Which travel vaccines are an NHS provision and which are private?
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There has been much confusion about this over many years with a number of surgeries doing different things and no one correcting those who are in the wrong (in the main). There is a useful piece written about the topic on page 8 of the RCN Competencies document and a very helpful document from the British Medical Association entitled Focus on Travel Immunisation that explains in great details what can and cannot be charged for – when you link to the page, scroll down to the bottom to download the PDF of this document. These two publications will provide you with all the information required and it is highly recommended you look at both.
To summarise the charges
Travel vaccines that must always be given as part of NHS provision through GMS additional services are:
Hepatitis A, typhoid, cholera and polio and any combination vaccine that has one of these disease protections within the product eg. Revaxis (combined tetanus, polio and diphtheria), combined hepatitis A+B vaccines etc.
Travel vaccines that cannot be given as an NHS service and are therefore private service vaccines are:
Japanese encephalitis, tick-borne encephalitis, yellow fever and rabies for travel purposes – (please note post exposure treatment vaccine must be an NHS provision).
Travel vaccines that can be given either as an NHS or private service are: but see the note 03.01.18 below on this page
Hepatitis B and meningitis ACWY (it is up to the GP surgery to decide whether they want to provide it as an NHS provision or as a private service – see also specific hepatitis B provision document from the BMA – click here). Regarding the Meningitis ACWY vaccine for travel – see below on this page in ‘a note of interest’)
A charge cannot be made for travel advice, or providing a travel record book detailing the vaccines given. Vaccine certificates for yellow fever and meningitis ACWY can be charged for although this cost is usually included in the total cost of the vaccine provision. Equipment (e.g. mosquito nets, mosquito repellents, first aid kits etc. can be sold in an NHS setting thus generating income but for further details see the BMA guidance Focus on travel immunisations – guidance for GPs as detailed above.
NHS Choices pages on charging here
A note of interest (08.09.17 and updated 09.02.18) when you look at the BMA page for Focus on Travel Immunisation the website indicates now that meningococcal disease protection for travel (the ACWY conjugate vaccines, Menveo and Nimenrix) are only available privately. However this contradicts the information in their guidance also available on the same page in the downloads section. This guidance was written in November 2012 and has not be changed so there is still the option to give this vaccine NHS or privately as detailed above. However – this is one of the two vaccines that has been discussed in the consultation document about the future of certain NHS drugs – see the piece I wrote in Practice Nurse about it here.
Update on 03.01.18
In July 2017, NHS England launched an action plan to drive out wasteful and ineffective drug prescriptions, saving the NHS over £190 million a year. A consultation document was subsequently published detailing a list of items considered need not be routinely prescribed in primary care. The outcome of this consultation was that the following vaccines should not be prescribed on the NHS exclusively for the purposes of travel (in England):
• Hepatitis B
• Japanese Encephalitis
• Meningitis ACWY
• Yellow Fever
• Tick-borne encephalitis
These vaccines should continue to be recommended for travel but the individual traveller will need to bear the cost of the vaccination. (NHS England 2017). A patient leaflet has been produced providing the current provision of travel vaccines – see here and scroll down to travel vaccine prescribing.
At the same time, NHS England asked Public Health England to conduct a review of travel vaccines currently available on the NHS to assess their appropriateness for future NHS prescribing – these are cholera, diphtheria/tetanus/polio, hepatitis A and typhoid. This evaluation is currently being undertaken but at the present time, no outcome is known. However, when the information becomes available, I will update this webpage.