The new general practice contract has stated that vaccinations and immunisations will become an essential contractual service this year amid a payment model overhaul.
All practices will be expected to offer all routine, pre- and post-exposure vaccinations and NHS travel vaccinations to the eligible practice population.
A named lead for vaccination services will be introduced in all practices who is responsible for meeting the core standards and requirements of the contract, and ‘maximising’ vaccination opportunities.
The vaccination payment model will be ‘overhauled’ to boost vaccination coverage, a change which the contract called the ‘most significant in 30 years’.
As part of this, ‘item of service’ payments will be introduced and standardised across all routine programmes during the next two years.
This will begin with measles mumps and rubella (MMR) in 2020/21, before extending to other vaccines from April 2021.
The contract states that £30m extra funding is being put into vaccinations and immunisations in general practice.
The item of fee payment will be fixed at £10.06 for the next three years and there will be incentive payments for practices that achieve the required coverage for vaccinations, which benefit from a ‘herd immunity effect’ such as MMR. This will form part of a new QOF domain.
It states: ‘All investment currently committed to routine vaccination that is not redistributed into IoS payments, will be used to fund this new routine vaccination QOF domain which we expect to have a value of at least £40m. We will work with clinical leads and experts from the BMA, Public Health England and other partners over the coming months to optimise the design of this new domain.
‘We anticipate that the thresholds for MMR and the six-in-one vaccine will be set at ~90%+, with points allocated to maximise the incentive and minimise negative redistributive effects.’
The agreement claims that all practices – except those with poor coverage – will benefit financially from the new arrangements.
Additionally, new incentive payments will be introduced in order to maximise population coverage as part of QOF. This replaces the current childhood immunisation DES.
Two months ago, an advisory group including representatives from the BMA GP Committee, NHS England and RCGP concluded the current childhood incentive scheme targets of 70% and 90% coverage were ‘misaligned’ to World Health Organisation-recommended levels for population protection.