C-19 & Adult Flu vac: joint 2026/27 service spec published, with fee uplifts from April 2026

Summary:

• New joint service specification for COVID-19 and adult flu vaccinations published.
• COVID-19 vaccinations become an Advanced service.
• Fees for both vaccinations uplifted, but additional fee for housebound patients removed.
• Pharmacy owners must use the National Booking Service (NBS) for COVID-19 vaccinations, but this is still not a requirement for flu.
• Registration for spring COVID-19 campaign opens from 5th January, and pharmacy owners must register by 2nd February 2026 to guarantee supplies in time for the start of the spring season.

Following discussions with Community Pharmacy England, NHS England has today (15th December 2025), published a new service specification that covers the provision of both seasonal vaccination services (COVID-19 and adult flu) in community pharmacy for the 2026/27 season.

From 1st April 2026, the COVID-19 Vaccination Service will become an Advanced service. The new service specification will allow pharmacy owners to either offer COVID-19 and adult influenza vaccinations together or just offer adult flu vaccinations.

The approach removes the need for Integrated Care Boards to separately procure a COVID-19 Vaccination Service and seeks to streamline the provision of COVID-19 vaccinations in line with the Adult Flu Vaccination Service. The service specification retains the requirement for pharmacy owners to offer flu vaccines when providing COVID-19 vaccinations but maintains the flexibility for pharmacy owners just to provide an NHS Flu Vaccination Service.

The service specification includes revised registration requirements and these are set out below, along with relevant deadlines.

Funding changes

NHS England has confirmed in a system letter an increase in the adult flu item of service fee for community pharmacies in 2026/27 from £9.58 to £10.06. This brings the fee in line with the GP arrangements and follows continued pressure by Community Pharmacy England for an increase in service fees for the sector.

NHS England has also agreed to an increase to the COVID-19 vaccination item of service fees. Pharmacy owners will be able to claim £8.70 per vaccine administered between 1st September 2026 and 31st January 2027 while the flu vaccination campaign is underway; and £10.06 outside the flu vaccination campaign period.

As part of the change in fees, there will no longer be an additional £10 payment for the administration of COVID-19 vaccinations to housebound people.

Changes to the service requirements

In addition to the changes in item of service fees, and to the registration requirements set out below, several amendments have been made to the service requirements:

• Pharmacy owners will be commissioned under an Advanced service for COVID-19 vaccinations from April 2026. As is the case now, where a pharmacy owner wants to provide the COVID-19 Vaccination Service, they will also be required to deliver the Adult Flu Vaccination Service.
• The current COVID-19 vaccination provisions around surge, pausing of services and designation of sites have been removed to align with the flu service requirements.
• There is no change to the requirement to use the NBS. Pharmacy owners that will be providing COVID-19 vaccinations must use NBS and pharmacy owners are strongly encouraged to use NBS for adult flu vaccinations and co-administered vaccinations.
• The training requirements for the service (see paragraph 5.2.1 of the service specification) now include the completion of e-learning for healthcare website modules on COVID-19 vaccinations and flu vaccinations (staff providing the service at pharmacies only offering flu vaccination do not need to undertake the COVID-19 vaccination training module).
• Pharmacy owners must seek agreement from their commissioner if they want to provide COVID-19 and flu vaccinations away from the pharmacy premises.
• Pharmacy owners may be asked by their commissioner to vaccinate the following patients:

• • Those who are housebound for COVID-19 and/or flu;
  • Those who are in a care home for COVID-19 and/or flu;
  • Those who are under 18 years old for COVID-19 only, where they also have an enhanced DBS check against the adult and children’s barred list; and
  • Those who have developed severe immunosuppression when there is no active COVID-19 campaign, but who would benefit from having a COVID-19 vaccination.

Pharmacy owners, however, do not need to agree to provide these vaccinations. Pharmacy owners can also ask their commissioner for permission to vaccinate these patients, but they must have their commissioner’s approval before vaccinating.

• Pharmacy owners who want to provide the service must now complete a service registration both for the COVID-19 and adult flu vaccination services, in line with other Advanced services.
• If pharmacy contractors do not register to provide the service before administering COVID-19 or adult flu vaccines, they will not be paid for the vaccines administered while they were not registered.

Commenting on the announcement, Janet Morrison, Chief Executive of Community Pharmacy England, said:

“Community Pharmacy England is pleased that community pharmacies will now receive the same vaccination fees as GP practices after many years of us calling for parity.

“The Committee has also secured concessions, such as keeping the National Booking System optional for flu vaccinations and allowing the use of local appointment systems.

“These changes should help planning for future vaccination seasons and provide a long-overdue fee increase for seasonal vaccinations starting in April 2026.” 

Read the NHS England system letter and new service specification

Access the COVID-19 Vaccination Service electronic registration declaration form (open from 5th January 2026)

Further Information

Spring 2026 COVID-19 Vaccination programme

The publication of the system letter and combined specification coincides with the Government’s confirmation of its acceptance of the Joint Committee on Vaccination and Immunisation advice on eligibility for the spring 2026 COVID-19 vaccination programme.

The letter confirms the authorised eligible cohorts for the COVID-19 spring 2026 vaccination programme are:

• Adults aged 75 years and over;
• Residents in a care home for older adults; and
• Individuals aged 6 months and over who are immunosuppressed, as defined in COVID-19: the green book, chapter 14a.

Vaccination will begin from 13th April 2026 and end on 30th June 2026, with priority being given to patients living in care homes for older adults and eligible housebound patients.

Signing up to provide the services, including deadlines

• Pharmacy owners that want to provide the COVID-19 Vaccination Service from the start of the spring campaign must register between 5th January 2026 to 2nd February 2026 to ensure that they receive supply of COVID-19 vaccines in time for the start of the spring campaign.
• Pharmacy owners can continue to register for the COVID-19 vaccination service after 2nd February 2026, but they are not guaranteed to receive supplies of the COVID-19 vaccine for the start of the spring campaign.
• Pharmacy owners that want to register for the COVID-19 Vaccination Service on or before 31st March 2026, must complete their electronic registration declaration using this form (the form will only be open from 5th January 2026). This is an interim arrangement until the NHS Business Service Authority’s ‘Manage Your Service’ (MYS) registration is available in April 2026.
• Pharmacy owners that want to de-register from the COVID-19 Vaccination Service on or before 31st March 2026 can also de-register using this form.
• MYS will be available for registration and de-registration from 1st April 2026, for both the COVID-19 and Adult Flu Vaccination Services.
• Any pharmacy owner that has registered or de-registered for the COVID-19 service on the interim form before this date will have this information automatically transferred into MYS. They will not need to re-confirm their registration or de-registration.
• Pharmacy owners that want to register to provide the COVID-19 Vaccination Service from the anticipated autumn/winter campaign must do so by 31st July 2026 through the MYS portal.
• Pharmacy owners can continue to register after this date, but they are not guaranteed to receive supplies of COVID-19 vaccine in time for the start of this campaign. If they have registered to provide the service for the spring campaign, they do not need to re-register.
• Pharmacy owners that register for the COVID-19 Vaccination Service will be automatically registered for the Adult Flu Vaccination Service, as this is a requirement of COVID-19 vaccination registration. In this circumstance, pharmacy owners will not have to register for the Adult Flu Vaccination Service separately. This will be automatic, regardless of whether they registered using the interim form or the MYS portal.
• Pharmacy owners that want to provide only the Adult Flu Vaccination Service will be able to sign up from 1st April 2026 on the MYS portal. Pharmacy owners are encouraged to register to provide adult flu vaccinations by 31st July 2026 to inform local system planning for autumn/winter.
• The overall deadline for pharmacy owners to register to provide COVID-19 and/or adult flu vaccinations on MYS is 30th November 2026. If pharmacy owners do not register by this date, they will not be able to deliver either of the vaccinations under the service in 2026/27.