Flu vaccination – Funding and claiming payment
Flu vaccination – Funding and claiming payment
The national community pharmacy Flu Vaccination Service 2020/21 has now finished. Community pharmacy contractors are therefore reminded not to administer any further vaccinations under this service.
The information below relates to the Flu Vaccination Advanced Service 2020/21; this will be updated as and when information on the 2021/22 service is published.
This page contains information on the funding for the flu vaccination service, how to claim payment and the post-payment verification process which is used by the NHS.
PSNC has agreed a position with NHS England and NHS Improvement (NHSE&I) and the Department of Health and Social Care on funding for the Community Pharmacy Seasonal Influenza Vaccination Advanced Service in 2020/21.
The fee per vaccination will remain at £9.58, but we have also agreed, for this year only:
- £0.50 per vaccination will be paid, funded from the Transition Fund; and
- up to £1m of medicines margin can be retained for flu vaccinations administered above the number in a normal year. This will be in addition to the allowed £800 million medicines margin under the Community Pharmacy Contractual Framework.
This means the combined value of fees paid per vaccination will be £10.08. As is normally the case, contractors will also be reimbursed for the vaccine costs at the basic price (list price) of the individual vaccine administered and an allowance at the applicable VAT rate will also be paid.
Funding for the main £9.58 fee is from NHS vaccination budgets, not from the CPCF global sum.
Additional funding for off-site provision
For the 2020/21 service, NHSE&I are making £3.2m available to support the venue hire and cold storage costs contractors might incur if they organise vaccination sessions off the pharmacy premises.
Contractors will be required to:
- obtain pre-authorisation of the hire of the venue and cold storage costs from the regional NHSE&I office; and
- undertake a minimum of 20 vaccinations at the venue hired to be eligible to receive the pre-authorised payment.
Contractors can claim up to £200 for the hire of a venue, but where the hire of the venue costs less than £200, they can only claim up to the actual cost of the hired venue. When claiming for the cost of venue hire for the first-time, contractors can additionally claim a one-off payment of £200 for cold storage equipment.
In relation to the pre-authorisation of venue hire, NHSE&I will only authorise where:
- there is no other venue that has already been paid for either very near or at the same place, at the same time, that the contractor could make use of;
- the session is not deemed by NHSE&I to create over-provision in a certain area or certain time which would lead to reduced expectation of numbers of vaccinations required, or the numbers are reduced, or providers are competing for the same patients;
- in the contractor’s professional opinion, the venue is suitable for the provision of pharmaceutical services and the contractor is satisfied that they can meet General Pharmaceutical Council and COVID-19 Infection Prevention Control standards; and
- the contractor has enough vaccine supplies to run the offsite clinic and vaccinate expected attendees.
Pre-authorisation of payment for the cost of venue hire and cold storage will be given on a first come first served basis, from a finite budget, where a contractor meets the conditions above.
A contractor can submit up to five claims for venue hire, but in exceptional circumstances, NHSE&I regional teams may authorise more venue hire payments to meet local need, subject to the availability of funding.
Claims for payments for pre-authorised monies should be made monthly, via the Manage Your Service (MYS) platform. Claims will be accepted by the NHSBSA within six months of hire of the venue or by 31st August 2021, whichever date is earlier, in accordance with the usual Drug Tariff claims process.
Each claim must include a declaration that the payment has been authorised by NHSE&I, the date of that authorisation, the cost incurred in the hire of the venue, confirmation that the contractor has met that cost and the number of vaccinations undertaken at the venue.
When using the MYS platform, contractors should ensure they only make a single claim for each calendar month, as subsequent submissions for that claim month will not be accepted by the platform.
Community pharmacy contractors must claim payment monthly, via the Manage Your Service (MYS) portal.
Claims for the 2020/21 flu season will be accepted by the NHSBSA within six months of administration of the vaccination or by 31st August 2021, whichever date is earlier, in accordance with the usual Drug Tariff claims process. Later claims will not be processed. Payments to contractors will be made monthly as part of their normal payment schedule.
Post-payment verification (PPV) process
NHS England and NHS Improvement (NHSE&I) is responsible for monitoring the provision of Advanced Services by contractors and they have a duty to assure themselves of the quality and probity of activity provided under the Community Pharmacy Contractual Framework; PPV is one way in which they undertake this monitoring.
The NHSBSA Provider Assurance team undertake PPV on behalf of NHSE&I.