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Managing seasonal influenza (flu) vaccines in care homes

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  • Organisations we regulate

Care providers have been reviewing the way they manage seasonal influenza (flu) vaccines in light of the coronavirus pandemic.

The following are useful considerations but are not intended as clinical guidance.

The flu vaccine is a prescription only medicine (POM). You must only give it under a valid patient specific direction (PSD) or patient group direction (PGD). The most common type of PSD is an FP10 prescription, but there are other types.

General information

Health and social care providers must be clear who will be responsible for managing the administration of flu vaccines. For example, this could be the care home or a GP surgery. This is very important for people living in care homes. The authority to administer the flu vaccine must be in place before giving the vaccine.

Staff working in care homes can administer flu vaccines to people in their care. They must have a valid PSD. And they must be trained and competent to do so.

The flu vaccine cannot be supplied on a bulk prescription.

Several healthcare professionals (including registered nurses) can now give flu vaccines to staff. This must be part of an NHS or local authority occupational health scheme.

Find out more about workplace flu vaccination.

Ordering and obtaining flu vaccines

Care homes with nursing may get and hold stocks of flu vaccines to help them vaccinate people in their care.

The Human Medicines Regulations define care homes with nursing as independent hospitals. They're usually registered with CQC for the 'treatment of disease, disorder or injury'. This means they can hold stock of POMs - such as adrenaline used for anaphylaxis.

The person responsible for the treatment of disease, disorder or injury can order POMs. This could be the care home manager. They do not need to be a clinician. The ability to order POMs is linked to this activity we regulate.

Anaphylaxis

The Green Book states: ‘In all settings providing vaccination, facilities should be available and staff trained to recognise and treat anaphylaxis.’

The person administering flu vaccines must have access to emergency equipment and medicines. Care providers must make sure they have this access in line with national guidance.

The Resuscitation Council has information on the treatment of anaphylaxis.

The Green Book has more information on vaccine safety and the management of adverse events.

In an emergency, anyone can administer certain medicines. This law applies to adrenaline injection when it is being used to treat anaphylaxis. You should contact the emergency services immediately after adrenaline is given - even if the person starts to feel better.

Consent

You must only give the flu vaccine with consent from the relevant person. If a person lacks capacity, the relevant person might be a family member or a member of staff. You should keep a record of any 'best interest' decisions made.

Follow Regulation 11, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Administering the flu vaccine

Before administering the flu vaccine, be aware of and take all necessary precautions. You must consider any allergy or acute illness.

Do not give the flu vaccine to people who are allergic to egg without seeking further advice from the prescriber. There are egg-free flu vaccines available.

The product chosen must take into account the age-group of the person receiving the flu vaccine.

Find out more in The Green Book chapter 19: Influenza

Storing the flu vaccine

Follow the manufacturer’s instructions for storing flu vaccines.

Find out more about storing medicines in fridges in care homes.

Record keeping and information sharing

‘As a wide variety of influenza vaccines are on the UK market each year, it is especially important that the exact brand of vaccine, batch number and site at which each vaccine is given is accurately recorded in the patient records.’

The prescriber must keep clear prescribing records. Care home staff must keep and share records about flu vaccines they administer. This reduces the risk of giving duplicate doses.

Training and competency assessment

The Royal College of Nursing states:

‘Anyone involved in the prescribing or administration of vaccines must be suitably competent and have the knowledge as well as the skills to ensure patient safety, and public trust in immunisation is maintained.’

NICE guidance 'Managing medicines in care homes' states: ‘Health professionals working in, or providing services to, care homes should work to standards set by their professional body and ensure that they have the appropriate skills, knowledge and expertise in the safe use of medicines for residents living in care homes’.

Summary

Health and social care providers must work together to safely manage flu vaccinations.

Staff administering flu vaccines must be trained and competent

Staff must have access to the relevant emergency equipment and medicines as directed by national guidance.

Key local decision makers should decide how to manage flu vaccines, emergency equipment and medicines. For example, GPs, commissioners, care providers, community pharmacies, and the local authority should make the decision together.

Last updated:
18 November 2020