Important Londonwide CEO message, volume 2, number 5 - 29 October 2009
Three items of essential contractual information for Doctors, Nurses and Managers.
- The DES for Swine Flu Vaccination
- Housebound patients
- Seasonal clinical At-Risk groups for swine flu vaccination purposes
- The DES for Swine Flu Vaccination
This has been published this afternoon. PCTs have been directed to pay practices £5.25 per vaccination given to those at-risk, irrespective of whether the vaccination is performed by your practice or any other service such as a district nurse or pharmacist. You will be responsible for identifying those at risk, and will provide the following information to the PCT:
(aa) the patient’s name;
(bb) the patient’s date of birth;
(cc) the patient’s NHS number, where known;
(dd) confirmation that the patient is in a priority group;
(ee) the date on which the vaccine was administered,
but where a patient, parent or carer objects to details of a patient’s name or date of birth being supplied to the Primary Care Trust, the contractor need not supply that information provided it supplies the patient’s NHS number.
Practice Managers Please Note: No other information requirement from PCTs is anticipated. The Secretary of State’s DES Directions to PCTs can be found in full here.
- Housebound Patients
Within the DES there is provision to the effect that:
“(i) the contractor is not under an obligation to offer a patient on the housebound patients list the H1N1 vaccine; and
(ii) the Primary Care Trust shall not recover the cost of administering the H1N1 vaccine to those patients on the housebound patients list from the contractor”
The agreement between the NHS Employers and our own GPC negotiators is clear, that housebound patients will be vaccinated by the District Nursing service. The words ‘in line with swine flu’ have appeared in a DH letter to PCTs, which is confusing matters on the ground. These words were simply meant to signify that the CLINICAL need to vaccinate housebound patients at risk of swine flu was in line with seasonal flu. But as usual, some PCTs are wrongly using it as a financial or logistical excuse not to deploy their district nurses to any or some of those who are not already on their seasonal flu caseload, and to not comply with the agreement which in return for the low payment rate (set in order to cover only our – that is GP practices over the UK as a whole - costs in taking on the additional workload on behalf of the government). We will be working to see that the actual agreement is adhered to by all PCTs, so please let us know through flu@lmc.org.uk if your district nurse or PCT is giving out a different message.
- Seasonal Clinical At-Risk groups for swine flu vaccination purposes
There has been some confusion about who is in seasonal flu at-risk groups for swine flu purposes. That’s because it is confusing! For example, believe it or not the seasonal at-risk groups include those not at clinical risk of seasonal flu. Take for example the London poultry worker population which includes people who work in areas where poultry are kept for rearing or egg production, sort eggs in poultry houses, slaughter or clean poultry or handle or catch live poultry (domestic chicken rearing is in fact a growing pastime in London). These people are considered to be at slightly greater risk of catching bird flu if there is an outbreak of bird flu. If the bird flu and human flu viruses were to mix, a new flu virus could be made. A flu vaccination protects against human flu, reducing the risk of the viruses mixing even if a person had both human flu and bird flu at the same time. Thus they are not at risk of seasonal flu, but are offered the seasonal flu vaccine for free as a precautionary measure to eliminate this slight risk. There is currently not an increased risk of a bird flu outbreak in the UK and this risk remains low. The same logic is not being applied to swine flu.
Apart from that, the seasonal flu at-risk groups are:
- chronic (long-term) respiratory disease, such as severe asthma, COPD or bronchitis,
- chronic heart disease, such as heart failure,
- chronic kidney disease,
- chronic liver disease,
- chronic neurological disease, such as Parkinson's disease or motor neurone disease,
- diabetes, or weakened immune system due to disease (such as HIV/AIDS) or treatment (such as cancer treatment).