NHSE approves major shake-up to vaccination and screening services

NHS England has approved a plan for ICBs to become responsible for commissioning all vaccination services, and most screening services, from next year.

The commissioner will delegate the majority of these services to ICBs on 1 April 2026, to ‘support’ ICBs’ role in population health and prevention.

They have not said how this is expected to impact GP vaccination services that are currently paid for via the national QOF scheme and enhanced services.

The plan builds on the national vaccination strategy, which set out proposals for ICBs to take over population-level management.

The changes, approved by the NHS England board at a meeting yesterday, include:

• Commissioning of all vaccination services is delegated to ICBs
• Commissioning of most components of screening services is delegated to ICBs, with the exception of some functions which are delivered ‘across large footprints’ and are more ‘suitable’ to be retained by NHS England
• Commissioning of Child Health Information Services is retained by NHS England

NHS England said that it expects that this will lead ICBs to deploy ‘a range of different models’ across the country. 

NHS England’s director for vaccinations and screening Steve Russell told the board that ICBs are ‘really interested’ in this area, and have been ‘leaning into it all’ for some time.

He said: ‘The reason that we have come to the proposal to delegate the vast majority of vaccination and screening services to integrated care boards is that prevention and improving population health sit firmly as one of the key purposes of ICBs, and actually, these sorts of services should be integrated into all of the other work that ICBs are doing in this space.

‘I think it’s important to say these will continue to be national services. They are consistent services across the country, they follow advice of the Joint Committee on Vaccination and Immunisation, or the UK National Screening Committee, and that will continue to be the case. The thing that will vary across the country is how the delivery of them works.’

NHS England will keep some screening services which will be commissioned once for the whole country, including:

• Bowel cancer screening hubs and bowel cancer screening managed service provision
• Cervical Screening Administration Service
• HPV cytology laboratories
• Newborn bloodspot laboratory services

NHS England said: ‘This arrangement will make best use of resources, both in terms of commissioning budget and staff, and will help to align these services with other relevant areas of national commissioning, such as genomics laboratories.

‘Retaining these service components will also enable us to deliver service transformation and programme changes rapidly, efficiently and consistently across the country.’

The UK National Screening Committee, UK Health Security Agency and the Department of Health and Social Care are ‘supportive’ of the delegation proposal, NHS England added.

The vaccination strategy proposed for ICBs and PCN-level teams to take over the responsibility of vaccinations, with NHS England maintaining overall accountability for vaccination services.

When it was published at the end of 2023, there were suggestions that it could bring an end of the current GP practice enhanced services and QOF targets.

Last year, NHS launched 12 ‘demonstrator sites’ to test new models for delivering vaccinations, including health visitors taking on catch-up jabs for children, as part of the strategy.

But GPs have warned about the impact of potentially losing vaccination services, saying this could cause a ‘serious loss of income’ for practices.