This article was first published on Healtandcare.scot.

Plans for a centrally-run Scottish vaccination and immunisation service are under development, healthandcare.scot can reveal. It comes just as the deadline has passed for NHS boards to complete the vaccination transformation programme, transferring routine vaccinations out of GPs services.

First mention of the plans appeared in the minutes of a meeting of NHS Scotland leaders late last year, but the Scottish government has refused to respond to a freedom of information request asking for details, saying only that:

“The strategy for Scotland’s future vaccination service is currently under development. Correspondence, briefings and reports relating to the development of this strategy are covered by exemptions regarding the free and frank sharing of advice.”

Public Health Scotland is the successor body to Health Protection Scotland and monitors and advises on vaccination services. Public Health Scotland confirmed that it is supporting the Scottish government in developing plans for a future vaccination service in Scotland – but declined to give further information.

The policy was presented by the Scottish government’s Director of Vaccine Policy and Strategy to NHS Chairs, Stephen Gallacher, in December last year and published in the meeting minutes.

Stephen Gallacher told NHS board leaders that a portfolio board has been created to oversee the establishment of a new national vaccination and immunisation service for Scotland that is to be ‘led by public health principles and help to reduce inequalities’.

A sustainable workforce and necessary financial support, he said, would be put in place to support its establishment.

This will be the second major change to policy on the delivery of routine vaccination in four years.

The deadline for NHS boards to have completed the process of vaccine transformation, involving the transfer of responsibility for routine vaccinations – traditionally organised by local GPs –to health boards, expired at the beginning of this month.

Since then, GP practices are no longer to provide any vaccinations under their core contract.

Instead, NHS boards have set up and staffed community vaccination centres – many operating from NHS board-owned health centres – enhanced the role of midwives in supporting vaccinations for pregnant women, set up childhood immunisation teams and broadening the role of school vaccination teams.

GPs working in rural and remote areas of Scotland have questioned the plans, amidst concerns about shortcomings in health boards’ delivery of the covid booster jab programme and problems with the government-led booking service.

In letters from the government’s senior medical officers, health boards were told to no longer contract GPs to deliver vaccinations as enhanced services – rather, where GPs need to continue providing vaccinations on a transitional or exceptional basis, arrangements are in place enable practices to do so.

Under a memorandum of understanding (MoU) signed last August between the Scottish government, doctors’ trade union the BMA, NHS boards, and Scotland’s integrated health and social care partnerships recommitting them to deliver the changes agreed in the 2018 GP contract, it was agreed that health boards could commission GPs to be vaccinators in remote and rural places where they are the best option for local people.

The MoU agreed that some aspects of overseeing the delivery of vaccines services were already being supported by Scotland-wide systems, stating:

“Boards have assumed overall logistical responsibility for implementing vaccination programmes, facilitated through national digital solutions such as the vaccination management tool and NVSS [National Vaccination Scheduling System] appointment system.

“Learning from the delivery of last year’s adult seasonal flu and pneumococcal programme, as well as the ongoing Covid-19 vaccination programme, should be capitalised on to ensure the implementation of the programme in full by April 2022.”

The Scottish government has told healthandcare.scot it intends to publish details of the new strategy for a national vaccination service ‘in due course’.