Publication reference: C1654

To:

All PCN led local vaccination services and all GP Practices
All community pharmacy led local vaccination services and all pharmacy contractors
All NHS England and NHS Improvement regional directors of commissioning and public health

CC:

Integrated care system leads
NHS England and NHS Improvement heads of primary care

30 June 2022

Dear colleagues

New GP and CP COVID-19 vaccination enhanced service specifications for autumn/winter 2022

Further to the system letter of 22 June 2022, we have published today new enhanced service specifications (ES) for general practice and community pharmacy contractors for the period from 1 September 2022 to 31 March 2023 (phase 5).

Local vaccination services have been critical to the success of the programme thus far and we are grateful for your on-going support.

• general practices that wish to continue into the next phase of the COVID-19 vaccination programme, or participate if not currently doing so, are invited to sign up before 5pm on 14 July by notifying their local commissioner
• all pharmacy contractors that are currently commissioned to provide COVID-19 vaccinations under the Phase 3 LES, including “paused” sites, that wish for their designated site to continue to deliver COVID-19 vaccinations from September 2022 should express an interest before 5pm on 14 July.Pharmacy contractors that are not currently commissioned but wish to participate in phase 5 should express an interest by 5pm on 20 July via the webform. An abbreviated form can be used if the pharmacy contractor has submitted information previously that remains relevant and appropriate. Services will be commissioned where there is a local population need, where pharmacy contractors can meet the key selection criteria and where NHS England considers the pharmacy contractor is best placed to meet that need.

We have provided further guidance on the site selection process for community pharmacy to support providers. Guidance on site designation for general practice and community pharmacy will be provided shortly.

Key changes to service specifications

The majority of the service specifications for phase 5 remain the same as in the previous phase, although there are some changes and alignments between the two contracts.

Both community pharmacy and general practice must:

• have the ability to administer any adult vaccine type to ensure resilience across the network
• ensure that delivery of COVID-19 vaccinations will not negatively affect their ongoing delivery of other services, recognising current pressures on general practitioners and pharmacy contractors
• record COVID-19 vaccinations on the day that they are administered due to the clinical risks associated with data latency
• agree with their commissioner their role in the system to respond to a surge where an increase in capacity is required both in terms of increased volume and/or timeframe.

As we move into a new phase of living with COVID-19, the financial mechanisms for the autumn/winter COVID-19 vaccination campaign will be brought in line with wider vaccination and immunisation services for general practice (the item of service fee will be £10.06 with an additional financial supplement of £10 per dose for the vaccination of housebound people). In addition, funding will be devolved to ICSs to support improvement to access and help tackle health inequalities building on the learning and successes of the earlier phases. Allocations have been designed to reflect key population differences including: size; rurality; ethnicity; deprivation. This additional funding will help support a continued focus on tackling health inequalities.

The specifications include the potential to extend the contract length for up to an additional six months subject to further Joint Committee on Vaccination and Immunisation (JCVI) advice. NHS England will seek preliminary market engagement on COVID-19 vaccination from 2023/24 via a formal prior information notice (PIN) to be issued shortly.

GP specific changes

General practice has played a vital role in the provision of COVID-19 vaccination to certain groups due to their knowledge and existing relationships with these patients. In phase 5 we are asking all PCN Groupings to vaccinate, subject to final JCVI advice:

• residents in older adult care homes within 10 weeks from the start of the contract or as soon as reasonably possible
• housebound patients
• immunosuppressed patients.

We encourage practices to align these COVID-19 vaccination visits as far as possible with other visits/obligations under their core primary medical services contracts.

PCN Grouping are also required to agree with their local commissioner how many COVID-19 vaccinations they will deliver per week before the start of the programme to support local planning and ensure appropriate additional capacity is commissioned where required to meet local population needs.

Community pharmacy specific changes

Community pharmacy can also support provision of COVID-19 vaccination for care home residents, housebound people and immunosuppressed people. For Phase 5, pharmacy contractors will be required to provide vaccination services for these clinically vulnerable groups if requested by the local commissioner to meet population need. We expect that the local commissioner will signal this requirement to pharmacy contractors before contracts are issued.

We will continue to fund current arrangements on clinical waste given remaining uncertainties on waste that may be generated. We expect that once we have more clarity as to future vaccination requirements and can signal these to pharmacy contractors that we will revert to usual arrangements for clinical waste.

The current (phase 4) contracts for community pharmacy and general practice currently run until 30 September 2022. Our intention is to serve notice on the phase 4 contracts, so that they end on 31 August 2022, so that they do not run in parallel with the new contract for phase 5 which starts on 1 September 2022. Providers which are not continuing into phase 5 will therefore cease vaccination activity on or before 31 August. We intend to do this after JCVI have issued their final advice relating to the autumn booster programme and the government has made a final decision based on that advice.

Next steps

Over the next few weeks systems will need to further engage with their providers to understand their capacity and the commissioning requirements to support the delivery of our autumn priorities.

Timeline and actions for general practice, community pharmacy contractors and local commissioners

30 June

Activity/milestone: Expressions of interest open for pharmacy contractors

• start expression of interest (EOI) submissions from pharmacy contractors that are not currently included in the programme via the call for community pharmacy-led local vaccination service expressions of interest portal  subject to the regional team having identified a population need
• regional teams will accept EOIs directly from pharmacy contractors currently operating under the phase 3 local enhanced service that wish to continue operating their site under the phase 5 enhanced service.

14 July (5 pm)

Activity/milestone: General practices indicate to their local commissioner/system willingness to participate in the enhanced service before 5pm on 14 July 2022.

Pharmacy contractors operating under the phase 3 local enhanced service to inform local commissioner if they wish to continue under the new Phase 5 enhanced service (subject to population need).

20 July (5pm)

Activity/milestone: Deadline for Pharmacy Contractors who are not currently included in the programme to submit their EOI. tbc in September We will confirm the exact start date following final JCVI guidance.

20 July (5pm)

Activity/milestone: Deadline for Pharmacy Contractors who are not currently included in the programme to submit their EOI.

tbc in September

Activity/milestone: We will confirm the exact start date following final JCVI guidance.

We will be holding a webinar for community pharmacy contractors and general practice on Monday 4 July 2022 at 6pm to share further detail about the phase 5 arrangements. Sign up to register to attend this webinar. For more information, please contact england.pccovidvaccine@nhs.net.

Thank you again for your continued work that has without doubt saved thousands of lives.

Yours sincerely

Caroline Temmink
Director of Primary Care Vaccination
NHS England

Dr Nikita Kanani MBE
Medical Director for Primary Care
NHS England