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Nigel's surgery 89: Immunising people with an underlying medical condition

  • Organisations we regulate,
  • GP and GP out-of-hours services

GP practices need to take extra care that immunisations they carry out are appropriate for people with an underlying medical condition.

We consider how GP practices support the immunisation programme, and whether staff providing immunisations are trained and competent to do so. This relates to key lines of enquiry (KLOE):

Professional guidance

  • Public Health England (PHE) immunisation schedules for the UK population based on the recommendations of the Joint Committee of Vaccination and Immunisation. There is a section with specific recommendations for immunisation of those with an underlying medical condition.
  • The Green Book, jointly produced by PHE and the Department of Health and Social Care, is updated regularly. It includes chapters on principles of immunisation and on each vaccine-preventable infection. Chapter 7 deals specifically with immunisations for people with an underlying condition.
  • The Patient Group Direction (PGD) also provides guidance on eligible groups for each vaccination. This includes vaccination of people with asplenia and sickle cell disease, as well as conditions such as diabetes and chronic respiratory disease.

GP practices must ensure that when patients are offered vaccination the benefits are explained to the patient clearly. To do this they need systems to identify relevant patients and ensure they are vaccinated in line with current recommendations.

When we inspect

We expect GP practices to:

  • have a reliable system to make sure appropriate Read codes are added to patient records, for example from correspondence when a new relevant diagnosis is made
  • carry out regular audits using Read code searches to make sure vaccination and boosters have been offered to relevant patients
  • follow PHE guidance on storage of vaccinations
  • make sure nurses who are not qualified as independent prescribers are adopting PGDs and using them appropriately .

All immunisers must:

  • have received specific immunisation training, based on PHE standards for vaccination and immunisation
  • stay up to date with current practice in immunisation, including new recommendations
  • have access to the monthly publication ‘Vaccine Update’ produced by PHE
  • know how to contact local PHE immunisation staff for advice.
Last updated:
22 November 2018