The 2026/27 COVID-19 Vaccination Service | What Could Change for Primary Care Networks

At THC, we provide resources for primary care leaders and the focus of this blog is the delivery of COVID-19 and adult influenza vaccinations moving forward.

What struck me isn't just the operational change. This specification asks practices to deliberately decide what they want to deliver at the practice level versus the PCN level.

As neighbourhood working develops, the question of what is best delivered at the practice, PCN, and federation/ neighbourhood levels will need to be answered more often.

The 2026/27 COVID-19 Vaccination Service Headlines:

On 15th December 2025, NHS England published the 2026/27 COVID-19 and adult influenza vaccination Enhanced Service Specification, found here.

For the first time, both programmes sit in a single document.

• Individual practices can now deliver COVID-19 vaccinations – PCN groupings are no longer required

• The £10 housebound supplement has been removed

• COVID-19 vaccinations are now recorded in GPIT (not point-of-care systems)

• A lower item of service fee applies during flu season – the model assumes co-administration

• For some PCNs, this represents an opportunity to offer network-level support where practices would value it

Keep reading for the details.

What's Changed from 1 April 2026

COVID-19 Vaccination Service

Practice-level delivery is now permitted. From April 2026, individual practices can sign up to deliver COVID-19 vaccinations directly. They are no longer required to form a PCN grouping. Practices that wish to collaborate through their PCN can still do so, but this is now optional rather than mandated.

Important: If a practice signs up for the COVID-19 vaccination service, it must also deliver the adult influenza vaccination service. This requires a separate CQRS registration. You cannot deliver COVID-19 vaccinations without also offering flu.

GPIT recording replaces point-of-care systems. Practices will record COVID-19 vaccinations in their clinical system and claim via CQRS – the same process used for other vaccination services. Manage Your Service (MYS) will no longer be used for COVID-19 claims.

The £10 housebound payment has been retired. There is no longer an additional payment for vaccinating housebound patients. However, the base item of service fees have been increased.

Adult Influenza Vaccination Service

The combined specification covers vaccination for patients aged 18 years and over. Childhood flu vaccinations (ages 2–17) will be commissioned through a separate

Enhanced Service specification.

The adult flu item of service fee remains £10.06 per vaccination.

Changes Applying to Both Programmes

Call/recall requirements have been aligned. Practices must now undertake proactive call/recall for all eligible patients for both COVID-19 and flu vaccinations.

Vaccination locations. Practices can administer vaccines on practice premises, in patients' homes, and in care homes. Commissioner consent is required for any other location.

Care home coordination remains mandatory. Practices participating in one or both seasonal vaccination programmes and belonging to a PCN must collaborate with other practices within their network to offer vaccinations to all care home residents collectively.

The Payment Structure

Period	COVID-19 Payment
1 April – 31 August 2026	£10.06
1 September 2026 – 31 January 2027	£8.70
1 February – 31 March 2027	£10.06

The reduced COVID-19 rate during flu season reflects an expectation of co-administration.

For PCNs that have operated centralised COVID-19 clinic models with dedicated staffing and premises, the £8.70 rate may not cover overheads if vaccines are not being delivered alongside flu.

The adult flu item of service fee is £10.06 throughout the programme. Flu service dates will be announced by the Commissioner.

Spring 2026 COVID-19 Campaign – Confirmed Cohorts

The government has confirmed acceptance of JCVI advice for Spring 2026. The eligible cohorts are:

•       Adults aged 75 years and over

•       Residents in a care home for older adults

•       Individuals aged 6 months and over who are immunosuppressed (as defined in COVID-19: the green book, chapter 14a)

Campaign dates: 13 April 2026 to 30 June 2026

Priority should be given to care home residents and eligible housebound patients. Autumn/winter 2026 eligibility and start dates will be announced separately.

Key Dates for Sign-Up

Deadline	Action Required
5 January 2026	CQRS registration opens for COVID-19 vaccination service
23:59 on 2 February 2026	Deadline to register for COVID-19 service to receive vaccine supply for Spring campaign
31 July 2026	Deadline to register for COVID-19 service to receive vaccine supply for Autumn/Winter campaign
31 July 2026	Deadline for adult flu service sign-up (to be confirmed)
23:59 on 30 November 2026	Final deadline for flu-only registration

Practices can register after these dates, but vaccine supply in time for campaign start dates is not guaranteed.

Why Has This Changed?

The Publication accompanying the specification states that NHS England knows practice-level delivery "will be welcomed by many practices." The move to GPIT recording is explicitly described as "in response to practice feedback."

In short: this change aligns COVID-19 vaccination delivery with how flu has always worked – practice-level sign-up, clinical system recording, CQRS claims. For many practices, that's operationally simpler and mirrors existing workflows.

What This Means in Practice

For PCNs that already deliver flu collectively, this is largely business as usual. Nothing prevents collective delivery; it's simply no longer mandated.

For PCNs that don't currently deliver vaccinations collectively, this could be an opportunity. Some practices may welcome PCN-level support where capacity or premises constraints make independent delivery difficult.

For PCNs that have delivered collectively but are reconsidering, that's a legitimate choice as well. If practices have capacity and want to retain income, practice-level delivery might be the right answer.

The Decision for PCN Leaders

The default delivery model has changed. This requires an active decision from your network – not passive continuation of existing arrangements.

The question for your PCN Board

Are practices delivering COVID-19 vaccinations independently, or is the PCN coordinating a collective approach?

There is no prescribed answer. Both models are permitted. But the choice needs to be made explicitly.

If practices deliver independently

•       Each practice registers on CQRS

•       Each practice orders vaccine, runs clinics, and claims payment

•       Practices retain their own income

•       The PCN role focuses on care home coordination (which remains a Network Contract DES requirement)

If the PCN coordinates delivery

•       The network agrees on governance, cost-sharing, and payment distribution

•       Shared clinics and pooled resources remain an option

•       This is a local choice, not a contractual requirement

•       Financial modelling should account for the £8.70 flu-season rate

The Operational Details That Matter

Planning assumptions are required. When signing up, practices must provide planning assumptions on vaccine numbers. If included in the February sign-up, they do not need to be resubmitted for the July deadline.

15-day recording rule. Vaccinations must be recorded in the patient record on the day of administration. If a record is not created within 15 days, the practice will not be eligible for the item of service payment.

Vaccine wastage threshold. Persistent COVID-19 vaccine wastage above 30% may result in reduced or paused supply.

Newly diagnosed patients. Patients who develop severe immunosuppression outside the delivery period should be considered for catch-up vaccination based on clinical judgement. This can be delivered by another practice within the PCN if agreed.

The Conversation to Have with Your Practices

Some practices will want to deliver independently, it mirrors how flu has always worked and they keep the income.

Others may find independent delivery difficult due to smaller lists, limited nursing capacity, or premises constraints. Surface this early.

Every network will have a different starting point – financially, operationally, and in terms of what's worked before.

What Happens If You Don't Decide?

If the PCN does not actively address this:

•       Some practices sign up, some do not

•       Vaccine supply fragments

•       Care home coverage becomes unclear

•       Patients fall through gaps

•       September becomes firefighting rather than vaccinating

The Bottom Line

This programme is now designed around routine general practice delivery rather than PCN infrastructure.

PCNs can still deliver collectively, but by choice, not requirement. The funding model assumes practice-level, co-administered delivery.

Have the conversation now. Make a decision. Document it. Plan accordingly.

About Us

THC Primary Care is an award-winning healthcare consultancy specialising in Primary Care Network Management and the creator of the Business of Healthcare Podcast. With over 20 years in the industry, we've supported more than 200 PCNs through interim management, training, and consultancy.

Our expertise spans project management and business development across both private and public sectors. Our work has been published in the London Journal of Primary Care, and we've authored over 250 blog posts sharing insights on primary care networks.