Department of Health's guidance on swine flu vaccination leaves local health chiefs confused

Sep 4 2009

Thousands of frontline health workers in England are trapped in a postcode lottery after Department of Health (DH) guidance on swine flu vaccination has left local health chiefs confused over who is eligible for the jab.

A document leaked to Chemist+Druggist revealed NHS North West Strategic Health Authority (SHA) has advised all Primary Care Trusts (PCTs) in the region to exclude pharmacists from vaccine plans. However, pharmacists will get the jab in other areas, a straw poll of 21 PCTs found.

Last week the DH announced PCTs will decide which pharmacists were eligible for the first round of inoculations, after pharmacists and staff were excluded from a list of priority health workers in DH vaccine guide, the Green Book.

However, the lack of clear guidance has split PCTs, according to Chemist+Druggist's research.

Pharmacists in the North West of England will miss out on the swine flu vaccine after the SHA instructed PCTs pharmacists were not considered "involved in direct patient care" - despite many collection points for antiviral Tamiflu being located in community pharmacies around the UK. NHS North West SHA covers Cheshire, Lancashire, Greater Manchester, Cumbria and Merseyside.

In contrast, pharmacists in Barking and Dagenham and across Hampshire and the Isle of Wight are guaranteed the jab, after health chiefs agreed sector staff were frontline health workers according to the DH guide.

Speaking exclusively to Chemist+Druggist, DH director of immunization Professor David Salisbury insisted the DH list of priority healthcare workers was not definitive and "did not exclude" pharmacists.

Professor Salisbury said: "We can give examples, but it's not for us to give hard and fast rules that won't necessarily apply in all circumstances."

"I'm sure there are some pharmacists who have clinical contact that puts them at equal risk with other groups."

The DH had to "trust to the discretion of PCTs" to decide who should be inoculated, Professor Salisbury said.

Pharmacists in North East Essex and Stoke on Trent will also miss out in the first round of inoculations after PCTs ruled pharmacists were not included in DH priority groups.

And Birmingham East and North PCT said that while the PCT had ruled the DH list excluded pharmacists, it would still supply the vaccine as pharmacists were "vital" to health provision.

Great Yarmouth and Waveney PCT head of prescribing Michael Dennis said plans were still being developed "because the guidelines are so unclear", with the PCT "split down the middle" as to whether pharmacists would be included as a priority group.