COVID-19 VACCINATION PROGRAMME CONTRACTUAL ARRANGEMENTS
Richard Vautrey, GPC Chair has issued the following statement:
Following the announcement of the Covid19 vaccination programme (CVP), the BMA has confirmed that this will now take the form of an Enhanced Service Directed by NHSE/I under Section 7a of the 2006 NHS Act.
Whilst discussion with NHSE/I had initially been on the basis of a Directed Enhanced Service to ensure binding national agreement, and the full details that we had at the time were provided to GPC England for agreement and then announced to LMCs and practices, NHSE/I has since advised that S7a arrangements would provide the most appropriate contractual vehicle for the programme.
S7a delegates powers from the Secretary of State to NHSE/I and allows it to exercise all the powers that the Secretary of State would have in terms of a DES, but it cannot be called a DES as that refers to a Direction from the Secretary of State. Similarly, this is not a NES, as many people understand it from 2004.
Commissioning under S7a provides flexibility for necessary amendments to the Specification to be made swiftly, by national agreement between NHSE/I and GPCE only. This is crucial in such a fast-moving environment where we will need to add in new information without delay as more vaccines are supplied with different requirements.
To be clear:
- the content of the Specification has not changed due to it being an Enhanced Service Directed by NHSE/I rather than a Directed Enhanced Service
- programmes commissioned under this route are a ‘reserved function’ of NHS England, and cannot be changed or varied by local commissioners
- NHSE/I is offering this, through CCGs, to every practice in England – CCGs cannot prevent this and must do this
- Any amendments to the Specification will be done through agreement between GPCE and NHSE/I only.
In these respect there is no difference to a DES and is in line with other public health vaccination programmes already delivered by general practice as Enhanced Services Directed by NHSE/I, such as shingles catch-up, pertussis for pregnant women, freshers meningococcal and childhood flu.
The process has not been ideal, it has clearly caused confusion, and I apologise for this. This was in large part due to the necessary speed with which we have had to develop these proposals and begin implementation as details about potential vaccinations became clearer.
We have been advised by our legal team that this change in contractual mechanism makes no difference to the details we have agreed. They should not alter national or local plans to implement the substance of what has been agreed, and must not prevent practices that wish to engage in this vitally important programme from discussing this with their colleagues and making the immediate preparations that are required to ensure our patients can access the vaccine as soon as it becomes available.