GP surgeries across London are warning they may opt out of the 2026/27 flu vaccination programme unless the government addresses what they describe as a severe funding shortfall. The dispute centres on BMA flu vaccine funding, with doctors arguing that the current payment structure no longer reflects the real cost of delivering safe and effective vaccination services.
The British Medical Association (BMA) has formally warned the Chief Medical Officer that the current payment of £10.06 per flu jab frozen since 2018/19 is no longer financially viable. Rising staffing costs, higher energy bills, increased indemnity expenses and broader inflationary pressures mean practices are effectively delivering vaccinations at a loss.
While the issue is national, London surgeries say the impact may be particularly acute in the capital, where operating costs are among the highest in the UK.
Why Are GPs Demanding a 34% Increase in Flu Vaccine Funding?
The central issue in the BMA flu vaccine funding debate is the Item of Service (IoS) fee paid to GP practices for each flu vaccine administered.
The Specific Demand
The BMA is calling for the IoS fee to increase from £10.06 to £13.48 per dose – a rise of 34%.
This increase, according to the BMA, would restore the fee to its 2018/19 value in real terms after years of inflation. The association argues that without this uplift, practices will struggle to justify participating in the seasonal vaccination campaign.
The Inflation Gap
Although the £10.06 fee has remained unchanged since 2018/19, practice costs have not.
Confirmed economic data shows:
- General inflation has significantly eroded spending power since 2018.
- Staffing costs in healthcare have risen.
- Energy and operational overheads have increased sharply, particularly in urban areas.
The BMA states that practices have absorbed an estimated real-terms cut of around 25% over the past seven years.
This is a confirmed financial reality: when a payment remains static while costs rise, its real-world value declines.
A Comparison With Childhood Vaccination Fees
In contrast, childhood vaccination fees received a £2 uplift in 2025/26, highlighting a disparity that many GPs find difficult to justify.
The BMA argues that adult flu vaccination a cornerstone of winter public health planning should receive similar recognition.
It is important to clarify:
- Confirmed fact: The adult flu IoS fee is £10.06 and has not increased since 2018/19.
- Proposed change: The BMA is requesting a rise to £13.48.
- Not confirmed: There has been no government agreement to implement this increase.
What Is the Risk to London Patients?
The debate around BMA flu vaccine funding is not simply about GP income. It concerns how and where patients access vaccinations during winter.
Opt-Out Threats
Many practices must commit to ordering flu vaccine stock months in advance. If the funding structure remains unchanged, some London practices are reportedly considering:
- Not signing up to deliver the 2026/27 campaign
- Reducing the number of clinic sessions offered
- Limiting outreach programmes
These are not confirmed withdrawals at this stage. However, the warning signals a potential disruption.
Health Inequality Concerns
Professor Chris Whitty, the UK’s Chief Medical Officer, has previously warned that failing to maintain systematic vaccination coverage in older groups could cause “significant harm”.
Older adults, people with chronic conditions, and vulnerable groups rely on accessible GP-led vaccination services. London boroughs with higher deprivation levels may be particularly affected if local surgeries reduce provision.
The Pharmacy Factor
If GP participation declines, more responsibility would fall to community pharmacies.
Pharmacy flu vaccination fees were recently raised to match the GP rate of £10.06. However:
- Pharmacies may not have the same long-term patient relationships.
- Capacity during peak winter months can already be stretched.
- Some patients prefer receiving vaccines from their registered GP practice.
The concern is not that flu vaccination will stop entirely, but that access patterns may shift, potentially widening health inequalities.
Government and NHS Response to the Funding Dispute
The Department of Health and Social Care has pointed to an additional £1.1 billion investment in the 2025–26 GP contract as evidence of broader support for primary care.
The Official Position
The government maintains that:
- GP practices are receiving increased overall funding.
- Winter vaccination remains a national priority.
- Flu vaccines continue to be provided free to eligible patients.
These are confirmed policy positions.
The BMA’s Rebuttal
The BMA counters that general contract investment does not address the specific operational demands of running large-scale flu clinics.
Running flu clinics involves:
- Hiring additional staff or locums
- Extending opening hours
- Administrative scheduling
- Cold-chain storage and clinical safety compliance
The BMA argues that without targeted uplift in flu vaccine reimbursement, practices may have to subsidise the programme from already stretched budgets.
This is the crux of the BMA flu vaccine funding debate: whether general funding increases adequately support targeted public health delivery.
Fact Box: Flu Vaccine 2025/26 Key Statistics
| Key Metric | Figure |
| Current GP Flu Vaccine Fee | £10.06 |
| BMA Proposed Fee | £13.48 |
| Percentage Increase Requested | 34% |
| Last Fee Increase | 2018/19 |
| Total NHS Flu Jabs (2024/25) | 18.2 million |
These figures reflect confirmed data from NHS programme reporting and BMA communications.
Why Does This Matter for Patients in Practical Terms?
Consider a typical London GP practice serving 10,000 patients.
If 3,000 eligible patients receive flu jabs:
- At £10.06 per dose, income totals £30,180.
- At £13.48 per dose, income would be £40,440.
That £10,000 difference may fund additional nursing hours, weekend clinics, or administrative support.
Without it, practices must either absorb the shortfall or scale back activity.
For patients, this could mean:
- Fewer appointment slots
- Reduced community outreach
- Greater reliance on pharmacy services
- Potential travel to alternative providers
Importantly, flu vaccines will still be available through the NHS. The debate concerns sustainability and delivery structure not eligibility removal.
Confirmed Facts vs Proposed Changes vs Misinformation
Confirmed Facts
- The GP flu vaccine IoS fee is £10.06.
- The fee has been frozen since 2018/19.
- The BMA is requesting an increase to £13.48.
- 18.2 million flu jabs were delivered by the NHS in 2024/25.
Proposed Changes
- A 34% uplift in the IoS fee.
- Potential reassessment of vaccination delivery models if funding remains unchanged.
Misinformation to Avoid
- There is no confirmed cancellation of the flu programme.
- There is no announcement that patients will be charged.
- There is no evidence that flu vaccines will become unavailable.
The issue is about funding adequacy, not programme termination.
The Bigger Picture: Primary Care Sustainability
The BMA flu vaccine funding campaign reflects wider concerns about the financial sustainability of general practice.
GP surgeries across the UK have faced:
- Workforce shortages
- Increasing patient demand
- Rising premises costs
- Expanding administrative obligations
Seasonal vaccination programmes are vital public health tools. However, they must also be financially viable for providers.
London practices, operating under particularly high cost pressures, argue that without adjustment, participation decisions may become increasingly difficult.
What Happens Next?
The outcome will likely depend on negotiations between the BMA, NHS England and the Department of Health.
Possible scenarios include:
- A negotiated partial uplift
- Continued freeze with compensatory contract adjustments
- Structural changes in delivery models
For now, flu vaccination remains part of national winter planning.
Patients are advised to:
- Monitor official NHS communications
- Book vaccinations early once eligible
- Check availability with both GP practices and pharmacies
Conclusion
The debate over BMA flu vaccine funding highlights a broader tension between public health priorities and frontline financial realities.
GPs argue that without a 34% uplift, delivering flu vaccinations at scale may become unsustainable. The government maintains that broader investment supports primary care.
For patients, the key reassurance is that flu vaccination remains a national priority. However, how and where it is delivered could depend on the outcome of ongoing funding negotiations.
As winter planning begins for 2026/27, clarity on flu vaccine reimbursement may prove crucial in safeguarding both clinic sustainability and patient access.
FAQs
How is flu vaccine funding structured for GP practices?
GPs receive an Item of Service payment for each eligible flu jab administered. This payment covers staffing, clinical time and operational costs rather than the vaccine product itself.
Does the funding dispute affect eligibility for a free flu vaccine?
No. Eligibility criteria are set nationally and remain unchanged.
Why hasn’t the flu vaccine fee increased since 2018?
The fee was set in 2018/19 and has remained frozen. Inflation has since reduced its real-world value.
Could London patients struggle to access flu vaccines?
There is no confirmed reduction in access. However, some practices are warning that participation could be affected if funding concerns are not resolved.
Are pharmacies better funded than GP practices for flu vaccines?
Pharmacy fees were recently aligned to match the GP rate of £10.06 per dose.
What is the main argument behind the 34% increase request?
The BMA argues the uplift restores the fee to its original real-term value after years of inflation.
When will a decision be made about the funding increase?
There is no confirmed timeline. Discussions are ongoing between stakeholders.
