Home visits to undertake influenza vaccinations as part of the 2025-26 influenza vaccination requirements

Regarding provision of home visits for flu vaccinations and the recent direction of patients from the immunisation team.

We understand the significant capacity pressures the practice is currently facing, particularly when managing "opportunistic" vaccination alongside routine care. However, we have reviewed the 2025-26 PCCS:I Service Specification, and we must clarify the practice's obligations to ensure you remain compliant with the contract you have signed.

Contractual Requirements and Equality

Under the service specification for Immunisations and Vaccinations, the practice is responsible for delivering the service to its eligible registered population. Specifically, regarding accessibility, the specification (page 25, sections s–u) states:

• Accessibility: Services must be accessible, appropriate, and sensitive to the needs of all persons.

• Equality Act 2010: Eligible persons must not experience "particular difficulty" in accessing the service due to protected characteristics, specifically disability.

• Home Visiting: If a patient has a disability or clinical condition that prevents them from attending the surgery, the practice is required to provide a reasonable adjustment to ensure they are not excluded. In this context, that adjustment may be a home visit.

Determining Eligibility for Home Visits

While the immunisation team may be directing patients to you, the practice retains the clinical responsibility to determine if a home visit is strictly necessary.

A home visit should be reserved for those who are truly housebound due to illness or disability. If a patient is physically able to attend the surgery (or does so for other appointments), the practice is within its rights to insist they attend a clinic. However, if a disability truly prevents them from attending, the PCCS:I framework requires the practice to facilitate the vaccination at their place of residence.

You could as per section (u) of the specification, if capacity makes this impossible, you should engage with the Local Health Board to discuss how they can support your equality plan for under-served or housebound groups.

Failure to provide these visits for eligible disabled patients could be viewed as a breach of both the PCCS:I specification and the Equality Act 2010.

We hope this clarifies the guidance but ultimately it is up to the practice that they do not discriminate against a patient who has a true disability that prevents them from leaving their house.

Your practice may wish to take this into consideration in deciding on whether to participate in next year's influenza campaign.