Letter to Community Pharmacy – phase 3 of the COVID-19 vaccination programme



Classification: Official

Publication approval reference: C1347

To: Community Pharmacy Contractors

14 July 2021

Dear Community Pharmacy Contractors,

Community Pharmacy Local Enhanced Service Specification and Expression of Interest process for phase 3 of the COVID-19 vaccination programme

As we near the end of phase 1 and 2 of the COVID-19 vaccination programme, thank you to all community pharmacies who have been involved in the delivery of over 67 million COVID-19 vaccinations. Community pharmacy has been a vital part of this historic programme and we are very grateful to everyone involved.

We have published today the Local Enhanced Service Specification for phase 3 of the COVID-19 vaccination programme (“Phase 3”) and guidance on the Community Pharmacy Phase 3 Expression of Interest and Site Designation process here.

The Phase 3 service specification seeks to implement interim advice from JCVI on the potential COVID-19 booster programme. This advice suggests that the COVID-19 booster vaccines should be offered in two stages from September, starting with those most at risk from serious disease and that the seasonal flu vaccine should be offered alongside the third, booster dose of the COVID-19 vaccine. Our letter of 1 July sets out further details to enable local systems to prepare.

The NHS will also deliver COVID-19 second doses to those who receive their first COVID-19 vaccination over the summer and continue to offer a new first and second dose of the COVID-19 vaccine to all eligible patients (the “evergreen offer”), continuing to tackle inequalities, including through roving models.

We are expecting further advice from JCVI over the summer regarding whether the booster dose should be the same or different to that received for a first and second dose, which vaccines will be used and advice on co-administration of COVID-19 and flu vaccines. Community Pharmacy sites must therefore be able to receive, store, prepare and transport (where appropriate) the vaccines which are currently approved, as well as any new vaccines which may be approved in future.

Given the expected further advice, we may need to update the Local Enhanced Service Specification with further details once known, including the governance arrangements that will need to apply where vaccines are being co-administered. We will notify LPCs and Pharmacy Contractors in advance of any changes.

We are now opening the designation process again to all pharmacy contractors on the NHS England pharmaceutical list who may be able to provide a COVID-19 vaccination service as part of the autumn COVID-19 booster programme (phase 3).

In line with requirements Regional representatives of the Commissioner should ensure they consult their Local Pharmaceutical Committees (“LPCs”) on the Local Enhanced Service: COVID-19 vaccination programme: phase 3 2021/22 (“the LES”).

A. Overview of local Enhanced Service Specification for phase 3

The service specification for phase 3 is largely based on the current local enhanced service specification for phases 1 and 2. In developing the service specification for phase 3, we have taken into account lessons learned from our engagement with providers and local systems and patient insight work on phases 1 and 2 of the COVID-19 vaccination programme.

To allow current community pharmacy sites to offer further vaccinations to all adults in England, it is our intention (subject to appropriate engagement) that the Local Enhanced Service: COVID-19 vaccination programme 2020/21 (“the LES 2020/21”), delivering Phase 1 and 2 will be extended to 31 October 2021 for existing community pharmacy sites. With the LES starting on 6 September 2021 there is an expectation that the Pharmacy Contractor and the Commissioner shall agree to the termination of the LES 2020/21 if the Pharmacy Contractor is commissioned to deliver services under the LES. We will publish details of the extension and an updated specification later in July 2021. Pharmacy Contractors currently delivering Phase 1 and 2 under the LES 2020/21 who are not commissioned to deliver COVID-19 vaccinations in Phase 3 can continue to offer first and second doses to cohorts 1-12 until the end date of their LES 2020/21 agreement but cannot deliver booster vaccinations for Patients who have already received first and second doses.

Key updates:

  • Community pharmacy COVID-19 vaccination service site capacity options: following a successful pilot we are now enabling Pharmacy Contractors to express an interest in being commissioned to deliver COVID-19 vaccines from a low capacity site in addition to the previous medium and large volume site options. Pharmacy Contractors can express an interest in administering 100/350/1000 vaccinations per week as agreed with the Commissioner (NHSE) and subject to vaccine supply.
  • Co-administration of flu and COVID-19 vaccines: following JCVI’s interim advice, we intend to put in place arrangements to enable co-administration of flu and COVID-19 vaccines in Trusts, residential care homes, to housebound patients and in other residential settings.
  • Eligible patients: JCVI’s interim advice proposed the patient eligibility for the booster vaccine; this will be confirmed in their later final advice.
  • Payment: subject to compliance with the LES, a payment of £12.58 will be payable to the community pharmacy provider for administration of each vaccination to each Patient. In addition, a payment of £10 shall be made to community pharmacy providers:
    • for administration of each vaccination to each patient where that patient is:
      • resident in and receives the vaccination at a Care Home or residential setting; or
      • employed or engaged by a Care Home and receives the vaccination at that Care Home or residential setting;
    • for administration of each vaccination to each housebound patient

    Further additional reasonable costs funding will be available to medium and large pharmacy sites delivering COVID-19 vaccinations in phase 3. Further guidance will be issued shortly but the arrangements will be similar to phases 1 and 2. Additional reasonable costs will only be approved for small community pharmacy sites by exception. Additional reasonable costs funding will also be available to Pharmacy Contractors delivering flu vaccination in 2021/22.

  • Supply of equipment and consumables: we will supply a nationally-agreed initial Supply Inventory List (SIL) of equipment that will be required on a site by site basis to allow new community pharmacy-led vaccination sites to commence and operate (please note this will be by exception for small sites). We will centrally supply linked vaccine consumables to all sites in phase 3 (e.g., syringes etc), but providers will need to purchase non vaccine linked consumables e.g., handwash, waste bags, sharps bins etc. as they would normally do for other vaccination programmes. We expect that PPE will continue to be available for community pharmacy to draw down through the DHSC portal.
  • Vaccine ordering: we are exploring moving to a capped pull vaccine ordering model in phase 3 to support sites to have greater visibility and influence over the supply of COVID-19 vaccine to designated sites and to aid with earlier scheduling of clinics. This means that sites would have the flexibility to request their own vaccine, up to a maximum limit. This would also enable sites to align COVID-19 vaccine with their flu vaccine supply to support co-administration, where timing of cohort phasing and eligibility of the programmes align. The Commissioner (NHS England) will, where possible, distribute available vaccine supply to providers that are best placed to meet the population need.
  • Workforce: providers will be able to continue to access centrally sourced workforce, including unregistered vaccinators through the lead employer model, utilising the national protocol as appropriate. Workforce and training guidance for phase 3 will be published shortly.
  • Tech and data requirements: pharmacy sites will have access to Outcomes 4 Health to record vaccination events and will be required to sign-up to the National Booking Service for COVID-19 boosters and the evergreen COVID-19 offer. The Sonar have developed a COVID-19 vaccination service that we are seeking to make available for Phase 3 and can share more details once we have completed our assurance work. Through our engagement with providers and commissioners, we have identified some core tech and data requirements for Phase 3, including the need for an improved approach to the point of care capture for non-age based cohorts such as health and social care workers to track against a single denominator, and an infrastructure that enables point of care recording of both a co-administered and individual vaccination event. We will look to implement this and support integrated interfaces where it is not feasible.
  • Indemnity: Government is working closely with the insurance sector to provide support for Pharmacy Contractors commissioned to deliver Phase 3.

B. Expression of Interest and site designation process

We are inviting community pharmacy contractors on the pharmaceutical list to express an interest in being commissioned to be a phase 3 COVID-19 vaccination enhanced service by 5pm on Wednesday 28 July 2021. Community pharmacy contractors already delivering the COVID-19 vaccination service for phases 1 and 2 will also be required to express an interest in phase 3 following the same process.

We attach to this letter the expression of interest and site designation guidance for community pharmacies wishing to express an interest in delivering the phase 3 local enhanced service. This includes the key actions and timescales and should be read by community pharmacies and commissioners.

C. Next steps

We will be holding a webinar at 18:30 on Thursday 15th July 2021 to share further details about the phase 3 arrangements. Follow this link for joining details here. Registration for the webinar will close at 16:30 on 15th July 2021.

We will also write soon with further details on the adult seasonal flu programme but Pharmacy Contractors should continue to plan as usual for this year’s flu season.

Thank you again for your hard work throughout the programme so far. We know that many lives have been saved by your dedication.

For more information, please contact england.pccovidvaccine@nhs.net.

Dr Nikita Kanani | Medical Director for Primary Care

Caroline Temmink | Director of Primary Care Vaccination

Annex A – Indicative timetable

This timetable is subject to change but is provided to help with planning.

Date Activity
14 July 2021 Designation process and draft LES published
14 July 2021 Expressions of Interest from Pharmacy Contractors opens
15 July 2021 Briefing session for general practices, community pharmacy contractors and commissioners on the process
17:00 28 July 2021 Deadline for Pharmacy Contractors to advise NHS England and NHS Improvement regional teams of nominated site for designation (closure of expressions of interest process).
28 July to 6 August Prioritisation of proposed sites by NHS England based on Expressions of Interest
5 August 2021 and additional dates if required Further Expressions of Interest from Pharmacy Contractors as required if Integrated Care System needs are not met.
Rolling through August Assurance of proposed site to confirm that proposed Designated Site meets the ICS needs and should be commissioned.
Rolling through August – Assurance + 1 week Readiness preparation before Site Designation meeting.
Rolling through August Site Designation meeting to approve sites who have completed readiness assessments.
Group 1 sites – w/c 23 August 2021
Group 2 sites w/c 31 August 2021
Site is allocated vaccine, schedules clinics and makes vaccination appointments live
September Sites go live