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December 2021

QOF workload eased to support booster programme

NHS England has suspended parts of QOF and put over-75 health checks on hold following advice from the Joint Committee on Vaccination and Immunisation (JCVI) that all adults aged 18 – 39 should become eligible for a COVID booster to help curb the spread of the Omicron variant.

The basic fee per immunisation has also been increased to £15, and CQC inspections will be paused, except where a risk-based assessment is deemed critical to safety and quality.

To increase capacity in general practice, QOF indicators for vaccination, cervical screening, register indicators and those related to optimal prescribing will continue, and will be paid on the basis of practice performance, but other targets will be paused, with income protected in line with historical performance. Investment and Impact Fund (IIF) targets for flu immunisation and completed work on appointment recording will be paid as normal, but other indicators will be suspended.

Practices that had opted out of the earlier phases of the booster programme will now have the opportunity to sign up.

The recently-elected BMA GP committee chair, Dr Farah Jameel said: ‘At this critical time in the fight against COVID-19, GPs and their teams want to do all they can to protect and look after their communities, focusing on those most in need.

‘This means finely balancing the clear national priority to deliver booster vaccinations to as many people as possible with ensuring that people who need care and treatment from their GP practice continue to receive it.

‘With a finite number of staff and hours in the day, and while GPs and their teams will want to step up and do all they can in the midst of this national emergency, there must be a recognition that they cannot do everything for everyone all of the time.’

Dr Jameel said that the NHSE changes ‘begin to recognise this’ and by removing some of the more bureaucratic and target-based elements of practices’ contracts, staff time could be freed up to ‘get more jabs into arms while allowing practices to focus on patients who need their attention most.’

She added: ‘Patients need to know that if they are unwell or have concerning symptoms…GP teams will continue doing their very best to keep their sickest patients safe in every way they can and know how.’


Booster vaccination eligibility should be expanded to include all adults aged 18 – 39 years. Booster vaccination should be offered in order of descending age groups, with priority given to older adults and those in a COVID-19 risk group, 3 months after completion of the primary vaccination course.

Severely immunosuppressed patients who have not yet had their third dose should be given it now to avoid further delay, with a further booster dose given in 3 months. Both the Moderna and Pfizer-BioNTech vaccines can be used in the booster programme.

The JCVI has also recommended that children and young people aged 12–15 should be offered a second dose of the Pfizer-BioNTech vaccine, at a minimum of 12 weeks after their first dose.

The NHSE letter to practices, co-signed by Dr Nikki Kanani, Medical Director for Primary care, concludes with an update of the effect of the vaccination programme – it is estimated that since the first vaccine was given in the UK outside a clinical trial, 127,500 deaths and 24,144,000 infections have been prevented. ‘We want to thank you for your continued commitment to saving lives and protecting communities.’

Practice Nurse 2021;51(10):6