GPs face losing control of flu jabs programme

Flu vaccine
Image caption Doctors say any changes to management of the flu vaccination campaign are not necessary.

GPs face losing control of managing the flu vaccine programme following supply problems in England this winter, the government's head of immunisation says.

There is a "pretty compelling" case for the government taking charge of ordering and supplying jabs, said Professor David Salisbury.

GPs ran out of seasonal flu jabs earlier this month, forcing ministers to use swine flu vaccine stockpiles.

The BMA said changing the "complex and intense" programme would not work.

Most vaccines, including the entire childhood immunisation programme, are ordered by the Department of Health for the whole of the UK.

Flu is one of the few exceptions, with GPs in England ordering jabs direct from manufacturers and similar systems operating elsewhere in the UK.

Prof Salisbury said this was a "historic hangover" that now needed addressing.

He is leading a review into what happened this winter with the shortages. Even though there is plenty of the 2009 pandemic vaccine left it does not protect patients against all the strains of flu circulating.

In an interview with the BBC News website, Prof Salisbury said: "Certainly this winter we have seen an unsatisfactory position. That is a situation that we don't want to see happen again.

"We compare that with the routine childhood immunisation programme where we have not had to suspend part of the programme because of shortage of vaccine for at least a decade. This argues that we do need to look very carefully at whether flu vaccine supply can be done on a more dependable basis."

The government has set up a tailored IT system that allows officials to supply vaccines to the NHS within hours of orders coming in. Those vaccines can then be tracked and there is an up-to-date record of how many are left in the system.

But Prof Salisbury said any move to take ordering away from GPs would take time.

Doctors get paid for running the vaccine programme and Prof Salisbury conceded the payment issues would need resolving. He said the government would be seeking talks soon.

He suggested as an interim measure for next winter, the government in England may purchase an emergency stockpile as happens in Scotland.

He also suggested the shortages that were reported could have been down to GPs giving the vaccine to those who were not in high risk groups.

However, he added it would be wrong to blame anyone at the moment as the issue needed looking at thoroughly.

But the British Medical Association rejected the suggestions.

Dr Richard Vautrey, deputy chairman of the BMA's GPs' committee, said he did not believe doctors had relaxed restrictions.

He said the shortage was more likely to be caused by the late surge and the fact that healthy pregnant women had been added to the risk groups fairly late on.

On the issue of handing control of the vaccination campaign to the government, he said: "I don't think a wholesale change like this would work. The flu programme is complex and intense as we have a lot of people coming for immunisation at once.

"That does not happen with childhood vaccines and so I am not sure a central system could cope with the volume of vaccine GPs need almost all at once.

"What we need is for an emergency stock to be held, perhaps regionally, in case doctors do run out."

Prof Salisbury also re-entered the debate about vaccinating healthy children - there have been calls for this to happen after a number of children died or became seriously ill this winter.

Current vaccination policy is based on immunising those most at risk of getting seriously ill. But he said there was "merit" in also vaccinating those who were the most likely to spread the disease - children - as a way of curbing the scale of future outbreaks.

He said this was a matter for the government's independent expert body, the Joint Committee on Vaccination and Immunisation, to consider and it needed to be proved cost-effective, but he said in his personal view it was an "attractive concept".

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