General practice vaccination and immunisation services: standards and core contractual requirements

General practice vaccination and immunisation services: standards and core contractual requirements

The NHS England document this support article relates to was published on 15th April 2024

What do I need to know?

Why has this been issued now

Previously a letter issued on 10th March 2021 had laid out the V&I standards and core contractual requirements.  These contract requirements now add these formally into the GP contract from this point onwards.

Are there any changes?

As part of the 2024/25 contract consultation there has been the addition of the data quality requirements.  In the vast majority of instances practices will have already been doing this work because payment for QOF for the Vaccination and Immunisation indicators requires it.

What do the standards cover?

The standards cover:
  1. Invitations for appointments when patients become eligible
  2. What practices should do if there is no response to a vaccination
  3. The provision of immunisation appointments
  4. What practices should do if a patient does not attend an appointment
  5. What to do when patients who are eligible but have not previously received a vaccine requests one
  6. The identification of gaps in vaccination record of patients and the offer and provision of immunisation appointments to them
  7. The processing of records relating to patient vaccinations and immunisations including records relating to patient vaccination status and administration

What are the core contractual requirements?

There are 5 core contractual requirements:
  1. a named lead for vaccination services
  2. standards for call/recall programmes and opportunistic vaccination offers
  3. provision of sufficient convenient appointments
  4. standards for record keeping and reporting 
  5. participation in national agreed catch-up campaigns

What are the requirements for call/recall?

Initial call requirements

Any of the following can be used (ideally use a patients prefered method of communication):
  1. letter
  2. telephone
  3. text
Invitation must include information on how to book an appointment, and where pre-booked appointment slots are sent it should include information on how to change the appointment if it is unsuitable.
For children the initial contact should normally provide a pre-booked appointment.
Some local Child Health Immunisation Services (CHIS) do offer a call/recall element, others do not.  Where they do not, it is the practices responsibility to ensure that all children are offered a minimum of 3 invitations for each vaccine.

Recall requirements

  1. Patients not attending/respond to the initial invite, should be recalled on a minimum of 2 separate additional occasions.  In most cases, best practice recall activity should continue beyond 3 contacts until vaccination has been completed.
  2. Where the patient does not respond to the 2nd invitation a healthcare professional should make a third contact, either face-to-face or a telephone conversation.  There are published resources to aid these discussions.
  3. Patients who remain unvaccinated following this 3rd contact should be flagged on the GP record as unimmunised to maximise the chance of opportunistic vaccination.
  4. For children, practices are required to ensure that the local CHIS is notified of those who are vaccinated and those who are not.
  5. For children, practices are also required to ensure the local school-aged immunisation teams are notified of those who remain unvaccinated. 

Opportunistic delivery

This can be triggered by a patient requesting vaccination or the practice identifying gaps in a patients vaccination record.

Appointments

Should be at a range of times and can be delivered in extended access.

Standards for record keeping

Practices must ensure that the following records are kept for each vaccination event:
  1. Any refusal of immunisation
  2. where an offer of immunisation is accepted
  3. details of the informed consent to the immunisation
  4. the batch number, expiry date and name of the vaccine
  5. the date of administration
  6. when 2 or more vaccines are administered in close succession, the route of administration and injection site of each vaccination
  7. any contraindication to the vaccine or immunisation
  8. any adverse reaction to the vaccine or immunisation

Recoding of vaccination events

This may be necessary as the transfer of data between major system suppliers often transfers the data as degraded entries without the required SNOMED codes.  You can see how to correct the vaccination data in our separate article "Correcting Vaccine Entries in patients records arriving via GP2GP (DEGRADE entries)"