This is taken from and for more detail see: BMA’s Focus on Travel Vaccinations
Travel immunisations that must be given as part of NHS provision through GMS & PMS Additional Services
(i.e. you cannot charge for the following vaccinations)
- Hepatitis A (infectious Hepatitis) first and second/booster doses
- Combined Hepatitis A & B two doses with a third for over 16s
- Typhoid first and second/booster doses
- Combined Hepatitis A and Typhoid first and second/booster doses
- Tetanus, Diptheria & Polio as given in the combined Td/PV vaccine
In the current climate some practices are reconsidering additional services. You can stop providing this aspect but you would loose 2% of your global sum.
Travel immunisations that cannot be given as an NHS service
The following immunisations are not prescribable as part of NHS services and are not remunerated by the NHS as part of additional services:
- Yellow Fever
- Japanese B encephalitis
- Tick borne encephalitis
The contractor may therefore charge a patient registered for GMS/PMS/APMS services for the immunisation if requested for travel.
The patient may either be given a private prescription to obtain the vaccines, or they may be charged for stock purchased and held by the practice. The process of administration of the immunisation is chargeable as well. Practices should also give the patient written information on the immunisation schedule proposed and the charges involved at the outset of the process.
An FP10 (or equivalent NHS prescription) must not be used to provide these vaccines.
Travel immunisations that can be given as either NHS or as a private service
The following immunisations for travel are not remunerated by the NHS as part of additional services and are in this category:
- Hepatitis B (single agent) any dose
- Meningitis ACWY (quadrivalent meningococcal meningitis vaccine; A, C, Y and W135)
This category is the one that causes most confusion. The ambiguity in this section stems from the regulations regarding the charging of patients that are registered with the practice. Schedule 5 of the NHS regulations 4 states that:
“The contractor may demand or accept a fee or other remuneration…. for treatment consisting of an immunisation for which no remuneration is payable by the Primary Care Trust and which is requested in connection with travel abroad”
This wording leaves the decision as to whether the practice levies a charge or not to the discretion of the practice. The regulations do not impose any circumstances or conditions as to when these immunisations should be given on the NHS or as a private service nor do they allow any outside organisation to decide which option should be chosen.
Practices therefore need to be clear about their policy to avoid falling foul of regulations that prohibit charging NHS registered patients. The service must be provided either entirely as an NHS process or entirely as a private service, and the following paragraphs illustrate that difference.
To provide this as an NHS service, the practice would either prescribe the immunisation on an FP10 (or national equivalent) or (in England and Wales) provide the vaccine from purchased stock and claim reimbursement through the normal channels (in the same way as immunisations provided under additional services). The practice must not charge the patient for the administration of the vaccine.
If a confirmatory certificate is requested by the patient then the practice may charge for this, but cannot charge just for recording immunisation details for the patient’s personal record.
Alternatively the practice may decide that providing this is as a private service and charge a patient registered for GMS services for the immunisation. In this situation this can either be provided on a private prescription or the patient charged for the supply from practice stock. In this situation a charge may be made for the administration of the vaccine.
It is important to avoid mixing these two scenarios. If these immunisations are provided as an NHS service, then no charge can be made to the patient other than for certification if requested by patient (which is not compulsory).
Practices also have to ensure that their policy is non-discriminatory and that this is not done contrary to the Equality Act 2010 (formerly the Disability Discrimination Act).
Competencies: Travel health nursing: career and competence development
The RCN have published 2018 updated guidance on “the current guidelines and standard of care of travellers”.
Access to the RCN web page and their document, “Competencies: Travel health nursing: career and competence development” can be found on the following link: