Childhood Flu Vaccination Service

The aim of the seasonal influenza vaccination programme is to protect those who are most at risk of serious illness or death should they develop influenza, by offering protection against the most prevalent strains of influenza virus.

It helps to reduce unplanned hospital admissions and pressures on urgent and emergency care and as such it is a key factor in the resilience of the NHS during winter.

Vaccinating eligible children not only provides individual protection for the child but can help reduce transmission of the disease to the wider population, including those who are at higher risk of getting seriously ill from flu.

The Department of Health and Social Care (DHSC), the UK Health Security Agency (UKHSA) and NHS England continue to seek to improve on the uptake rates for all flu vaccinations, including the vaccination of children.

Children aged 2 and 3 years old

UKHSA data shows a rise in overall vaccination uptake rates of children aged 2 and 3 years in the 2025/26 season compared to the 2024/25 season although still not at the combined level achieved in the 2023/24 season.

Last season (2025/26), the eligible cohort of children was just below 1.2 million and the UKHSA data shows the following uptake rates for children:

• Aged 2 and 3 years combined was 44.2% compared with 42.6% in 2024/25 (44.4% in 2023/24)
• Aged 2 years was 43.5% compared with 41.7 % in 2024/25 (44.1% in 2023/24)
• Aged 3 years was 44.8% compared with 43.5% in 2024/25 (44.6% in 2023/24)

To improve access and uptake, NHS England decided to commission a trial of the new Advanced service for community pharmacies to provide seasonal influenza vaccinations to all children aged 2 and 3 years of age on 31st August 2025. This trial is being extended into the 2026/27 and 2027/28 flu seasons.

Children aged from 2 years to less than 18 years in clinical risk groups

UKHSA data for 2025/26 showed improvement in overall vaccination uptake rates of children aged 2 years to less than 16 years in clinical risk groups compared to the 2024/25 season. In the 2025/26 season, the eligible cohort of children was over 650,000 and the UKHSA data shows the following uptake rates for children:

• Aged 2 years to under 5 years in a clinical risk group was 45.7% compared to 43.5% in 2024/25 (45.9% in 2023/24); and
• Aged 5 years to under 16 years in a clinical risk group was 54.9% compared to 52.1% in 2024/25 (51.6% in 2023/24).

School children in primary and secondary school (Reception to Year 11)

Most school-aged children are vaccinated in school. For the 2025/26 season, there were over 4.1 million children from school years Reception to Year 11 in England vaccinated with a flu vaccine. The cumulative flu vaccine uptake based on combined data for the target populations (Reception to Year 11) was 52.2% (4,147,773 out of 7,939,623) compared with 50.2% during the 2024/25 season.

Based on official statistics from UKHSA, comparability between different seasons for school-aged flu vaccine uptake is a challenge due to differences in cohort eligibility and planning over time. The highest national uptake on record in England for school-aged children (61.7%) was during the 2020 to 2021 season (Reception to Year 7 were eligible that season).

NHS England is seeking pharmacies to sign up to provide the service to offer improved access and coverage across the whole country. The impact of community pharmacy participation in this vaccination programme will continue to be evaluated after each season to inform future policy decisions around whether the service will be commissioned in future years.

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Community Pharmacy England’s view on this Advanced service

Following negotiations with NHS England, we agreed to a one-season trial of the new service in 2025/26.

The commissioning of this service is fully aligned with NHS England’s vaccination strategy, the Government’s recently published 10 Year Plan for Health in England and the community pharmacy sector’s strong desire to provide more NHS vaccination programmes.

We were pleased to be able to agree an expansion of the Advanced service in 2026/27. While it remains a trial, we are confident that it will further demonstrate how community pharmacy teams will be able to increase vaccination rates through the provision of a convenient and accessible service offer to parents and their eligible children.

The expanded cohorts come after lobbying by Community Pharmacy England and other pharmacy bodies to expand the scope of vaccination services that the sector can offer.

It represents yet another strategically important step forwards for community pharmacies to support the delivery of NHS vaccination programmes in line with our calls for the sector to become a hub for the provision of all NHS vaccinations.

Service specification

Service specification for the Childhood Seasonal Influenza Vaccination Advanced Service 2026/27 (published 2nd July 2026)
The service specification describes the requirements for provision of the service and it is essential reading for all pharmacists, pharmacy technicians and other vaccinators providing the service.

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Patient Group Direction and Vaccine Group Direction

UKHSA produces the Patient Group Direction (PGD) and the Vaccine Group Direction (VGD) that provide the legal mechanism for the administration of flu vaccines under the service.

PGD

Influenza vaccine (IIV and LAIV) patient group direction (PGD) (published 18th June 2026)
The PGD provides the legal mechanism for administration of flu vaccines under the service to both eligible adults and children and has been developed by UKHSA and authorised by NHS England.

The practitioners who can legally administer under the PGD will be listed in the Qualifications and professional registration section of the PGD and this will largely mirror the groups of practitioners authorised to supply or administer medication via a PGD under current legislation.

That means the service will generally be provided by pharmacists and pharmacy technicians within community pharmacies, but other registered healthcare professionals able to operate under this PGD may also administer vaccines.

Any listed practitioners must provide the service under the oversight of the Responsible Pharmacist at the pharmacy.

The PGD cannot be used to authorise administration of flu vaccines under any other NHS or private services.

Appropriately trained practitioners, who will administer flu vaccines under the authority of the PGD must:

• Download a copy of the latest version of the PGD from the NHS England website;
• Read the PGD and ensure they fully understand its content, including the eligible patient groups, the inclusion and exclusion criteria and the record keeping requirements; and
• Print off a copy of the PGD and complete the Practitioner declaration to confirm they have read and understood the content of the PGD and that they are willing and competent to work to it within their professional code of conduct.
• If there is more than one practitioner in the community pharmacy or working with the community pharmacy who will be providing the vaccination service, one copy of the PGD can be printed and all practitioners can complete the practitioner declaration on this one copy.

The Authorising Manager declaration must then be completed. The Authorising Manager’s role is to confirm the practitioner(s):

• Is/are aware of the service specification and requirements for provision of the service;
• Have demonstrated their competence to provide the service; and
• Has/have the organisation’s approval to provide the service.

In certain circumstances, for example, a community pharmacy where the pharmacist who will administer vaccines is also the superintendent pharmacist or pharmacy owner, it may be necessary for the authorising manager to be the same person as the practitioner, though this situation should be avoided wherever possible.

These steps must be completed before an individual practitioner is authorised to administer flu vaccines as part of the service. Pharmacy owners using PGDs should retain copies, along with the details of those authorised to work under them, for 25 years after the PGD expires.

Once published, any questions on the PGD should be emailed to england.communitypharmacy@nhs.net.

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VGD

During the COVID-19 pandemic and up until 31st March 2026, National Protocols provided an additional legal mechanism for the administration of adult flu and COVID-19 vaccines by appropriately trained persons following amendment of the Human Medicines Regulations.

The legislation which enabled the development of National Protocols lapsed on 31st March 2026. However, following a Government consultation on the introduction of a new, similar legal mechanism for the administration of vaccines – VGDs are a new legal route which can be used to authorise administration of vaccines.

They operate in a similar way to a PGD, with pharmacists and pharmacy technicians operating as the clinician, but with the opportunity for some tasks within the process (preparation, administration and record-keeping) to be delegated to other suitably trained staff. This allows suitably trained non-registered staff to participate in the programmes.

Read more about VGDs on the Specialist Pharmacy Service website

Vaccine Group Direction for Flu vaccines (IIV and LAIV) (updated 18th June 2026)
This VGD is for the administration of flu vaccine to eligible adults and children from the age of 2 years, in accordance with the national flu vaccination programme.

The VGD allows those who are registered healthcare professionals who cannot operate under a PGD, and those who are not registered healthcare professionals, in the context of the vaccination service being provided, to safely administer a licensed vaccine. The VGDs for vaccines are developed by UKHSA and are very similar to a PGD.

The VGD provides the flexibility to define the training and competence requirements of vaccinators. It also allows the process of administration to be split into its component parts, i.e. clinical assessment and consent, preparation of the vaccine (not required for flu vaccines), administration of the vaccine and record keeping. This allows wider use of workforce skill mix to support the provision of the vaccination service. All these stages can be done by one competent person (the registered healthcare professional), but these tasks can also be split with each person trained and authorised to complete their specific task as defined in the VGD. The clinical assessment and consent process must be undertaken by a registered healthcare professional.

The choice of whether to operate under a VGD is the decision of the pharmacy owner. Pharmacy owners using the VGD are responsible for ensuring:

• Those persons involved in the service or elements of the service are trained and competent to safely provide the activity they are employed to provide under the VGD;
• As a minimum, competence requirements stipulated in the VGD under Characteristics of staff must be adhered to;
• They and registered healthcare professionals have adequate and appropriate indemnity cover;
• Persons must be authorised by name to work under the VGD;
• The staff characteristics for the activity being undertaken are met;
• Practitioners make a declaration of competence and are authorised in writing. This can be done by completing Section 7 of the VGD or maintaining an equivalent electronic record;
• A clinical supervisor, who must be a pharmacist, pharmacy technician or other practitioner named in HMR2012 (Schedule 16, Part 4) as being able to operate under a PGD and who are named under qualifications and professional registration, must be present and take overall responsibility for provision of vaccination under the VGD at all times and be identifiable to service users; and
• Any time the VGD is used, the name of the clinical supervisor taking responsibility and all the people working under different stages of the VGD must be recorded for the session.

The clinical supervisor has ultimate responsibility for safe care being provided under the terms of the VGD. Staff working under the VGD may be supported by additional registered healthcare professionals, but the clinical supervisor retains overall responsibility. Staff working to the VGD must know who the clinical supervisor is at any time and only proceed with their authority. The clinical supervisor may withdraw this authority for all members of staff or individual members of staff at any time and has authority to stop and start service provision under the VGD as necessary. Every member of staff has a responsibility to, and should, report immediately to the clinical supervisor any concerns they have about working under the VGD in general or about a specific individual, process, issue or event.

Appropriately trained practitioners or staff, who will be authorised to work under the authority of the VGD must:

• Download a copy of the latest version of the VGD;
• Read the VGD and ensure they fully understand its content and the appropriate stages that they are expected to be able to provide; and
• Print off a copy of the VGD and complete the Practitioner/staff declaration to confirm they have read and understood the content of the VGD and that they are willing and competent to work to it under the supervision of the clinical supervisor. If there is more than one practitioner/staff member in the community pharmacy or working with the community pharmacy who will be providing the COVID-19 and/or Flu Vaccination Services using the appropriate VGD, one copy of the VGD can be printed and all practitioners/staff can complete the practitioner/staff declaration on this one copy.

The Authorising registered healthcare professional declaration must then be completed. The individual taking on this role must be familiar with the competence required by all aspects of the VGD. The role is to confirm the practitioner(s) and staff:

• Is/are aware of the service specification and requirements for provision of the service;
• Has demonstrated their competence for the role and completed the necessary documentation; and
• Has/have the organisation’s approval to provide the service.

In certain circumstances, for example, a community pharmacy where the pharmacist who will administer vaccines is also the clinical supervisor and the authorising registered healthcare professional, it may be necessary for them to make a self-declaration of competency.

These steps must be completed before an individual practitioner, or staff member is authorised to administer flu vaccines as part of the service. Pharmacy owners using VGDs should retain copies, along with the details of those authorised to work under them, for 25 years after the PGD expires.

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Pharmacy sign-up process

Pharmacy owners who wish to provide the service, should first read the service specification to ensure they are able to meet NHS England’s minimum requirements as specified in the service specification. These include:

• Providing at least one NHS commissioned vaccination service and one service that involves the assessment or treatment of children (for example, the NHS Pharmacy First Service).
• Staff who will provide the service must have an Enhanced Disclosure and Barring Service (DBS) certificate, with checks against the children’s barred list.
• The pharmacy must register for access to NHS England’s Federated Data Platform (FDP) to manage their vaccine orders and submit stocktakes for the service.
• Offering appointments for the service through the National Booking Service (NBS) to patients. This will require:
  • Accurate information and timely publication of appointment or clinic times to allow patient bookings to take place.
  • At least 20 appointments being listed per month from the pharmacy owner’s service commencement date.
  • Maintaining available appointments times throughout the pharmacy’s full opening hours, including late afternoons and Saturdays (where the pharmacy owner is open on Saturdays).
• Pharmacies must administer at least 10 vaccines between October 2026 and January 2027 (or pro-rata for contractors who sign up later in the season though pharmacy owners must consider wastage limits, which must be less than 30%).

Pharmacy owners who feel they can meet the requirements set out in the service specification and who are confident they can support access to the eligible patients are encouraged to consider how they could provide this service alongside their existing vaccination services.

Pharmacy owners that choose to sign up to provide the service will be able to do so via the NHSBSA’s Manage your service (MYS) portal.

In order to receive vaccine ahead of the start of the service on 1st October 2025 (for children), pharmacy owners will need to register on MYS by 11.59pm on 31st August 2026.

Later registration after 31st August 2026 will be possible, but the provision of the centrally procured vaccine will be received after the starting date for the service.

The final deadline to register to provide the service is 11.59pm on 30th November 2026. If a pharmacy owner doesn’t register by this date, they will not be able to provide the service in 2026/27.

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Service start date and duration

The Annual flu letter confirms and authorises vaccination of all eligible children by general practices and the School Aged Immunisation Service (SAIS).

An update to the Annual flu letter was published on 9th June 2026 to add the vaccination of eligible children via the community pharmacy service.

The pharmacy service is intended to supplement the existing general practice offer (which commences on 1st September). It also aims to provide increased access to opportunities to receive a vaccination for children who missed being vaccinated in school by the SAIS.

The pharmacy service will begin from 1st October 2026 for pharmacies registered to provide the service at that point. Pharmacy owners that choose to provide the service can commence provision in line with the following timings:

Start date	Eligible cohort
From 1st October 2026	Children aged 2- and 3-year-olds; and Clinically at-risk children aged 2 years to less than 18 years
From 1st December 2026	Catch up vaccinations of school aged children (Reception to Year 11)

NHS England is asking participating pharmacies to maximise administration of the vaccine to Children aged 2- and 3-year-olds and clinically at-risk aged 2 years to less than 18 years by 30th November 2026.

They also note in the service specification, that following 30th November 2026, where an eligible patient presents for vaccination, it is generally appropriate to still offer it; this is particularly important if it is a late influenza season.

In the event that an eligible patient is in one of the at-risk groups and presents late in the flu season after all LAIV stock has expired, immunisation with an appropriate inactivated influenza vaccine is an option.

NHS England advise that vaccinators should apply clinical judgement to assess the needs of patients for immunisation. The decision to vaccinate should take into account the level of flu-like illness in the community and the fact that the immune response to influenza vaccination takes about 2 weeks to fully develop.

The service will close on 31st March 2027.

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Eligible patients

The Annual flu letter and the Update to the Annual flu letter confirm the eligible patient cohorts for the 2026/27 season.

The service covers:

• All children aged 2 and 3 years of age on 31st August 2026 – that means children who were born on or after 1st September 2022 and on or before 31st August 2024;
• Clinically at-risk children aged 2 years to less than 18 years; and
• Any primary school and secondary school aged children, from Reception to Year 11, who missed the opportunity to receive a flu vaccination from the SAIS and are not clinically at risk.

All children aged less than 2 years of age on 31st August 2026 are not covered by the service.

Pharmacy owners are not authorised to administer flu vaccines to other patient groups as part of the Childhood Flu Vaccination Service.

If a vaccine is administered to patients in other groups, the pharmacy owner will not be paid for that vaccination and the administration will have been undertaken outside the legal authority of the PGD or VGD.

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Vaccines for use in the service

The Annual Flu letter and the Update to the Annual flu letter confirms the vaccines to be used in the service.

Children aged 2 years to less than 9 years old in a clinical risk category and receiving influenza immunisation for the first time, will require a second dose of the appropriate vaccine at least 4 weeks after the first dose. Where two doses of vaccine are required, pharmacy owners should note that a failure to give both doses may leave a child incompletely protected.

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First line vaccine

The majority of eligible children will be vaccinated with Live attenuated influenza vaccine (LAIV) nasal spray suspension which is the first line vaccine.

If a pharmacy does not have stock of LAIV when a patient presents, the parent/guardian should be directed to an alternative provider who has stock of LAIV or they should be asked to rebook when further stock will be available at the pharmacy.

LAIV will be supplied by NHS England to pharmacies from centrally procured stock. This will be undertaken through the NHS England Federated Data Platform (FDP), rather than by UKHSA through ImmForm.

The FDP is the national data platform managed by NHS England that hosts the vaccine supply and ordering tools that will be used for the service.

Pharmacy owners must register for access to FDP to be able to order vaccines. The platform will also include an element of service readiness assurance ahead of the commencement of the service and it will also be used for the submission of vaccine stocktakes.

Guidance on how to register to access the FDP

Pharmacy owners will be able to order a minimum quantity of 10 doses (1 pack) of centrally supplied LAIV from the FDP.

Participating pharmacies who register to provide the service on MYS by 31st August 2026 will receive vaccine supply by 1st October 2026 (the service commencement date).

Pharmacy owners may only request subsequent supply of LAIV when:

• The pharmacy has recorded administration of at least 50% of the previously supplied doses; and
• Their current stock levels are confirmed to be below 1 pack; and
• They have appointments listed on NBS, which comply with the requirements set out in the service specification (at least 20 appointments per month after the pharmacy’s service commencement): or
• NBS booked appointments indicate a need for additional supply.

Any order placed by a pharmacy owner that does not meet the above requirements will be deferred until the pharmacy owner evidences they have been met.

All LAIV stock must be actively managed, with vaccine usage reported in the FDP in a timely manner. Pharmacy owners must not stockpile vaccine and are expected to utilise doses within the product shelf life.

Pharmacy owners must submit a valid stocktake in FDP within 7 days of any requests for additional vaccine; failure to report vaccine usage or stock levels accurately may result in temporary suspension of supply of the vaccine.

Pharmacy owners must take reasonable steps to reduce vaccine wastage and any that report more than 30% wastage (3 or more unused doses per pack not administered or salvaged within the shelf life) may have further supply withheld pending review by NHS England.

There is no reimbursement payment for vaccine stock that has been centrally procured, as it will be provided free-of-charge to pharmacy owners.

The manufacturer of the LAIV vaccine used in the NHS vaccination programme has a website for healthcare professionals, providing information on the product, including a video on how to administer the vaccine:

AstraZeneca Fluenz website for healthcare professionals

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Second line vaccine

When LAIV is contraindicated or otherwise unsuitable (for example, where parents object to LAIV on the grounds of its porcine gelatine content), cell-cultured inactivated influenza vaccine (IIVc).

IIVc will not be centrally supplied and pharmacy owners should obtain supplies by placing an order via manufacturers or wholesalers, in line with their normal approach to purchasing flu vaccine. They will be reimbursed for any stock they have used appropriately within the service.

If a pharmacy owner does not have IIVc in stock when required by a patient, parents/guardians, they should be directed to an alternative provider who has stock of IIVc or should be asked to rebook an appointment when stock is available at the pharmacy.

The reasons for use of the second line vaccine should be documented in the clinical record; evidence of this may be requested by NHS England before reimbursement is agreed.

The annual flu letter does include a third line vaccine, but this cannot be administered as part of this service.

There are several conditions that are specified in the service specification which pharmacy owners must comply with prior to provision of the service. These include:

• Pharmacy owners must be satisfactorily providing all Essential Services and be compliant with the clinical governance requirements of the Community Pharmacy Contractual Framework (CPCF).
• Pharmacy owners must be providing at least one NHS commissioned vaccination service and one service that involves the assessment or treatment of children (for example, the NHS Pharmacy First Service) to be able to provide this service.
• Pharmacy owners must notify NHS England that they intend to provide the Childhood Seasonal Flu Vaccination Service by completion of an electronic registration declaration through the NHSBSA MYS portal.
• Staff who will provide the service must be competent to provide the service (see section on training requirements and resources for further details).
• Staff who will provide the service must have an Enhanced Disclosure and Barring Service (DBS) certificate, with checks against the children’s barred list.

Other requirements or matters that pharmacy owners should consider before providing the service are detailed below:

• You must register on MYS by 11.59pm on 31st August 2026 to receive vaccine ahead of the service commencement date. Pharmacy owners can register after this date and before the registration deadline, however, it is not guaranteed they will receive vaccine in time for the service commencement date.
• The deadline to register on MYS is 11.59pm on 30th November 2026. If not registered by this date, pharmacy owners will not be able to provide the service in 2026/27.
• Pharmacy owners must not administer vaccines until they have registered to provide the service.
• There must be a consultation room at the pharmacy premises, except for distance selling premises (DSP) pharmacies, which meets the applicable requirements of the Pharmacy Regulations (see premises requirements below).
• DSP pharmacies are not permitted to provide vaccinations to patients at the pharmacy premises.
• You must have a standard operating procedure (SOP) in place for this service (see SOPs below).
• Vaccines administered under this service will usually be carried out on the pharmacy premises (except for DSP pharmacies), but they can also be undertaken in other suitable locations, such as in the patient’s home, or community venues (for example, community centres) subject approval from the service commissioner.
• Pharmacy owners must not administer vaccines to patients who are housebound unless the commissioner requests them to do so. Pharmacy owners can decide to accept or refuse this request. Pharmacy owners may also approach the commissioner to obtain approval to vaccinate these patients.
• Pharmacy owners must obtain approval from the commissioner if they wish to carry out vaccinations at a location that is not the pharmacy premises.
• The Responsible pharmacist (RP) at the registered pharmacy premises is professionally responsible for overseeing this service (see Professional oversight below)

A checklist to help pharmacy owners to prepare for and to provide the service is being developed and can be found below.

Download the pharmacy owner implementation checklist for the NHS Childhood Flu Vaccination Service (coming soon)

Vaccinator checklist

Download the vaccinator implementation checklist for the NHS Childhood Flu Vaccination Service (coming soon)
This checklist provides suggested actions that vaccinators need to undertake to prepare to provide the service.

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Standard Operating Procedure (SOP)

Pharmacy owners must have an SOP in place for provision of the service, having regard to the requirements of the PGD and service specification, and which covers the following points as a minimum:

• The provision of the service to patients and the roles of different staff members, including the training required for staff members;
• The ongoing conditions under which the service needs to be provided (set out in the service specification);
• Cold chain integrity;
• Needle stick injuries;
• The process for escalating any issues (clinical and non-clinical) identified during provision of the service and signposting details that can be used to guide parents/guardians to further support, where needed;
• The identification and management of adverse reactions;
• Record keeping requirements;
• The handling, removal and safe disposal of any clinical waste related to the provision of the service.

All pharmacy staff involved in the provision of the service, must be familiar with and adhere to the SOP.

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Premises requirements

The pharmacy (except for DSP pharmacies) must have a consultation room in which to provide the service, which meets the requirements of the Terms of Service.

The vaccination must take place in the consultation room wherever the patient, patient’s parent or guardian expresses this preference.

Vaccinations can also be offered in any area of the pharmacy where suitable facilities are available, infection prevention and control standards can be maintained and patient confidentiality and dignity is able to be respected.

Pharmacy owners must appropriately dispose of any clinical waste or personal protective equipment (PPE) used during the vaccination process and will therefore need to ensure they have contracted for a suitable clinical waste disposal service for their pharmacy premises.

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Professional oversight

The RP at the registered pharmacy premises is professionally responsible for overseeing this service.

If the RP is unable to provide sufficient oversight, for example due to workload or where vaccinations are undertaken off the pharmacy premises, an on-site pharmacist or pharmacy technician responsible for the delivery of the service must be linked and work closely with the RP and Superintendent Pharmacist through an appropriate governance framework to ensure appropriate oversight of the service.

Where vaccinations are undertaken off the pharmacy premises, pharmacy owners must ensure there is an on-site pharmacist or pharmacy technician responsible for the provision of the service (or delivering the vaccination service themselves) and that:

• Vaccines are administered by appropriately trained vaccinators in line with the appropriate legal mechanism;
• Appropriate professional indemnity insurance is in place that covers off-site vaccinations;
• Staff continue to adhere to all professional standards relating to vaccinations;
• Staff follow appropriate cold chain storage measures;
• The setting used to administer the vaccines is appropriate (including ensuring patient confidentiality and dignity can be respected); and

Staff appropriately dispose of any clinical waste or personal protective equipment used during the vaccination process.

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National Booking Service (NBS)

NBS will be used by patients, parents and guardians to book vaccination appointments at pharmacies.

Pharmacy owners must offer vaccinations through NBS to patient, parents and guardians, and the service specification states that:

• Accurate information must be published and appointment or clinic times be uploaded in a timely way to allow bookings to take place;
• At least 20 appointments must be listed per month from the service commencement date; and
• Appointments should be available at various times throughout the pharmacy’s full opening hours, including late afternoons and Saturdays (where the pharmacy is open on Saturdays).

Further information on use of NBS will be provided by NHS England to pharmacies signing up to provide the service.

Additionally, the pharmacy owner must offer vaccinations through advertised walk-in clinics via the Pharmacy Services Finder. The walk-in clinic times offered should promote access to the service, including late afternoons and Saturdays, where the pharmacy is open on Saturdays.

Pharmacy owners will be able to add the details of their walk-in clinic times via NHS Profile Manager.

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Provision of the service off the pharmacy premises

Vaccinations can also be undertaken in other suitable locations, such as in the patient’s home or community venues (e.g. community centres).

Pharmacy owners must obtain consent from the NHS England regional vaccinations team if they wish to carry out vaccinations at a location off the pharmacy premises.

There are various matters that a pharmacy owner will need to consider ahead of any provision of the service off the pharmacy premises, including:

Professional oversight: Where vaccinations are undertaken off the pharmacy premises, pharmacy owners must ensure there is an on-site pharmacist or pharmacy technician responsible for the delivery of the service (or delivering the vaccination service themselves) and who will ensure provision of the service is in line with the requirements of the service specification.

The setting used for vaccination: pharmacy owners must ensure that the setting used to administer the vaccinations is appropriate, including ensuring patient confidentiality and dignity.

Support staff: vaccinators should consider being accompanied by a trained pharmacy support staff member. The primary role of the support staff member would be to assist in the event of an emergency, but they could also undertake administrative tasks and, where necessary, act as a chaperone.

Clinical waste: pharmacy owners must appropriately dispose of any clinical waste or personal protective equipment (PPE) used during the vaccination process. That should include ensuring they meet the requirements of waste disposal legislation in relation to transferring pharmaceutical waste from the site of vaccination back to the pharmacy premises for subsequent safe disposal.

Maintaining the cold chain: vaccinators must ensure that the cold chain storage of the vaccines is maintained. Vaccines should be taken from the pharmacy fridge and placed into an appropriate validated cool box (which will maintain the vaccines at a temperature between 2˚C and 8˚C) just before travel to the off-site location.

The vaccines should be kept in their packaging and should be insulated from the cooling system within the cool box, e.g. using bubble wrap, to avoid the risk of freezing.

Professional standards: when considering any provision of flu vaccination services outside the pharmacy, pharmacy owners and their pharmacists/pharmacy technicians must ensure they continue to comply with all professional standards.

Any planning or risk assessments undertaken ahead of off-site provision need to keep these standards central to considerations of how to provide the service, as they will offer a useful framework to help decision making.

Indemnity insurance: pharmacy owners must ensure their professional indemnity cover applies to provision of the service off the pharmacy premises.

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Engagement with local GP practices 

Prior to provision of the service, pharmacy owners may want to engage with local general practices to make them aware the pharmacy is participating in this service.

A letter / email template to support pharmacy owners to notify GP practices that the pharmacy will be providing the service is available.

Download the GP letter/email service notification template (Microsoft Word) (coming soon)

Staff providing the service and administering vaccines will need to be authorised to operate under the PGD. That means the service will generally be provided by pharmacists and pharmacy technicians within community pharmacies, but other registered healthcare professionals able to operate under a PGD may also administer vaccines.

Any pharmacy staff involved in the provision of the service should receive appropriate training relevant to the role they will undertake and pharmacy owners are required to demonstrate that all staff providing the service in their pharmacy have the skills and knowledge needed to do so, including working within the relevant systems and processes set out by the pharmacy owner and understanding how to report concerns, should any be identified.

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The content of training for vaccinators

Staff providing the service and administering vaccines will need to be authorised to operate under the chosen legal mechanism (PGD/VGD). That means the service will generally be provided by pharmacists and pharmacy technicians within community pharmacies, but other registered healthcare professionals able to operate under a PGDs/VGDs may also administer vaccines.

Any pharmacy staff involved in the provision of the service should receive appropriate training relevant to the role they will undertake and pharmacy owners are required to demonstrate that all staff providing the service in their pharmacy have the skills and knowledge needed to do so, including working within the relevant systems and processes set out by the pharmacy owner and understanding how to report concerns, should any be identified.

The content of training for vaccinators

Vaccinators providing the service must have undertaken appropriate training in line with the National minimum standards and core curriculum for vaccination training.

This document describes the training that should be given to all practitioners engaging in any aspect of immunisation so that they are able to confidently, competently and effectively promote and administer vaccinations.

The document was updated in June 2025 and replaces the previous training standards for registered healthcare practitioners and healthcare support workers.

Pharmacists, pharmacy technicians and other vaccinators who will administer flu vaccines must have completed practical training in vaccination that meets the requirements set out in the document.

They must also ensure they are competent to administer vaccines to children aged 2 years old and above using both LAIV and IIVc.

This may include the completion of the e-learning for health flu immunisation training for LAIV.

There are several organisations offering training and support for the provision of flu vaccination services and contact details can be found below.

The frequency of training

Pharmacists, pharmacy technicians and other vaccinators providing the service need to attend face-to-face refresher training periodically.

This refresher training should help to ensure consistency of practice, provide peer support and allow discussion of any clinical issues that are arising in practice.

Pharmacy owners and vaccinators will need to consider when it would be appropriate to attend refresher training or if ongoing competence of an individual vaccinator can be evidenced, without the need for face-to-face training.

An individual’s continued competence may be influenced by their prior experience vaccinating patients, including the overall number of vaccines administered and the regularity with which they administer vaccines.

Understanding the relevant clinical guidance

The service specification requires that the pharmacy owner ensures vaccinators have read and understood the clinical guidance available in relation to the service and that they have a process in place to check any updates to these documents.

The key sources of clinical guidance in relation to this service will be:

• Immunisation against infectious disease: the green book (Chapter 19 Influenza); and
• The PGD or VGD for the service (which is currently being developed by UKHSA and which will be published shortly.

Annual update training

Vaccinators are expected to undertake annual update training, to ensure their knowledge stays up to date with changes in practice and guidance.

This may involve self-directed learning, using relevant references sources, such as the Green Book and the annual flu letter. It may also include online training which is available from a range of providers.

Assessment of vaccinator competency

The National minimum standards and core curriculum for vaccination training recommends that immunisers should keep a portfolio of completed competency checklists, knowledge test score sheets, reflective logs, completion of e-learning course certificates and certificates of attendance at immunisation training courses and updates.

This will provide vaccinators with a means to be able to show evidence of completion of training and achievement of competence to both current and future employers. It will also provide useful evidence of continuing professional development for professional revalidation.

Pharmacy owners must ensure that vaccinators are competent to provide the service and they must keep evidence of competency relating to any staff that they employ or engage to provide the service.

The Declaration of Competence (DoC) approach, using the Vaccination Services DoC (hosted on the Centre for Pharmacy Postgraduate Education website) is one way which pharmacy professionals providing the service can demonstrate their competence to the pharmacy owner.

Alternatively, the competence of any vaccinators can be assured using the National minimum standards and core curriculum for vaccination training competency assessment tool in appendix A of the guidance.

This can be used as a self-assessment tool, an assessment tool for use with a supervisor or both depending on the previous experience of the vaccinator.

The recommendations that accompany the assessment tool advise that all new flu vaccinators should complete the competency assessment for formal assessment and sign-off of their clinical competency.

Any flu vaccinators returning to vaccination after a prolonged interval should also complete appropriate update training and the appropriate vaccination competency assessment. As the circumstances and training needs for individual practitioners returning to vaccination will vary, there is no defined time interval for ‘prolonged’, but vaccinators and their supervisors need to be assured of their competence before they provide the service.

Training resources

e-Learning for Healthcare Flu Immunisation online course
This interactive flu immunisation e-learning programme, written by UKHSA and NHS England, is available for anyone involved in providing the flu vaccination programme.

The manufacturer of the LAIV vaccine used in the NHS vaccination programme has a website for healthcare professionals, providing information on the product, including a video on how to administer the vaccine:

AstraZeneca Fluenz website for healthcare professionals

Immunisation
This is a gateway page that provides access to a variety of e-learning programmes and resources. The page is designed by CPPE and includes links to some of their e-learning programmes that support vaccination. Their programmes are developed for pharmacists, pharmacy technicians and foundation trainee pharmacists.

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Training providers

There are a number of organisations that provide vaccination training. Those that we have been made aware of are listed in the Training requirements and resources section of the Seasonal Vaccination Services – COVID-19 and Adult Flu webpage on our website.

Listing on this page does not constitute endorsement of the course or provider by Community Pharmacy England.

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Pharmacy team training 

The whole pharmacy team can proactively promote this service. Teams should be briefed on the service and coached on how to best approach people about the service.  A pharmacy team briefing is being developed to assist pharmacy owners to engage and brief their team members. 

This section contains additional information and resources to support pharmacy owners and their teams to provide the Children’s Flu Vaccination Service.

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Community Pharmacy England resources

We have developed additional resources which pharmacy owners can use to assist with their understanding, implementation and provision of this service to patients. 

Implementation guidance

Pharmacy owner implementation checklist for the NHS Children’s Flu Vaccination Service (coming soon)
A checklist to help pharmacy owners to prepare for and to provide the service. 

Vaccinator implementation checklist for the NHS Children’s Flu Vaccination Service (coming soon)
This checklist will provide suggested actions that vaccinators need to undertake to prepare to provide the service.

Pharmacy team briefing for the NHS Children’s Flu Vaccination Service (coming soon)
This Briefing will assist pharmacy owners to engage and brief their team members about the service.

Childhood Flu Vaccination Service webinar

Community Pharmacy England held a joint webinar on the service with NHS England, on Wednesday 20th August 2025.

Watch the on-demand version of the webinar

Webinar slides (20th August 2025)

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Joint guidance and briefing documents

National flu immunisation programme letter 2026/27 (the Annual Flu letter) (updated 26th February 2026)

Update to the Annual flu letter (published on 9th June 2026)

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UK Health Security Agency (UKHSA) guidance and briefing documents

UKHSA flu programme website hub

Influenza vaccines marketed in the UK  Influenza vaccines marketed in the UK for 2026/27, including ovalbumin content (26th February 2026)

Protocol for ordering, storing and handling vaccines

Vaccine incident guidance: responding to errors in vaccine storage, handling and administration

Flu vaccination programme: information for healthcare practitioners

Immunisation against infectious disease: the green book (Chapter 19 Influenza)

UKHSA Vaccine Update bulletin

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Other resources

Anaphylaxis action card – Personalise this card and keep it by the phone to guide staff on calling an ambulance if a patient has an anaphylactic reaction to a vaccine.

Anaphylactic guidelines and algorithm poster (Resuscitation Council UK) (May 2021)

NICE – Guideline 103, Flu vaccination: increasing uptake (August 2018)

This section provides information on some of the practical requirements related to provision of the Children’s Flu Vaccination Service.

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Patient consent

As with the provision of any pharmacy service, prior to vaccination, informed verbal consent must be sought from the patient (where appropriate),or the parent/guardian of each patient for the administration of the vaccine.

Informed consent should be recorded in the pharmacy’s clinical record, including the name of persons that have consented on the patient’s behalf and that person’s relationship to the patient.

The General Pharmaceutical Council’s Guidance on Consent provides further information on consent for pharmacists and their teams.

The patient (where appropriate)/parent/guardian of each patient should also be advised of the information sharing that will take place for the appropriate recording of the vaccination in the patient’s GP practice record and information that will be shared with NHS England and the NHS Business Services Authority (NHSBSA) as part of post-payment verification.

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Service records, IT support and sharing of data

Pharmacy owners must use NHS England’s Record A Vaccination Service (RAVS) system for making their clinical records.

Read more about RAVS

RAVS user guide

Pharmacy owners without access to RAVS can request access through the following link.

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General requirements related to record keeping:

• Pharmacy owners must maintain appropriate electronic records to ensure effective ongoing service delivery. Records must be managed in line with the Records Management Code of Practice for Health and Social Care.
• Pharmacy owners must ensure that the vaccination event is recorded on the same day that it is administered unless exceptional circumstances apply.
• Pharmacy owners must ensure vaccination records are complete and include all of the required fields about the patient.
• Pharmacy owners must ensure that any staff recording the administration of the vaccination have received relevant training to be able to update records appropriately and accurately.
• Where the Point of Care System is unavailable due to exceptional circumstances beyond the control of the pharmacy owner, then the record of vaccination events must be added to the it as soon as possible after the system becomes available again.
• Where a record of a vaccination needs amending or has not been created on the point of care system, the pharmacy owner is responsible for undertaking the amendment or creation as soon as reasonably possible following notification from the patient or another healthcare professional that the record is not complete or correct.

Use of Point of Care IT systems:

• There must be robust user and access management processes to ensure high levels of security in relation to staff access to the Point of Care System. That should include frequent updates to system access levels to add users who join the pharmacy team or remove accounts where staff leave or do not have shifts scheduled at the pharmacy.
• Only one Point of Care System can be used to record vaccinations in any calendar month except where it is necessary to make amendments to previously recorded vaccination events or where this has been agreed with NHS England during the transition to a new Point of Care System.

Retention of records:

• Records must be managed in line with the Records Management Code of Practice for Health and Social Care.
• The necessary records required for reimbursement must be kept for a period of three years to demonstrate the service was delivered in accordance with the service specification, and to assist with PPV activities. These records must be provided by a pharmacy owners when requested by the NHSBSA Provider Assurance Team.
• Pharmacy owners should ensure that clinical records for the service are retained for the appropriate period. This retention period may be beyond the specified period for PPV purposes and should be in line with both the requirements for the record type and the age of the person being vaccinated. You can find links to further guidance on this topic on our Data handling, record keeping and disposal webpage.

Sharing of data:

• Data recorded via the Point of Care System regarding the patient’s vaccination will be shared with the patient’s registered general practice (where this is known) automatically on the day of provision or on the following working day. This will be sent as a structured message in real-time by the point of care system.
• If the structured message system is not available or fails, the pharmacy contractor must ensure a copy of the vaccination notification is sent or emailed (via NHSmail) to the patient’s registered general practice as soon as reasonably possible.
• Some of the data recorded in the Point of Care System will be shared via an application programming interface (API) with the NHSBSA’s MYS platform as part of normal payment arrangements.
• Pharmacy owners must promptly comply with any reasonable request for information from NHS England (or an organisation acting on their behalf) relating to this service.
• Personal data recorded in Point of Care Systems will flow to NHS England for managing and monitoring vaccination programmes; it will also be shared with the UKHSA under a Data Sharing Agreement.
• Data that has been pseudonymised may be used by the NHS for evaluation and research purposes.

Storage of vaccines

Vaccines should be stored in line with the requirements set out by their manufacturer in the Summary of Product Characteristics.

In 2014, Public Health England issued guidance on the protocol for ordering, storing and handling vaccines for all healthcare providers involved in vaccinations, including community pharmacies.

Additional guidance, published by UKHSA, is also available in Chapter 3 of the Green Book ‘Storage, distribution and disposal of vaccines’.

All refrigerators in which vaccines are stored must have a maximum / minimum thermometer. Readings must be taken and recorded from the thermometer on all working days and appropriate action taken in a timely manner when readings are outside the recommended temperature range.

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Information resources for parents/guardians to use before/during/after consultations

Childhood Flu Vaccination Service – online information sources for parents and carers (coming soon)

When pharmacy professionals are providing these vaccinations, there are several leaflets/websites for parents and carers to be signposted to.

This resource lists all the patient-facing leaflets/website links, including the marketing authorisation holder’s patient information leaflets (hard copies will be available within the vaccine’s packaging, with copies also being available from medicines.org.uk/emc).

Parents and carers of each child being administered a vaccine should be given a copy of the manufacturer’s patient information leaflet about the vaccine or be directed to a web-based version of the leaflet.

Hyperlinks to the leaflets/websites are listed, alongside QR codes for each leaflet/website so parents and carers can scan these to access the leaflet/website link on their mobile phones.

UKHSA leaflets to promote the service are also available and these can be downloaded and printed or parents or carers can be directed to a web-based version of the leaflets. Links to these can be found in the Promoting the service to patients section below.

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Safeguarding

During the consultation, if there are concerns about a potential safeguarding issue, then appropriate action should be taken, where necessary, in line with local safeguarding processes.

Guidance on safeguarding can be found in NHS England’s Safeguarding App/website.

Your Local Pharmaceutical Committee may also have details of local safeguarding contacts on their website.

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Clinical waste

Pharmacy owners are required to make arrangements for the removal and safe disposal of any clinical waste and PPE related to the provision of this service. This includes where vaccinations are carried out off-site or in a patient’s home.

Pharmacy owners must also ensure that staff are appropriately trained and made aware of the risks associated with the handling and disposal of clinical waste and that correct procedures are used to minimise those risks. A needle stick injury procedure must be in place.

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Communicating and working with GP practices

When pharmacy teams provide the service, notifying the patient’s GP practice of the administration of the vaccine is an important service requirement.

Data recorded via the Point of Care IT System regarding the patient’s vaccination will be shared with the patient’s registered general practice automatically on the day of provision or on the following working day. This will be sent as a structured message in real-time by the point of care system.

If the structured message system is not available or fails, the pharmacy owner must ensure a copy of the vaccination notification is sent or emailed (via NHSmail) to the patient’s registered general practice as soon as reasonably possible.

Where a patient presents with an adverse drug reaction following the initial vaccination and the pharmacist believes this is of clinical significance, such that the patient’s GP practice should be informed, this information should be shared with the GP practice as soon as possible.

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Dealing with local issues related to the service

Sometimes issues with the service may arise between GP practices and community pharmacies; in this situation pharmacy owners may wish to seek support and advice from their LPC.

Occasionally we receive reports of GP practices issuing information to their patients that unfairly or inaccurately represents the community pharmacy service. If this occurs, we advise pharmacy owners to raise the issue with the GP practice concerned. If that does not resolve the issue, pharmacy owners should raise the matter with the ICB primary care contracting team and their LPC.

Sometimes examples of such information get circulated via social media and other routes, which can create a larger issue from a single incident than may be warranted and it also potentially inspires others to copy the approach. We recommend that LPCs and pharmacy teams avoid sharing such matters via social media, as it will not help long term community pharmacy/GP relationships; incidents should be dealt with locally wherever possible.

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Dealing with incidents arising from the provision of the service

If an incident occurs in relation to the service, pharmacy owners are required to report any patient safety incidents in line with the Clinical Governance Approved Particulars for pharmacies.

Where necessary, the pharmacy owner is also expected to follow UKHSA’s Vaccine incident guidance: responding to errors in vaccine storage, handling and administration.

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Withdrawal from provision of the service

If the pharmacy owner wishes to stop providing the service, they must notify NHS England that they are no longer going to provide the service via the MYS platform, giving 30 days’ notice prior to the cessation of the service. They must continue to provide the service for the duration of the notice period. Pharmacy owners that de-register before the service commencement date are not required to give 30 days’ notice.

Pharmacy owners must ensure they update NBS and NHS Profile Manager when they cease provision of the service.

If a pharmacy owner de-registers from the service, they will be unable to re-register for a period of 4 months from the date of de-registration.

The deadline to register for this service is 11:59pm on 30th November 2026; de-registering may mean that a pharmacy owner will be unable to re-register to provide the service in 2026/27.

NHS England is developing a communications campaign to highlight the new pharmacy offer to the patents/guardians of eligible children. This will include the development of communications assets which can be used locally and NHS England will also be seeking supportive national and local press coverage of the service once it commences in October.

National invitations to present for vaccination sent by NHS England to the parents/guardians of eligible children will include information about the pharmacy offer and details of how to book an appointment at a pharmacy via NBS.

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Community Pharmacy England resources

We have developed a range of materials which pharmacy owners can use to promote the availability of this service to patients and additional resource to highlight the additional cohorts will be available shortly. 

Our shared folder (link below) allows you to download the latest versions of the following resources: 

• Posters for display (both ready to use and editable versions); 

• Suggested social media graphics and messages; 

• Flyers for attaching to prescription bags; and

• Template local press releases.

Download here: Childhood Flu Vaccination Service promotional materials 

We are developing a checklist so pharmacy owners can work through the checklist to see if there are any additional activities that they or their teams could participate in to promote the service:

Childhood Flu Vaccination Service promotion to the public checklist (coming soon)

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UKHSA resources

Leaflets

Flu vaccination for children: leaflets and posters 2026 to 2027 (19th May 2026)
‘Protect your child against flu – information for parents and carers of children in primary school or pre-school’ leaflet. Paper copies of this leaflet will also be available to order for free or download on the Health Publications website.

This leaflet is available to order and download in the following languages: Albanian, Arabic, Bengali, Bulgarian, Chinese (Simplified), Chinese (Traditional), Dari, Estonian, Farsi, French, Greek, Gujarati, Hindi, Italian, Latvian, Lithuanian, Nepali, Panjabi, Pashto, Polish, Portuguese, Romanian, Romany, Russian, Somali, Spanish, Tagalog, Tigrinya, Turkish, Twi, Ukrainian, Urdu, Yiddish and Yoruba.

Accessible versions will soon be available to order and download.

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Stickers

Free stickers are available to order using product code SCHFLSTK. These stickers are for healthcare practitioners to give to children who have received a flu vaccine. There are 72 stickers per sheet.

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Posters

‘Five reasons to vaccinate your child against flu’ poster for primary schools and pre-schools is available to order using the product code FLU5RY24.

This poster is available in the following languages: Albanian, Arabic, Bengali, Brazilian Portuguese, Chinese (simplified), Chinese (traditional), Estonian, Farsi, Greek, Gujarati, Hindi, Latvian, Lithuanian, Panjabi, Polish, Romanian, Romany, Russian, Somali, Spanish, Turkish, Twi, Ukrainian, Urdu and Yiddish.

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Developing your own marketing materials

If pharmacy owners decide to develop their own marketing materials to promote the service they must ensure they comply with the requirements of the Terms of Service relating to promotion of services funded by the NHS.

If pharmacy owners choose to use the NHS identity on their marketing materials they must follow the primary care guidelines for use of the NHS identity.

An A-Z style guide of words and phrases about health and the NHS, which aims to make content aimed at patients easy to understand, is available on the NHS website. The NHS website team try to use words on their website that people use themselves when they talk about their problems and when they search for information on the internet. Community pharmacy teams may wish to refer to the guide when producing their own health content or communication materials.

Pharmacy owners will be paid £10.06 for each vaccine administered.

This fee is funded from NHS vaccination budgets, not from the Community Pharmacy Contractual Framework contract sum.

LAIV is supplied free of charge and will not be reimbursed as part of this NHS Influenza Programme.

When LAIV is  contraindicated or otherwise unsuitable, where pharmacy owners administer IIVc under the service, they will be reimbursed for the vaccine cost at the basic price (list price) of the individual vaccine administered and an allowance at the applicable VAT rate will also be paid.

Basic prices can be confirmed using the NHS Business Services Authority’s DM+D browser.

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Claiming payment

The Point of Care IT System which pharmacy owners and their teams use to make a clinical record for the service will also populate a claim for payment, via an API within the NHSBSA’s MYS portal.

The transfer of data via the API happens throughout the month, as data is entered into the IT system. The service provisions will then be available to view in MYS from the 1st of the following month.

For example, service provisions in October will be available to view in MYS on 1st November. Pharmacy owners will need to log into the MYS platform to check that the data matches the details in their IT system, and they will then need to submit their claim for payment.

Pharmacy owners must claim payment within one month of, and no later than three months from the claim period for the chargeable activity provided.

Claims which relate to work completed more than three months after the claim period in question will not be paid and the pharmacy owner will not receive any payment for the administration of those vaccinations. The exception to this is where the submission of a claim was delayed by IT issues outside the pharmacy owner’s control (such as issues with the NHS approved API system used by the contractor or with the MYS portal). Such claims will be accepted outside the usual grace period within 12 months of the date by which the claim should have been submitted. This is subject to the NHSBSA receiving evidence of the IT issue, and only if investigation finds that the evidence demonstrates that the IT issue was outside the control of the contractor, and it delayed the claim submission.

Payments to pharmacy owners will be made monthly as part of their normal payment schedule.

Payment will only be made for flu vaccinations administered from the service commencement date onwards.

Childhood Flu Vaccination Service – Frequently Asked Questions (FAQ) page

Success with the childhood flu vac service (18th February 2026)

Anil Sharma, pharmacy owner of a small group of pharmacies in Cambridgeshire, Suffolk and Norfolk, has been successful with provision of the new Childhood Flu Vaccination Service, as well as other vaccination services this season.

Read more about what Anil and his team have done to maximise the success of the Childhood Flu Vaccination Service, as well as other vaccination services, at their pharmacies

At Community Pharmacy England, we are always keen to hear from pharmacy owners and their teams about how the provision of national pharmacy services is going, be that niggles with the way services are commissioned, a success story you want to share or something else.

Please click on the link below to share a success story where you have helped achieve a good outcome for a patient following a consultation for a national pharmacy service or to provide feedback on one of the services.

Provide feedback on national pharmacy services