Travel Vaccine PGDs
Date sent: Friday 29 July 2016
All Somerset Practice Managers and Nurses email sent on behalf of Sue Mulvenna
The new local SW Hep A PGDs are now signed off, and on the NHSE South website – they start from Monday 1st August 2016.
Thanks to my peer reviewers, your help with this was invaluable! This has been just in time, as the local BNSSSG Hep A PGDs run out tomorrow.
The local Hep A PGDs in Devon and Cornwall are still in date for a month in Devon and till the end of October in Cornwall. These are still legally valid until they run out, and the clinical content is unchanged. However the new PHE style proforma contains updated links so it would be good to move over to them sooner rather than later.
The discussion about updating local travel vac PGDs across the SW has raised some interesting points. Due to the difficult financial situation in most CCGs, prescribing costs are under constant review. Many CCGs are reviewing their approach to travel vacs and trying to engage GP practices in rationalising their approach to offering them on the NHS.
There is some confusion between the Green Book (on appropriate use of travel vacs) and the old Red Book (on what travel vacs should be funded by NHS). Some travel vacs should always be available on NHS when clinically indicated, ie tet, dip and polio (Td/IPV), typhoid, hep A, and cholera. Some travel vacs should always be private (Japanese encephalitis, meningitis, rabies, TB, yellow fever). And for some, it is down to the GP practice to decide whether NHS or private for travel (Hep B, meningitis ACWY).
Combination vaccines are allowable on NHS for travel, e.g. hep A+hep B, but some CCGs are requesting that these vacs are not used, but separate ones as appropriate, with hep B for travel being given privately. There will be other indications for hep B to be given as NHS for travel, eg for men who have sex with men who are travelling abroad. As you can see it is complex and I have added some links below with more info.
The upshot is that whilst the local Hep A PGDs have now been updated and are ready to use, some of the travel vac PGDs that nurses have been used to using across the SW will be going out of date over the next few weeks and will not be replaced in the near future (tho may be next year as part of the national PHE PGD work plan). Specifically, these are Hep A and B, hep A and typhoid, and hep B.
We have a local SW cholera vac PGD which is in date until end of September 2017. The typhoid PGDs (inj and oral) run out at the end of next month, and I am proposing to replace the typhoid injection PGD but not the oral one.
So the main change will be with hep B which will no longer have a local PGD from end of August for BNSSSG and Devon, and end of October for Cornwall. Once the PGDs run out, admin of hep B, oral typhoid, and combinations Hep A and B, and hep A and typhoid will need to be done by PSD.
Can you please flag this up to the nurses in your CCGs, so that they are aware of the need to check PGD end dates? If they administer vaccines without having a valid PGD in place and something goes wrong, this could have very serious consequences for their registration.
I have attached my updated list of SW and local imms and vacs PGDs
Head of Pharmacy and Controlled Drugs Accountable Officer
NHS England South (South West)
Bristol BS1 3NX
TEL: 01823 331428
Attached file: PGD imms and vacs planner SW 0816.xlsx