Saturday 31 March 2018

The provision of travel in an NHS setting

I still get many queries on this topic and many anecdotal stories of different actions a variety of GP practices are taking.  To my knowledge although travel is being reviewed at the moment, little has changed and this is what is supposed to be happening in England (where the queries come from).

Under the GMS contract in England, travel is provided as an 'additional service of vaccinations and immunisations' in a GP practice and payment is made for such in their Global Sum (2%).  Depended on the number of full time GPs, this can be quite a sizable income but many are not actually aware of it.  A GP surgery can 'opt out' of providing the service of travel, but would have to opt out of other services too, such as the pre-school booster, Td/IPV doses to those over 6 who had not completed their five doses for the UK schedule and rabies vaccine for those at risk from rabies from a work related hazard - the full extent of this provision is set out in Annex BA of the Statement of Financial Entitlements (SFE)5 which was published on 30 April 2012 (starting at page 5).

Many surgeries are just stopping the service BUT they cannot do this - they need to inform their CCG, will have the funding taken away and another organisation will need to be found to provide (and be paid) for this NHS service to the NHS patients of the practice deciding to stop.  To decide to stop and keep the money paid into the Global Sum would be fraudulent.

The provision of travel as a service would include:

  • A travel risk assessment
  • Administration of the NHS travel vaccines (hepatitis A and all combined vaccines containing hep A), typhoid, cholera and polio - which would be given as Revaxis to a traveller so the whole vaccine is given as an NHS provision)
  • Appropriate travel advice according the the assessed risk of the trip (including malaria prevention advice)
Full details are on an FAQ page on my website HERE 

In Scotland immunisaiton services have been under review by the Scottish Government and a consultation which concluded that general practice no longer wanted to be responsible for the delivery of the National Immunisation Programme.  Therefore a Vaccine Transformation Programme is being carried out which will include travel.  The programme started this year and is expected to take three years.