General Practice Vaccinations & Immunisation – Standard and core contractual requirements
Update January 2026
Update on UKHSA Vaccination Guidance
Somerset LMC has noted a change in wording in the updated UKHSA guidance which suggests that Healthcare Support Workers, including HCAs, are unable to take informed consent for vaccination. This change has come as a surprise to a number of practices.
Wessex LMC has raised this issue with the UKHSA vaccination teams, who have confirmed that there has been no change in policy, but that the wording has been clarified. However, it has been acknowledged that many practices may have interpreted the previous wording differently, and that this clarification could have significant implications for vaccination delivery, particularly within mass vaccination programmes.
Wessex LMC has also encouraged regional NHSE vaccination teams to proactively contact practices to explain the updated wording and its practical implications. In the absence of such communication to date, Somerset LMC is sharing this update, sourced from Wessex LMC, to ensure practices are appropriately informed.
Somerset LMC will also be raising this issue with the General Practitioners Committee (GPC) to support further discussions with practices.
Summary of the key points:
- UKHSA guidance updated: New guidance replaces previous advice and clearly distinguishes between
informed consent for treatment and agreement to receive an injection. - Informed consent vs injection consent:
- Informed consent relates to the decision to receive the vaccine and must be obtained by a registered healthcare professional (RHCP).
- Consent to administer an injection is procedural (agreement to the physical act) and can be checked by a trained HCSW/HCA, but this does not replace informed consent.
- Accountability under Patient Specific Directions (PSDs):
- The prescriber/RHCP is responsible for:
- Clinical assessment
- Obtaining informed consent
- Deciding to delegate vaccine administration
- The HCSW/HCA is responsible for:
- Checking the patient has no new concerns on the day
- Referring any new issues back to the prescriber
- The prescriber/RHCP is responsible for:
- Who should obtain consent:
- Registered healthcare professionals (e.g. nurses, pharmacists, GPs) should obtain informed consent for immunisation, in line with updated best practice.
- Role of HCSWs in vaccination services:
- May administer selected vaccines (e.g. flu, COVID-19) under a valid PSD with training, supervision, and an RHCP on site.
- May check the patient feels well and confirm willingness for the procedure.
- May support clinic operations and escalate clinical concerns.
- Must not assess suitability, prescribe, work under PGDs, or answer clinical vaccination questions independently.
- Training and experience expectations:
- Only experienced HCSWs should administer vaccines.
- Expected to have training to QCF Level 3 (or equivalent) and work at NHS Career Framework Level 3 or above.
- Actions for practices:
- Review clinic processes to ensure informed consent is not implicitly delegated to HCAs.
- Ensure an RHCP is responsible for informed consent.
- Clearly document the consent pathway and roles.
- Update staff training to reflect the consent distinction.
- Refer to Green Book, Chapter 2 for consent guidance.
NHS England has published general practice vaccination and immunisation services: standards and core contractual requirements . This document outlines the vaccination and immunisation standards and core contractual requirements as set out in the Regulations and the previously issued 10 March 2021 NHS England letter .
2025_26 Somerset School Aged Immunisation Pathways Document v01
Adult Vaccination Programmes Toolkit SW 2025-26 v6.0 2025_26
BNSSG School Aged Immunisation Pathways Document v01
29.9.25 – IMPORTANT: CQRS information regarding claiming an Item of Service fee for Shingles vaccinations administered to adults who turned (or will turn) 80 years old from 1 September 2024 until 31 August 2026
Practices are now permitted to vaccinate adults who turned (or will turn) 80 years old from 1 September 2024 until 31 August 2026. This is an extension of the eligibility that was due to cease on 31 August 2025. Please note that for these individuals, Claims for IoS fees post the individual’s 80th birthday will need to be claimed manually by submitting a manual amendment request form to the SW VaST CQRS team mailbox england.swcqrs@nhs.net
School Aged Immunisation (SAI) Pathways 2025-26 – FAO BNSSG, BSW, Cornwall, Dorset and Somerset GP Practices only
For the attention of BNSSG, BSW, Cornwall, Dorset and Somerset GP Practices only (Devon and Gloucestershire pathway documents to follow shortly).
Please see the attached SAI pathway document for your area, which has been produced to support local practices in understanding the current SAI pathways and responsibilities for delivery of these vaccinations for the 2025-26 academic year. This includes information on the Influenza, HPV, MenACWY, Td/IPV and MMR programmes.
These pathways will also shortly be available via the SW Vaccination and Screening Team website: NHS England — South West » Immunisations
SAI Teams are currently delivering the school-based flu programme. Please be reminded that GP’s can and should administer flu vaccinations for children classed as ‘at-risk’. Further information is provided in the attached pathway documents.
If you have any queries regarding the pathway documents, please contact the SW Vaccination & Screening Team via england.swvast@nhs.net.
To help support you with all adult immunisation programmes we have developed an adult immunisation toolkit in the South West. We aim to keep this as up to date as possible and the latest version can be downloaded from the following link – Adult Vaccination Programmes Toolkit SW 2025-26 v6.0 – South West Vaccination & Screening Team – Futures. A copy is also attached to this email. This provides details on the routine adult immunisation programmes RSV, Shingles and PPV and includes other information which may be helpful, such as coding, payments and links to resources that support the vaccination programmes.
Shingles vaccination programme
On 1st September 2025, based on the latest advice from the Joint Committee on Vaccination and Immunisation (JCVI), eligibility for the NHSE Shingles vaccination programme changed to allow all severely immunosuppressed people aged 18 years and over to receive the shingles vaccine. This is an expansion of the current severely immunosuppressed cohort, who until now became eligible from aged 50 years of age. Further details about his can be found here – Shingles vaccination programme: expansion of Shingrix® vaccine eligibility to all those who are severely immunosuppressed and aged 18 years and over – GOV.UK
- To reflect these changes, the Shingles eligibility calculator has been updated and can be downloaded here – Shingles eligibility calculator
- The Shingles Vaccination guide leaflet has also been updated and can be ordered or downloaded from here – Shingle vaccination guide
- Other resources including posters, postcards, record cards and stickers can be downloaded from here – Find public health resources
- The PGD has also been updated and can be downloaded from here – Shingrix v3.0 PGD
RSV vaccination update
All patients in the catch up cohort for RSV (i.e. all those who were 75-79 on 1st September 2024) who have now turned 80 years of age will now remain eligible until 31st August 2026. The PGDs for these patients have not been amended to reflect this change, so any vaccinations given to a patient who is in this eligible cohort and is now 80 years or more can only be given the vaccination via a PSD.
The RSV vaccination remains a vaccination given all year around as a single dose – so any patients who have been given a dose already are fully immunised and do not require another dose this year. Any patients turning 75 or who are eligible but have not yet had a vaccination should be encouraged to have the vaccine. JCVI has assessed new data on co-administration and advised that for older adults’ RSV vaccines can be routinely scheduled alongside COVID-19 vaccines. This has been updated in the Green book. There is no change to advice that RSV and influenza vaccines should not ordinarily be scheduled on the same day, due to possible impact on immune response to both, though this can be done if it is thought that the individual is unlikely to return for a second appointment or immediate protection is necessary. Early data from new respiratory syncytial virus (RSV) vaccination programme shows 30% fewer hospital admissions in 75 to 79 year olds (the cohort eligible for RSV) last year and this was seen after around 40% of eligible older people had taken up the vaccine – showing how effective this vaccine is in helping older people avoid serious illness from RSV.
- Resources supporting this vaccination programme can be found here – Find public health resources
RSV Vaccination Programme – Updated Guidance for General Practice
NHS England has updated the contractual guidance for general practices on the RSV vaccination programme. The revised guidance clarifies eligibility for the older adult catch up programme, specifically that those adults aged 75 to 79 years old on 31st August 2024 will remain eligible until 31st August 2026. Updates have also been made to the RSV clinical coding requirements with both the older adult and pregnancy RSV services now offered in CQRS and GPES extractions supporting automated payments for those aged 75-79 years old at the point of vaccination.