Does an NHS GP Surgery have to provide a travel service?

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At the current time the answer is YES, all NHS GP practices must provide travel health in England. (This page was written 12th June 2023.)

The evidence is in:

The Update to the GP contract agreement published by the BMA and NHS England on 6 February 2020, it stated under the heading Global sum payment and new core standards, at point 5.4 (found on page 29): Vaccinations and immunisation becomes an essential service which should be available to the whole practice population, rather than an additional service. All practices will be expected to offer all routine, pre and post-exposure vaccinations and NHS travel vaccinations to their registered eligible population, as the overwhelming majority do. (Note, the contract that was negotiated was for a period of 5 years from 2020 so this remains a current provision of service).
The NHS patient page for immunisation including travel was updated in March 2023 and has comprehensive information the traveller needs to be aware of regarding their entitlement of travel services. It also includes details about which vaccines are provided as an NHS service and which are private travel vaccines.
The Care Quality Commission (CQC) Mythbuster for pre-travel health services also makes it clear that NHS GP practices are required to offer certain vaccinations for the purposes of travel, free of charge. (This was updated September 2024).

Additional information

Some have argued that the GP Contract only refers to the provision of ‘NHS travel vaccines’ and therefore, because there is no relevant wording, this does not include a pre travel risk assessment or provision of advice. It is unfortunate that it has been interpreted in this way because to practice safely it is impossible to give the NHS travel vaccines without undertaking a pre travel risk assessment. Part of that process is about providing advice to enable a shared decision making process with the traveller. (The advice includes the risk at the destination, the preventive risk advice to include all non vaccine preventable diseases e.g. safety, security, accidents etc. and the vaccine preventable diseases. A discussion of any contraindications to giving the vaccine to the traveller is needed. This must take into consideration their medical, medication and previous vaccine history. This would also include ensuring the national immunisation records were brought up to date if vaccines are missing e.g. MMR, and malaria prevention advice to protect the health of the traveller and reduce NHS costs of treatment on the traveller’s return (especially in the case of malaria).

The CQC says : A pre-travel risk assessment must be performed by the healthcare practitioner either: giving the travel vaccine under a Patient Group Direction (PGD), or delegating the administration of the travel vaccine under a Patient Specific Direction (PSD).

So what are the legal requirements?

In an NHS setting, travel vaccines are most often supplied under a Patient Group Direction (PGD). However, PGDs do not remove inherent professional obligations or accountability. It is the responsibility of each professional to practise only within the bounds of their own competence and professional code of conduct. Such or similar wording is found on the signatory section of national PGD templates and individuals signing the document, then agree to abide by the legal framework of the document.

Sometimes a Patient Specific Direction is used for administration of travel vaccines (e.g. if administration is outside the PGD framework) but then the person issuing that PSD should work within the Competency Framework for all Prescribers, and should be performing the travel risk assessment including the advice.

Where can you find further information?

The RCN Travel Health Nursing: career and competence development 2023 (see in particular pages 16 and points 4 and 5 on page 34). Also timing appointment guidance and timing see page 32. A blog about this publication can be read here.
Good Practice Guidance for a Travel Health Service 2020 from the Faculty of Travel Medicine at the Royal College of Physicians and Surgeons of Glasgow.

PLEASE NOTE:

I have created a short e learning piece to help understand some of the DILEMMAS in DELIVERING TRAVEL HEALTH at the current time as many things are happening which could put practice at risk. Please take a look to understand more.