General practitioner Practice manager GP practices England Scotland Wales

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Focus on vaccines and immunisations

Please note that this guidance is currently under review for the purposes of bringing it up to date.


Focus on vaccines and immunisations - guidance for GPs (June 2014) (Word 119K)

The guidelines refer to England, Scotland and Wales, unless where it is specified that the guidance or regulations differ in any of the devolved nations.

For ease of reading, most of the links in the document will refer to English guidance, but links to the devolved nations have been added to the end of the document for information. For information about the arrangements in Northern Ireland, please contact [email protected].

Any queries about this guidance should be sent to [email protected]



Since April 2004, under the new GMS contract, vaccines and immunisations have been funded through various mechanisms dependent on which services a practice wishes to provide. Payment may be through the:

  • global sum
  • enhanced services (ES)
  • quality and outcomes framework (QOF)
  • private income for some travel immunisations

The regulations regarding the NHS provision of immunisations can be traced back to the original ‘Red Book’  regulations of the 1960s. Under the Red Book, most vaccines and immunisations were paid on an item-of-service basis and additionally the main childhood immunisations had a target-based remuneration. The regulations were written to cover the immunisations available at that time and consequently do not reflect today’s clinical practice.

In 2004, the new GMS contract  took those regulations and carried them into the new contract as an additional service. Consequently everything in the Red Book was transferred unchanged and included in the global sum rather than the previous item of service system. The fact that these regulations had become out of date because of changes in the vaccines themselves and continued to contain inappropriate references, such as smallpox, did not prevent them being carried over into the new contract. The amendments to the Additional Services section of the NHS Regulations 2004 which were made in 2012 (in England), now more accurately reflect current practice, attempt to clarify the previous regulations to make them fully up to date but were not intended to introduce any new work. Further changes to the regulations have been made in 2013 and 2014.


Guidance and regulations in the devolved nations

A list of letters issued to health professionals during 2014 (Wales)

Vaccines and immunisation guidance (Scotland)

Immunisation guidance (Northern Ireland)

Department of Health, Social Services and Public Safety (Northern Ireland)


Further information

Department of Health (England) immunisation information for health professionals and immunisation practitioners

The Green Book - Immunisation against infectious disease

NHS guidance on childhood immunisations

Health Protection Agency (HPA) – Public Health England guidance on immunisation