Current status: Answered by Neil Gray on 8 August 2024
To ask the Scottish Government what its position is on whether the current GP contract, which has required, as of March 2023, the transfer of vaccination services in rural areas from GPs to NHS boards, has been a success; what its position is on whether this policy has resulted in any potential increased risks of death in infants, and, if so, whether it plans to take any action to address any such risks.
The 2018 GP Contract was negotiated on a national basis with the BMA’s Scottish GP Committee which represents all Scottish GPs. The Contract is based on the transfer of some services to Health Board delivery to allow GP practices to focus on what only GPs can do. This means that GP practices are no longer the default providers of vaccinations.
The Scottish Government agreed a process with the GP committee to allow the continued delivery of vaccines, and other services intended for transfer, by GP practices where, due to remoteness and rurality, Health Board delivery would be difficult.
The seven key principles of service design are that any redesigned services should be:
? safe for patients and staff;
? person-centred;
? equitable;
? outcome focussed;
? effective;
? sustainable; and
? affordable
The vast majority of vaccinations are now delivered by Health Board employed staff with a consequent release of capacity for GP practices.
If vaccination rates drop in any Health Board area, the Scottish Government would expect that board to examine its vaccination arrangements and make any necessary adjustments, including the full use of the flexibilities provided under the GP contract, to ensure a proper level of vaccination. This is a continuation of the expectation the Scottish Government would have had of Health Boards when delivery was mostly in the hands of GP contractors; Health Boards were still responsible for ensuring that a proper level of vaccination was met.
The decline in childhood uptake we are seeing nationally is of course a cause for concern. On 16 July, Public Health Scotland published a report on ‘Understanding and addressing declines in childhood immunisations’. This research provides valuable insights into various aspects of childhood immunisation delivery in Scotland.
The Scottish Vaccination and Immunisation Programme are working together to take forward the recommendations in the report. This will ensure that the learning and good practice highlighted in this report is put into action to improve uptake, and ensuring that the delivery of immunisations across all childhood programmes is equitable and accessible.