Local commissioning of vaccination programmes could be an opportunity for community pharmacies to expand their services, sector leaders have suggested.

This comes as NHS England (NHSE) has approved a plan for integrated care boards (ICBs) to become responsible for local commissioning of all vaccination services, and most screening services, from next year.

The national commissioner will delegate the majority of these services to ICBs on 1 April 2026, to ‘support’ ICBs’ role in population health and prevention.

Pharmacy organisations have suggested that ICBs could use this opportunity to commission more vaccination services through community pharmacies, including through the use of National Enhanced Services.

ICB local vaccination commissioning an opportunity for community pharmacy

Alastair Buxton, director of NHS services at Community Pharmacy England (CPE) suggested that the delegation of vaccination commissioning to ICBs would be an opportunity for community pharmacy 'to seek to expand its role in a wider range of vaccination programmes'.

He told The Pharmacist that CPE would be working with Local Pharmaceutical Committees (LPCs) 'to ensure those opportunities can be seized at a local level'.

National Enhanced Services could help pharmacies get commissioned for local vaccinations

And he suggested that ICBs 'could be better enabled to commission vaccination services from pharmacies' through the use of National Enhanced Services.

National Enhanced Services were introduced in December 2021. The use of this framework requires NHS England to consult with CPE on matters relating to the service specification and remuneration for the service.

Once the service is specified and standardised nationally, local commissioners can commission the service to meet local population needs, as part of a nationally coordinated programme.

Currently, only one National Enhanced Service is in place, for Covid-19 vaccinations.

But Mr Buxton said that using National Enhanced Services for a greater range of pharmacy services, including vaccinations, would 'make commissioning of pharmacy services, in response to the needs of their population, easier for ICBs'.

Pharmacies can help target harder-to-reach populations and increase uptake

Brendon Jiang, vice chair of the Royal Pharmaceutical Society (RPS) England Pharmacy Board, also welcomed the move to delegate vaccination commissioning to ICBs.

'Community pharmacy has a strong track record of improving access to care and tackling health inequalities, as seen with flu and Covid-19 vaccinations,' he told The Pharmacist.

'ICBs now have an opportunity to build on this success by fully utilising community pharmacies to target harder-to-reach populations and increase vaccination rates.'

Last year, NHSE launched 12 ‘demonstrator sites’ to test ‘new and innovative’ models of vaccination delivery.

And community pharmacy leaders have called for an expansion of pharmacy-based vaccination services, including pneumonia, shingles, meningitis, RSV and routine childhood vaccinations.

NHSE encourages patients to get RSV vaccine

‘A number’ of community pharmacies are already commissioned to provide the respiratory syncytial virus (RSV) vaccine to older adults.

And this week, NHSE is urging people aged 75-79, or who turned 80 after 1 September 2024, to book an RSV vaccination if they have not yet had one. 

Steve Russell, NHS national director for vaccinations and screening, commented: 'RSV is not just a winter illness. We see cases increase in winter but it can occur all year round and can make older people seriously ill, so it is vital everyone eligible gets vaccinated – which is why are now working hard to reach anyone who hasn’t yet been jabbed and urging them to book an appointment.'

Pharmacy multiple Boots has also launched a private RSV vaccination service for those aged 60 and above, priced at £245.

Local vaccination commissioning will begin from April 2026

The plan builds on the national vaccination strategy, which set out proposals for ICBs to take over population-level management.

The changes, approved by the NHS England board at a meeting last week, include:

  • Commissioning of all vaccination services is delegated to ICBs
  • Commissioning of most components of screening services is delegated to ICBs, with the exception of some functions which are delivered ‘across large footprints’ and are more ‘suitable’ to be retained by NHS England
  • Commissioning of Child Health Information Services is retained by NHS England

NHS England said that it expects that this will lead ICBs to deploy ‘a range of different models’ across the country.

Vaccinations will be 'consistent across the country', but delivery could be tailored locally

NHS England’s director for vaccinations and screening Steve Russell told the board that ICBs are ‘really interested’ in this area, and have been ‘leaning into it all’ for some time.

He said: ‘The reason that we have come to the proposal to delegate the vast majority of vaccination and screening services to integrated care boards is that prevention and improving population health sit firmly as one of the key purposes of ICBs, and actually, these sorts of services should be integrated into all of the other work that ICBs are doing in this space.

‘I think it’s important to say these will continue to be national services. They are consistent services across the country, they follow advice of the Joint Committee on Vaccination and Immunisation, or the UK National Screening Committee, and that will continue to be the case. The thing that will vary across the country is how the delivery of them works.’

NHS England said: ‘This arrangement will make best use of resources, both in terms of commissioning budget and staff, and will help to align these services with other relevant areas of national commissioning, such as genomics laboratories.

‘Retaining these service components will also enable us to deliver service transformation and programme changes rapidly, efficiently and consistently across the country.’

The UK National Screening Committee, UK Health Security Agency and the Department of Health and Social Care are ‘supportive’ of the delegation proposal, NHS England added.

This was first reported by Anna Colivicchi in our sister publication Pulse.