding the recommissioning of the vaccination service for 2015/16. Criteria for participation is still to be confirmed. You will be aware that an economic evaluation was conducted during March and April and this was to influence the planning for the seasonal flu campaign this year as well as any builds on the pharmacy immunisation service in general. At last the London Immunisation Board (LIB) has confirmed its decision to commission London community pharmacies once again to provide inactivated seasonal flu as well as pneumococcal (PPV23) vaccinations from September 2015. The LIB have also stated that they would like to consider commissioning some other vaccinations but that these are dependent on other issues and levers e.g. whether certain NHS restricted vaccine stocks are made available to community pharmacies through current distribution logistics being revised.
The Pharmacy London Flu team is making all possible efforts to get these major stumbling blocks removed in time before the new commissioned service is finalised. However, this will require some assistance at the national level and we are hopeful that this help is forthcoming as well as successful in achieving the desirable results in time. Furthermore, the evaluation has shown that substantial improvements in data transfer to General Practices and into the required NHS/PH systems is also necessary. The team will be working with our General Practice, NHS England London Region and Public Health partners to achieve this so that community pharmacy can make a more robust contribution to the vaccination programme in London this year. In essence, the current situation is that London pharmacies are confirmed to deliver inactivated seasonal flu and pneumococcal jabs for 2015/16 – the same as last year. We are unable to confirm any further builds on this at present.
A working group is being set up by NHSE to develop the service and has yet to meet. Pharmacy London Flu Team will update London LPC s after the first meeting as to what is agreed re the training requirements, this will then be sent out to pharmacists. Pharmacy London’s objective will be to gain agreement that IF the service is to include only inactivated flu and PPV again, then any pharmacist who successfully completed a Declaration of Competency last year (which was valid for 3 years where there are no changes to the service delivery) and delivered a service successfully last year should not be required to undergo practical training for injection technique this year; rather just require online refreshers for CPR & Anaphylaxis. However, this is subject to confirmation, which the Pharmacy London Flu Team hope will be within the next two weeks. Note that if you are new to this service, your LPC office can support you in understanding the training requirements in preparation for the service this year.
Raj Matharu, BBG LPC CEO and member of the Pharmacy London Flu Team commented ” This is a step in the right direction. I would encourage all London pharmacists to consider this very important service and build it into your daily practice. Many BBG pharmacists have Health Champions, please use them to raise awareness of Winter Health and recruit “at risk” patients.”
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Community Pharmacy Vaccination Service 2014-15
Vaccination Numbers. Pharmacy London is thrilled that London pharmacies have delivered nearly 116,000 vaccinations up to date during this season. Pharmacy in London has done us proud this year with this achievement. Thank you to each of you and your teams for all their hard work. BBG Pharmacists delivered just over 7,000 vaccine doses in the 2014-15 season.
The commissioner has confirmed that pharmacists in London should continue to vaccinate (both seasonal flu and pneumococcal) ALL ELIGIBLE cohorts of patients until 31st March 2015 as per the SLA that you are signed up to.
Despite the recent publicity re the Influenza A (H3N2) component of the vaccine being relatively ineffective this year, it is important to note that the current vaccine also contains components to protect against the H1N1 (2009 pandemic strain) and Influenza B and both of these strains are also circulating currently, be it at a low level. The H1N1 strain caused a number of deaths in pregnant ladies and some very serious illness in others in 2009. Therefore it is important to advise those at risk especially pregnant ladies (at any stage of pregnancy) to get vaccinated now if not already vaccinated this season.
There will be pharmacies holding some stocks of vaccines and it is in all our interests to try and use this up rather than have extra wastage within the pharmacy network – so please liaise with your colleagues and neighbors if they have any excess stock to use up rather than ordering more via wholesalers.
Patient Satisfaction Surveys You are reminded that the Service Level Agreement requires each pharmacy to have collected Satisfaction Surveys from at least 10% of patients vaccinated. We asked for pharmacies to do as many as possible as the data from these provides us extremely valuable information that will help us influence the service in the future.
Sonar has made available a data collection tool on the site and pharmacy teams can upload the data from the surveys collected. The majority of the data can be collated together before uploading to make it a lot easier to do it all together.
The Pharmacy London Flu Team has started a dialogue with the commissioner for the 2015-16 season and BBG pharmacists are advised to keep abreast and look out for statements from Pharmacy London.
