Intended for healthcare professionals


Covid-19: GPs could get extra funding to boost vaccine uptake in hard-to-reach groups

BMJ 2021; 372 doi: (Published 24 February 2021) Cite this as: BMJ 2021;372:n548

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  1. Gareth Iacobucci
  1. The BMJ

General practices could be offered “additional discretionary payments” to improve uptake of the covid-19 vaccine in hard-to-reach groups such as deprived and minority ethnic communities.

An update to the national covid-19 enhanced service,1 published on 22 February, said that NHS England “may make additional discretionary payments available to GP practices to support the delivery of or incentivise vaccinations in particular seldom heard groups in exceptional circumstances.”

The changes, which have been agreed with the BMA’s General Practitioners Committee, come amid concerns about the gap between different patient groups in terms of vaccine uptake, as emerging evidence23 shows that uptake is lower among ethnic minority patients.

NHS England said that details of additional payments would be made available on its website (

Sam Everington, a GP in Bromley-by-Bow in east London and chair of the Tower Hamlets Clinical Commissioning Group, said that, in addition to the extra funding, vaccines should be distributed to all general practices in deprived areas—not just designated sites—to reach more people. He cited GPs’ success locally in vaccinating housebound patients when all practices were involved.

“We have a 95% vaccination rate among housebound people, which is stunning, and that has happened when every general practice is involved in the vaccination programme,” he told The BMJ. “There is a very clear solution, and that is to bring vaccination down to every practice in areas like ours where you’ve got this big difference between the communities. People respond much better to the GPs and nurses that they know.”

Delivering vaccines

As of 24 February, said Everington, 87% of white adults aged over 70 in Tower Hamlets had been vaccinated, compared with only 76% in the Asian community and 62% in the black community. This variation concerned him, he said, because the way the covid vaccination system was being coordinated in England was “institutionally discriminating against deprived groups.”

He added, “Big vaccination sites are invariably further away from people’s homes. People may not have a car or may not be able to travel for medical reasons. We need the vaccine delivered like the flu vaccine to surgeries. I want every practice to be doing it.”

Earlier this week the Runnymede Trust, a race equality think tank, called for vaccines to be offered door to door in deprived and minority ethnic communities.4

And the government, in a document published this week setting out its covid-19 plan and road map for spring 2021,5 said that it wanted to ensure that “no one is left behind” in vaccination.

It said, “There are early signs of lower vaccine uptake in lower income and some ethnic minority groups which the government is taking steps to address. Surveys have found that there is higher vaccine hesitancy in some Black and Asian communities, hence the need to encourage uptake in these groups specifically.”

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