Medicine And Books

Managing Immunization in General Practice

BMJ 1995; 311 doi: (Published 26 August 1995) Cite this as: BMJ 1995;311:577
  1. Douglas Jenkinson, general practitioner
  1. Keyworth, Nottingham

    Michael Ingram Radcliffe, £14.95, pp 112 ISBN 1 85775 1558

    Giving immunisations in general practice requires clinical, organisational, and management skills. Clinical skills are largely catered for by the Department of Health's “green book,” but it did not answer the question I was asked this week: “How, doctor, can you be sure it is safe to give my baby whooping cough vaccine when he has been in contact with a case and may be incubating it?”

    Managing Immunization in General Practice does not concern itself with such questions because it is entirely about organising and managing an immunisation service--setting it up, running it, auditing it, meeting targets, calculating target payments, appointment systems, and stock control. Dr Ingram's chatty style glides effortlessly through these and all other aspects of managing immunisation in British general practice whether NHS or private--or the hotchpotch of both that necessitates a book such as this in the first place.

    Financial matters, medicolegal ones, who can do what, where, when and what their roles are, these topics are analysed and tabulated. The book makes clear what is almost incomprehensible in the “red book” of rules and is impressively up to date with current claim regulations. I have learnt that I cannot claim for oral typhoid vaccine, which probably explains why nobody uses it, and if I wanted to be really ambitious and get a franchise for a British Airways travel clinic this book can tell me how.

    Immunisation takes up a large amount of general practice time and effort and generates a good proportion of income, so general practitioners take it seriously through financial necessity, but I have mixed feelings about the way mediocre immunisation rates bounded through the 90% barrier when the target payment system was introduced, and how the wider application of this principle is now crushing general practice.

    This book would be useful for any member of the primary care team to dip into for reference or clarification of some bureaucratic difficulty, but if somebody in my practice really depended on it I would transfer the job to someone with more talent, and if a GP partner found fascination in any book on management I could worry about my future happiness.

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