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Is your practice ready for the flu season?

13 August 2018

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NHS England has issued new guidance to help GP practices plan for the 2018/19 flu vaccination season.
In a letter to GP practices sent earlier this year, NHS England, the British Medical Association (BMA) and the Pharmaceutical Services Negotiating Committee (PSNC) said appropriate planning is necessary in order to offer patients protection before the beginning of the flu season – which usually starts in December.
However, the organisations said that data collected in the past ‘suggest that not all of the 65 years and over group of patients are immunised early’.
In 2017/18, 60% were immunised by the end of October, rising to around 70% by the end of November and 72.6% at the end of January, they added.
So how can your practice get ready to face the next flu season? This is what you need to know to prepare your practice team.
Know your vaccines
This year, the flu programme will use three types of vaccines:

  • Adjuvanted trivalent flu vaccine (ATIV) – Following advice from Public Health England, practices are now asked to use the adjuvanted trivalent flu vaccine (aTIV) for those aged 65 or over starting from the upcoming flu season.

This was decided after clinical evidence showed it is the most effective type of vaccine for this group of patients.
Seqirus manufactures the only licensed ATIV (Fluad) in the UK, according to NHS England, the BMA and the PSNC. 
GP practices will receive their delivery for each of the three batches of ATIV in September (40%), October (20%) and November (40%), with the volumes and specific dates to be communicated shortly, according to NHS England’s Flu Vaccination Programme Delivery Guidance 2018/19.

  • Quadrivalent vaccine (QIV) – Practices will also need to be able to offer the quadrivalent vaccine (QIV) to those aged between six months and two years old and to adults from 18 to less than 65 years ‘at risk’ because they suffer from a long term condition.
  • Live attenuated influenza vaccine (LAIV) – Lastly, you need to have the live attenuated influenza vaccine (LAIV) available to offer toddlers (two and three years old).

Offer vaccination as soon as it becomes available
NHS England’s Flu Vaccination Programme Delivery Guidance 2018/19 encourages practices to offer the vaccine as soon as it becomes available.
All patients groups indicated in the flu vaccination programme should get their jab between September and December, according to the guidance, and they should be offered vaccination at any point of the flu season.
The guidance adds: ‘This can be particularly important if it is a late flu season or [for]  newly at risk patients present, such as pregnant women who may have not been pregnant at the beginning of the vaccination period.’
Planning for ATIV
The new vaccine, ATIV, is to be administered on a phased basis. For this reason, NHS England said that practices may need to reconsider their planned way of delivering flu vaccines.
Practices might want to get in touch with those eligible for ATIV via a call/recall process when the vaccine is available.
However, NHS England advises GP surgeries to opportunistically vaccinate those eligible who present in practice, if the vaccine is available. If the vaccine is not available, practice staff should ask the patient to return to practice as soon as the vaccine is in stock. 
Make sure that if you decide to offer vaccination in an opportunistic way you have enough stock to cover any planned clinic.
Planning flu clinics
NHS England recommends the following to effectively plan flu vaccination clinics:

  • Use your usual communication channels – website, posters, messages on prescriptions, PPGs or local newsletters – to raise your patients’ awareness on the upcoming flu season;
  • Practices have to call all eligible patients under the enhanced services, but they could also write to them;
  • If you have the information available, look back into the attendance patterns for patients aged 65 and over and patients in the risk group. At a national level, 60% of eligible patients received their vaccine at the end of October last year, according to NHS England.
  • Although the flu usually starts affecting people around December, practices can nevertheless give the vaccine in early November and still be ‘in time for the flu season’.