A sizeable number of patients have paid to receive a vaccination in a community pharmacy rather than getting it for free from a GP surgery, the Company Chemists Association (CCA) has reported.

The CCA said this shows the demand for vaccinations from community pharmacies, and suggested that all adult NHS vaccines should be commissioned through community pharmacies as well as GP surgeries.

It added that investing in community pharmacy delivery of vaccinations could help the NHS harness the opportunity provided by the more than 100 new vaccines currently in development.

'Desire for vaccination not currently met by NHS commissioning'

Data from CCA member pharmacies suggests that 57% of those paying for shingles vaccines and 13% of those paying for pneumococcal vaccines would have been eligible for NHS vaccination.

'These numbers suggest a desire for vaccination not currently met by NHS commissioning – either through lack of access or awareness,' the CCA said in its report released this week.

And it added people accessing vaccination through community pharmacies would be even higher if all adult NHS vaccines were commissioned through this setting, making access free to patients.

Pharmacies could improve vaccine uptake in deprived areas

The CCA report highlighted differing vaccine uptake across the country, with measles, mumps and rubella (MMR) vaccination uptake rates varying by as much as 22% across different local authorities, and uptake of the shingles vaccine 27% lower in the most deprived quintile, relative to the least deprived.

Given that pharmacies are often situated in deprived areas and are often staffed by people connected to local areas and cultures, commissioning vaccinations through this setting could help improve uptake, the CCA argued.

And it highlighted the convenience of pharmacies for patients without a car or other private transport, or for those who needed appointments in the evenings or at weekends.

The CCA also shared reports from pharmacy teams that 'some patients attend pharmacies multiple times, over a period of weeks to discuss the vaccines they need'.

'This allows a period of dialogue and reflection, building confidence, before a vaccination appointment,' the CCA said.

And it added that commissioning more vaccines through pharmacies would allow for discussion and promotion of vaccinations through other points of contact, such as through the winter flu immunisation programme.

Technology and investment needed to expand pharmacy vaccinations

Delivering a greater range of vaccination services in community pharmacy would require investment in premises, workforce and training, the CCA noted.

For instance, it suggested that vaccination would need to become 'a core part of pharmacy teams’ professional development' and an 'expected competency, rather than an additional skill, supported by appropriate training'.

To make this possible, pharmacy owners would need confidence in a return on this investment, the CCA said.

It called for nationally defined contracts, creating a consistent offer to patients, and commissioning the service for longer periods than one or two years, moving towards vaccination being part of core service provision as it is in general practice.

And it said that additional, locally tailored provision could also be commissioned.

In terms of technology, the National Booking System should be integrated with pharmacy booking systems, the CCA said.

And further read/write integration of pharmacy and GP records would enable pharmacies to identify patients eligible for vaccinations, and keep patient records up to date with vaccination history.

Supply chains may need to be reviewed to support pharmacy delivery of vaccinations

The CCA suggested that vaccine supply models may need to be reviewed in any consideration of expanded vaccination services through community pharmacies.

'Additional delivery locations and greater volumes can have unintended consequences on supply,' the report noted.

And the impact on, and relationship with, existing medicine supply chains should be considered, it added.

'Community pharmacies have different requirements to general practice, who in turn have different requirements to secondary care settings. Understanding these differences is important to understanding the requirements of any supply model,' the report said.

It also said pharmacies should have access to digital vaccine ordering facilities, so that they were able to order vaccines to meet demand and so that commissioners could know where stock was located.

Commenting on the report, CCA chief executive Malcolm Harrison, said: 'The UK has long held a world-leading position for vaccination but with uptake falling, we need action now to prevent further decline.

'Community pharmacy has a strong track record in administering flu and Covid-19 vaccines. Pharmacists are highly trusted by local communities and already play a huge role in community relations, combating misinformation and ensuring vaccines reach underserved communities.

'It’s time to awaken the sleeping giant that is community pharmacy and commission pharmacies to administer more NHS vaccines. With people typically visiting their community pharmacist twelve times more than their GP, this is a no-brainer.'

Responding to the CCA report, an NHS spokesperson said: 'Vaccination is one of the best ways to boost public health, second only to clean water. Community pharmacies play a role in the delivery of multiple vaccination programmes at times and in place that are convenient for patients, which is why they are such a crucial part of NHS England’s vaccination strategy.

'With more pharmacies located in areas of higher deprivation, they are well placed in reaching underserved communities and tackling health inequalities.'