What is the pharmacy’s role in vaccinations?
Flu is a major cause of harm to individuals, leading to around 16,000 attributable deaths last season (over 15,000 in over 65s) and it is a key factor in NHS winter pressures1. In 2017/18, peak admissions rates of influenza to hospital and intensive care units were higher than seen in the previous six seasons and preventing flu infection through vaccination protects individuals and also helps prevent secondary bacterial infections such as pneumonia1. Recent research2 has demonstrated that vaccination averts between 180,000 and 626,000 cases of influenza a year and helps avert between 5,678 and 8,800 premature deaths per year.
The 2018/19 flu vaccination service has now started with most GP practices and community pharmacies now focusing their attention on targeting those at most risk.
Last year saw record flu vaccination levels, with nearly 1.5 million more people getting the vaccination than last year. However, overall performance still falls below government targets for at-risk groups3 and over 65s4. NHS England has stated in their annual letter5, that we should further improve vaccine uptake rates in all eligible cohorts. The long-term ambition for eligible adults is for a minimum 75% uptake rate; this ambition is considerable and we are some way off this target in the at-risk group.
Continuing to commission pharmacy makes sense and the sector has demonstrated its significant contribution in the national programme delivery. Last year, 77.1% of all community pharmacies in England administered 1,344,462 flu vaccinations to patients with an average of 150 per pharmacy6. In addition, many thousands of people not eligible for the NHS vaccination also received their flu jab privately from pharmacists in the community where they live or work.
There is no doubt that pharmacy has played an important part in the service and yet, we still hear of GP practices and pharmacies ‘competing’ rather than collaborating in delivering the service. There are still many more people needing vaccinations than get it and working together has never been more important. Perhaps collective targets and joint incentives could change this?
With many pharmacists now able to administer vaccinations, the sector is starting to deliver a much broader range of vaccination services. In some localities, NHS England has commissioned additional vaccination services from community pharmacy including pneumococcal polysaccharide vaccine, meningitis (MenACWY), shingles and pertussis for pregnant women.
Private vaccination services are expanding, particularly with pharmacies looking to reduce their reliance on a shrinking NHS funding package. They are getting involved in offering a full range of travel vaccinations including yellow fever, tick-borne encephalitis, rabies, hepatitis A and B, cholera, meningitis, typhoid, polio, diphtheria and tetanus, and other vaccines against conditions such as pneumococcus, shingles, chickenpox and human papilloma virus (HPV).
There is no doubt that community pharmacy makes a real difference protecting the nation’s health.
Deborah Evans is Managing Director of Pharmacy Complete, a training and consultancy company working with pharmacy and the industry.
1 Surveillance of influenza and other respiratory viruses in the UK: Winter 2017 to 2018 Public Health England
2 An Economic Analysis of Flu International Longevity Centre (ILC)
5 National Flu Immunisation Letter 2018/19 NHS England, Department of Health and Social Care, Public Health England
6 Flu vaccination data for 2017/18, Pharmaceutical Services Negotiating Committee
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