NHS England (NHSE) and the government will undertake a ‘cost-benefit analysis’ examining the case for central procurement of adult flu vaccines, a new vaccine strategy published this week has revealed.

NHSE also said that it would pursue legislative change ‘that could enable the safe movement of vaccines across providers where appropriate and thereby support collaboration across a system’.

The community pharmacy negotiator has noted that this comes following two years of increased risk to pharmacy owners under the present system.

Currently, contractors purchase flu vaccines themselves several months ahead of the season, which Alastair Buxton, director of NHS services at Community Pharmacy England (CPE) ‘has pros and cons for the sector’.

But he highlighted that under this system, ‘the financial risk firmly sits with pharmacy owners’.

‘During the last two years, the size of that risk has increased with the short notice changes to the flu programme,’ Mr Buxton added.

This year, the flu vaccination season was expected to begin in September as normal, with community pharmacy providers having already ordered flu vaccine stock.

But in August the start date of the flu vaccination programme was changed to October, before the start dates of both flu and Covid vaccination services were ultimately changed to September.

The new NHSE vaccine strategy proposes that NHSE, the Department of Health and Social Care (DHSC), the UK Health Security Agency (UKHSA) and Integrated Care Boards (ICBS) ‘explore consolidation and alignment of vaccine supply chains to support greater uptake and efficiency where beneficial’.

And it suggests that NHSE, DHSC and UKHSA ‘consider the potential impact of centralising the procurement of adult flu vaccine on systems’ ability to flex their delivery network’.

‘We have heard that current arrangements can restrict systems’ flexibility to design their vaccination delivery network and plan for surges and outbreaks. Centralised procurement may also better support co-administration of Covid-19 and flu vaccine and facilitate the potential introduction of any future combined vaccine or mRNA flu vaccine,’ NHSE said in the strategy.

It also confirmed that the procurement and supply of Covid-19 vaccines would remain centralised, adding that it expected Covid-19 vaccines to become available for private purchase ‘in due course’.

What changes to vaccine procurement are being explored?

In the strategy, NHSE said that it needs vaccine supply and procurement routes that:

  • Simplify the ordering of vaccines
  • Are ‘efficient and value for money’
  • ‘Minimise vaccine wastage and our environmental impact’
  • Support co-administration ‘by bringing supply of flu and Covid-19 vaccines (and other relevant vaccines) closer together’
  • ‘Can respond to outbreaks and surges in demand’, with the ability to ‘rapidly introduce new technologies and products’
  • Can ‘accommodate a range of storage and transportation requirements’
  • Enable quick vaccine delivery to places where they are needed, helping to address disparity in vaccine uptake
  • Give commissioners and providers ‘visibility of supply and control over deployment of vaccine’

To achieve this, it said that it would work with DHSC, UKHSA and NHS Supply Chain to ‘co-design future models of supply and procurement’.

In addition to pursuing legislative change to enable movement of vaccines across providers, these models would aim to:

  • Increase national collaboration and data sharing, so that early warning can be given if supply limitations or other challenges emerge
  • Co-ordinate deployment of vaccines to use vehicle loads more effectively and streamline ordering systems
  • Improve supply chain software systems