- Site designation
- Local Enhanced Service (LES)
- Funding / payments
- Premises and supplies
- Patients and appointments
- Point of care systems (Pinnacle and Q-Flow)
Publications approval reference: C1134
16 February 2021
Can any pharmacy contractor provide the COVID-19 vaccination service from their premises?
No. Only pharmacy contractors who are designated Local Vaccination Service sites and are commissioned to provide the Local Enhanced Service by NHS England and NHS Improvement can provide COVID-19 vaccination.
A designation process was run in November 2020 for pharmacy contractors to apply to provide a Local Vaccination Service. This process is being repeated in February 2021. NHS England and NHS Improvement will determine which sites are commissioned to provide the service.
What happens after I have submitted my Expression of Interest?
The regional team will review whether additional vaccination services are required to meet the needs of the local population in the area that you have specified and whether a pharmacy-led Local Vaccination Service (LVS) is the best option. If your proposed service meets a gap in local need then they will assess the operational plans that you have submitted and may ask you more questions. The assessment may include a visit from an NHS England and NHS Improvement representative.
If the regional team has determined that the site is necessary and are assured of the safe and effective operation of the site, the contractor will be informed. The regional team will commission the contractor to provide a Local Vaccination Service under the terms of the LES agreement. The regional team will assign the contractor to a tentative go-live date.
Site readiness will then progress, with supplier and system accounts being set up by NHS England and NHS improvement and associated stakeholders and discussions with the regional teams on operational readiness. Training will be provided to pharmacy teams on the technical systems. There will be a national go/no-go meeting that will review each site’s readiness and designate the site as a vaccination centre before vaccine and equipment supplies are delivered.
Once a site is confirmed as being a designated site, can I move the vaccination service provision to another site?
No. The service is commissioned from a specific site and the regional team would need to undertake additional assurance checks before approving a change in site.
The designation process includes assessing site access and operational plans, where there might be gaps in provision, or where patients may need additional access to the vaccination service. Any proposals to offer the service from a different site must be submitted by the contractor, assessed by the NHS England and NHS Improvement regional teams, and approved by those regional teams before any change is made. If you close your designated site, you are not automatically entitled to move the activity somewhere else so you should discuss any such request with your NHS England regional team in plenty of time.
If vaccines are to be provided in locations other than the designated site, for example in a care home, then this must be agreed in advance with the regional team. The contractor must comply with any applicable Specialised Pharmacy Services Standard Operating Procedures, guidance and conditions regarding movement of vaccines.
What happens if my pharmacy relocates to another site? Can I provide vaccination from the new site?
No. There is no automatic right to take the vaccination service with you if you move. You should speak with your NHS England and NHS Improvement regional team as soon as you know you intend to relocate your pharmacy, as they will need to give permission for the LES to be offered elsewhere.
Will the cost of the pharmacy set-up be considered when NHS England decides whether to commission a particular contractor?
Yes. The NHS England and NHS Improvement regional team will be required to undertake a value for money assessment before agreeing to release additional funding, but they must also ensure that a safe and effective service can be provided. They will consider the number of vaccines that would be required to be provided from the site, the proposed plans, the likely benefit of the service in terms of population health, and additional funding that has been requested.
Why is the service being offered as a Local Enhanced Service (LES) and not an Advanced Service?
The Community Pharmacy Contractual Framework makes provision for Advanced Services, which are nationally commissioned and can be provided by any pharmacy contractor who meets the conditions in the Directions. Advanced Services are used where there is a uniform need, since they cannot be restricted to particular geographies, nor have limits on the number of pharmacies that participate.
The COVID-19 vaccination programme currently has a number of restrictions on supply of vaccine and logistics, and it is vital that we can target resources to the locations and populations who need it most. There is not a uniform need for all pharmacies to provide this service at present, and to do so could hamper national efforts to vaccinate the most vulnerable people.
This LES has been nationally agreed to ensure that there is a consistent approach but allows us to target resources on a basis of need and other practical considerations. The regional teams have consulted with LPCs about the LES and will continue to do in relation to any changes. However discussions between PSNC, NHS England and NHS Improvement and DHSC about an Advanced Service have commenced in preparation for a time when this may become possible and desirable.
Can the Local Enhanced Service (LES) be changed or adapted by the NHS England and NHS Improvement regional teams?
No, during this pandemic situation we cannot accommodate local variation in the LES agreement terms. Where amendments are needed NHS England will consult with LPCs as appropriate.
What happens if I can’t meet the terms of the Local Enhanced Service (LES) after it has been commissioned?
You should contact your NHS England and NHS Improvement regional team immediately to discuss how the issues might be resolved. If you cannot meet the terms of the LES agreement the contract may be withdrawn. Future vaccine supply is dependent on being able to meet the terms of the LES agreement. You can contact your regional team using the details here.
I can no longer provide / no longer wish to provide the services in the Local Enhanced Service (LES) – how much notice do I have to give?
There is 6 weeks (42 days) notice period set out within the LES. However, NHS England and NHS Improvement may allow less notice if they are able to find an alternative provider, so you should discuss this with them.
How long does the Local Enhanced Service (LES) last for?
The LES has a current expiry date of 31 August 2021.
How much is paid for each vaccination given?
£12.58 is paid for each vaccination given.
Can we claim reimbursement for the value of the vaccine?
No. The vaccine is provided direct to designated sites free of charge and therefore no reimbursement is due.
Can I get any help with costs at the designated site?
Yes. There will be equipment and consumables provided to you, and funds can be requested to cover additional venue hire etc. where these have been agreed in advance.
Equipment agreed in advance will be provided prior to go-live date, and there will be a regular delivery of consumables such as face coverings, needles and syringes. There are also funds being made available to help with other set up costs for designated sites. NHS England regional teams will need to pre-authorise claims against these additional funds after subjecting them to a value-for-money test, so you should discuss with them any additional set up costs you think you may have. The funding is intended to cover additional venue hire, changes to existing premises to allow the vaccination to be established, as well as other costs such as security, but not costs covered within the vaccination fee such as workforce, or to cover costs paid for through other routes. Costs should not be incurred before they have been agreed with NHS England and NHS Improvement.
As the service should be offered 7 days a week, is there any additional funding to cover increased staffing costs and overtime?
No. The cost of staffing the vaccination service is considered to be included in the £12.58 service fee. However, there may be additional staff, including volunteers, who may be available in your area. You should contact the lead employer for your area who can discuss these arrangements with you. Guidance for community pharmacy about how to access additional workforce can be found here, and a list of lead employers can be found here.
How do I get the equipment I need to provide the COVID-19 LES?
Most equipment will be provided to you by the NHS. Additional equipment may be reimbursed following discussion and a value for money assessment by your NHS England and NHS Improvement regional team.
Once you’ve been confirmed as a designated site, you will be added to the list for an initial supply of equipment to allow you to set up your site in readiness for ‘go-live’ with the vaccine programme. This will be provided in the days immediately before you start providing the service. Consumables will be provided based on the numbers of vaccines supplied to your site and will be based on a regular delivery schedule.
What equipment will I be provided with?
The Supply Inventory List (SIL) sets out the equipment that vaccination sites will receive. IT equipment will also be provided, and an engineer will come to your site to set it up if required. You will be usually be assigned to a non-NHS SIL if you are offering services from your current pharmacy and a non-NHS SIL if you will be using new premises (for example in a hired venue or church hall). A roving SIL will be supplied to contractors who are requested by NHS England and NHS Improvement to provide a service away from their designated site, for example in a care home.
These equipment lists have been compiled for sites administering 1000 vaccines per week or more, and equipment for sites who offer 400 vaccines per week will be generally be less extensive. NHS England and NHS Improvement will work with contractors immediately before the decision to designate your site to confirm what equipment, including IT kit, is needed.
There will be a regular delivery of associated consumables and PPE throughout the site operation.
Do I have to pay for the equipment that is supplied to me for use as part of the vaccination programme?
No. The equipment supplied will be free of charge.
Do I need to order my PPE for the vaccination programme via the portal as I normally would?
No. There is no need to order additional PPE for the COVID-19 vaccination programme – it will be provided to you free of charge with all the other consumables used as part of this service. You must not use the PPE portal to order additional volumes to cover the vaccination programme – you should only order PPE via the portal for business as normal pharmacy services.
How do I order vaccine?
You cannot currently order vaccine. Currently supplies are allocated to your site by a cross-system group who considers the number of unvaccinated people in relevant cohorts in your area. We expect over time to move to a model where sites have more say over their vaccine allocations. Sites are not guaranteed to get the same volume of vaccine each week, or to have vaccine delivered on the same day each week.
How do I know how much vaccine I have been allocated?
Currently this information is sent to you in the week before your vaccine is delivered so that you can schedule clinics. You must aim to use all vaccine in the 7 days after it has been delivered.
How do we order the vaccines we need each week? Can I just order them from my normal suppliers & wholesalers?
At present, vaccine cannot be ordered through usual supply routes. On a weekly basis NHS England and NHS Improvement will advise how much vaccine has been allocated to you. This may not be the same as you have requested. NHS England will prioritise available vaccine to sites where there are still patients in the highest priority cohorts to vaccinate. Stock is allocated as soon as it is received so there is no spare/back up stock.
Can we choose which vaccine we want to use at our site?
Because of the huge numbers of patients who will need vaccinating in a short time, it’s important that all designated sites are able to use any vaccine that is supplied to them. We fully anticipate community pharmacy sites will receive the Oxford AstraZeneca vaccine and we will contact you in advance to confirm arrangements should this need to change. We do not anticipate that we will send vaccines requiring storage at ultra-low temperatures to pharmacy-led LVS sites.
Do we have to buy the vaccines and then claim for reimbursement as we do with the flu service?
No. Vaccines will be supplied centrally free of charge to designated sites, so there is no reimbursement to claim on the vaccines being used.
What kind of information do I need to give patients at the time of vaccination?
Each patient will need to be given a copy of the patient information leaflet that is relevant to the vaccine they have received – these are being sent out to sites, but you can also direct patients to online versions if they prefer. There are also a number of patient information leaflets that you can print or direct patients to.
Designated sites will also receive a supply of COVID-19 vaccination record cards – each vaccinated patient should be given a vaccination record card following their first vaccination.
Can we give other vaccinations (eg flu vaccine) at the same appointment as giving the COVID-19 vaccine?
Wherever possible appointments should be separated by 7 days in case of adverse effects from any of the vaccines given. However, if this is not possible, then it is acceptable to give both a flu vaccine and a COVID-19 vaccine together as the Green Book states that: “as both of the early COVID-19 vaccines are considered inactivated (including the nonreplicating adenovirus vaccine), where individuals in an eligible cohort present having received another inactivated or live vaccine, COVID-19 vaccination should still be considered.”
After vaccination, how long do we need to observe the patient?
You should refer to guidance for each individual vaccine in use, as the advice will change from vaccine to vaccine. However, observation periods should follow normal arrangements for observation after vaccination as set out in the Green Book. Information relating to specific vaccines will be provided as it becomes available. (For the Pfizer/BioNTech vaccine recipients should be monitored for 15 minutes after vaccination, with a longer observation period when indicated after clinical assessment, as set out in the MHRA statement.) For the Oxford/AstraZeneca vaccine there is not a requirement for a 15 minutes observation period unless this is indicated after clinical assessment.
Some patients may need to be observed for longer if they experienced any kind of rash or reaction to previous vaccinations.
How will patients know that they can get their vaccine at my pharmacy?
Currently they will receive a letter from the national call / recall team that will invite patients to book using the National Booking Service.
The patient will be able to choose from a list of sites with appointments available that are close to their location.
Local booking arrangements may be used with the written consent of your NHS England and Improvement regional team, particularly to help improve vaccine uptake in eligible populations and where vaccine hesitance is a concern.
Signage can be used at your pharmacy if you wish. There is an NHS Vaccination site logo that you can use to help people identify the site, but this must be using in accordance with NHS Identity guidelines. The NHS COVID-19 Vaccination Service logo should be used on its own and not be co-branded with any other logo.
Can I use my own appointment booking system?
Yes. Most pharmacies will use the National Booking Service (NBS) so that patients can book using the website or telephone number sent to them in the national call and recall letters. However, it may be appropriate to use a local booking system to target specific eligible populations who are not choosing to use the NBS where this has been agreed in advance with your NHS England and NHS Improvement regional team.
Can I vaccinate patients not booked via the National Booking Service (NBS)?
Yes, you can vaccinate front-line healthcare or social care workers without an appointment, although they are able to make an appointment on the NBS until 28 February 2021. You can also vaccinate other eligible cohorts if you have the written permission of the NHS England and NHS Improvement regional team.
Can patients choose where to be vaccinated?
Yes. Patients contacting the National Booking Service will be offered a selection of sites who are offering the vaccination service based on their location and are free to choose from that list. People may also be contacted by their general practice and can choose to have their vaccination done at a PCN group site.
How do patients book their vaccination appointments?
Patients will receive a letter telling them when they are eligible to be vaccinated and this will give them information on how to book their appointments. They will be encouraged to choose the website but can also choose to use a telephone helpdesk (119). They will be expected to book appointments for both doses when they make contact, although they can change the second appointment if needed at a later stage.
Are we able to use the vaccine supplied to vaccinate our own staff?
Yes. Frontline Health and Social Care staff (including community pharmacy staff) are entitled to receive a vaccine under the LES. You may find these staff are most suitable to be vaccinated at the end of each session to reduce vaccine wastage. However, you can vaccinate any Health and Social Care worker (including your own staff) wherever you are satisfied they are eligible under the service and you also have enough vaccine to cover existing bookings.
Who can vaccinate patients?
Any person covered under a Patient Group Direction, or authorised under a National Protocol, relevant to the vaccine being used, is able to administer a vaccination. These documents and many others that will be useful for the programme can be found on the Public Health England COVID-19 vaccination programme website.
The Specialist Pharmacy Service also has a useful page which sets out who can work under a PGD or Protocol under the COVID-19 vaccination programme which you can access here. This confirms the legal basis for the vaccination process and who can be involved.
How do I find out what each member of my staff can do as part of the vaccination programme?
You should review the Patient Group Direction and National Protocol for each of the vaccines, as this sets out what each staffing group can undertake as part of the vaccination process. There are also training requirements for each member of staff working in the vaccination programme set out in the LES. You should review these and ensure staff are only allocated roles in which they are appropriately trained.
Are there any additional staff or volunteers we can draw on to help with vaccinations at our site?
Yes. Community pharmacy designated sites are expected to use/arrange their own staff to cover vaccination clinics. However, there may be additional staff, including volunteers, who may be available in your area. You should contact the NHS lead employer for your area who can discuss these arrangements with you. Guidance for community pharmacy about how to access additional workforce can be found here, and a list of NHS lead employers can be found here.
Do I need to offer appointments 8am – 8pm, 7 days a week?
Not necessarily. Although the LES requires you to be able to offer vaccination appointments over 7 days a week if required, you must offer appointments at times agreed with your NHS England and NHS Improvement regional team to provide access to vaccination when patient demand is greatest, depending on the populations being vaccinated. You should work with your regional team to understand when appointments are most needed, and that available vaccine is used quickly. All vaccine should be used within a week of delivery.
What systems will I use to manage my vaccination clinics?
You will use Q-Flow as an appointment booking system if you are using the National Booking Service, and Pinnacle Outcomes4Health to make clinical records of vaccines administered. Access to both systems and training will be made available to you.
How will I know which patients have booked appointments on the National Booking Service?
You will be able to view and print appointment information from Q-Flow. You will be provided with a username and password to be able to set up appointments and view booked appointments. Appointments cannot be made on the same day, so you will be able to see each day which patients are expected to attend the site. You will also be able to check-in patients as they arrive for vaccination, maintaining a record of any patients who did not attend.
How will we record clinical information when administering the vaccine?
You will need to record information on the Pinnacle Outcomes4Health system. This system is similar to PharmOutcomes but requires different set-up and administrator accounts.
Can we use our usual PharmOutcomes log-in for Outcomes4Health?
No. The details that you provide to us on your designation form will be used to set up an administrator account which can be used to set up additional users.
Will we need to send vaccination details to the patient’s GP?
No. An automated record of the vaccination will be in place that will be shared to the patient’s GP record.
Do I need a smartcard to access the National Booking Service (NBS) via Q-Flow?
What happens if patients don’t turn up to their appointment? What do I need to do?
Where a patient has booked through National Booking Service and does not arrive for their appointment then you will not check them in on the system and the national call/recall system will follow this up with the patient. You don’t need to do anything at the site about this patient. You may need to contact an eligible health and social care worker on your reserve list for an urgent appointment to ensure you use the vaccine.