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The launch of the children’s flu vaccination advance service comes at a time when independent pharmacies are already overstretched, as Victoria Goldman explains…

Since September 2025, the UK Health Security Agency (UKHSA) has been urging all eligible patient groups to book their NHS flu, Covid-19 and respiratory syncytial virus (RSV) vaccinations as soon as possible, as cases of all three infections are on the rise, along with Covid-19 hospitalisations.

The UKHSA has also been highlighting that toddlers can now get their flu vaccination (as a nasal spray) through community pharmacies.

The launch of the new children’s flu vaccination advance service comes at a time when community pharmacies are already overstretched – and will be even more so as the winter season continues.

There are concerns about how well community pharmacies will cope with the extra demands placed on their time, finances and expertise over the coming months.

Organisations are working to ensure stock availability

“Pharmacists are already central to supporting patients with winter ailments – from coughs and colds to sore throats and flu,” says Professor Claire Anderson, Royal Pharmaceutical Society president.

“With the right support and recognition, pharmacy teams can continue to play a pivotal role in keeping communities well this winter and are preparing with updated training, clear service specifications and robust protocols. Organisations are working to ensure stock availability and digital infrastructure are in place to support delivery.

“But we know that success depends on more than logistics – consistent commissioning, adequate funding and workforce support are essential. Pharmacists are ready to deliver, but they need the system to back them.”

Lindsey Fairbrother, superintendent pharmacist at the Good Life Pharmacy in Hatton, Derbyshire, says that pharmacies can no longer rely on sales of cold and flu remedies to keep them financially secure.

“The way to make pharmacy viable is to see patients regularly through Pharmacy First consultations,” she says, “as well as providing the winter vaccinations, especially since more vaccinations will be coming through pharmacies in the future, and training as independent prescribers and using the Independent Prescriber pathways where applicable.”

Expanded role

According to the Company Chemists’ Association (CCA) in September 2025, the number of conditions through Pharmacy First should be increased, with additional funding to support the additional workload for pharmacists to meet patient demand.

This would expand patient access, free up GP appointments, and enhance the capabilities of the pharmacy workforce. Initial conditions for expansion suggested by the CCA include lower respiratory chest infections, which would improve patient access to winter health advice.

Alastair Buxton, director of NHS services at Community Pharmacy England (CPE), says that the winter season will bring a boost in demand for Pharmacy First – as is common with all NHS service providers at this time of year.

“Given the huge potential of the service, we are pushing for DHSC and NHS England to scale up advertising and public awareness and drive referrals from GPs and other NHS providers to Pharmacy First,” he says.

“This will be of critical importance this winter when the service is likely to be of most value to patients struggling to access other parts of the healthcare system.”

One of the national campaign topics for this year’s Community Pharmacy Contractual Framework (CPCF) will require pharmacies to focus on promoting Pharmacy First to the public.

Buxton says: “We have developed a range of promotional materials to help pharmacy teams to meet that CPCF requirement and raise awareness of the service, including posters, social media assets and an animation – all available in our Pharmacy First hub: cpe.org.uk/pharmacyfirst.”

Toddler flu vaccinations

The new Childhood Flu Vaccination Advanced service has been commissioned for a one-season trial, administering flu vaccinations to children aged two to three years. Its impact will be evaluated after the 2025/26 season to inform policy decisions around whether the service will be commissioned in the future.

“There is growing evidence that using pharmacies to deliver vaccinations helps to increase take-up, particularly among patients who have historically not taken up the offer of vaccination,” says Henry Gregg, chief executive of the National Pharmacy Association.

“Pharmacies are quick and convenient to access for patients, and the government should use them for more NHS vaccination campaigns, if they are to maximise take-up and prevent more serious illness.”

Professor Claire Anderson says that community pharmacies are ideally placed to support vaccination uptake among children, given their accessibility and expertise in medicines.

“Extending this service to children aged two and three can help strengthen early protection against flu and reduce its wider impact,” she says.

“For this to be successful, pharmacy teams must receive the necessary support to deliver these services safely and effectively — including appropriate funding, training and access to digital infrastructure. Consistent and sustainable commissioning will be key to ensuring equal access and protecting public health.”

Lindsey Fairbrother agrees that this is an important service to be included within community pharmacy. “Pharmacies are using the nasal spray for children, and this is easy to do,” she says.

“When we launched the service at the beginning of October, we opened a separate clinic as we didn’t know how well parents and children would respond to a pharmacist giving the vaccine rather than a GP or nurse.

“We had no problems at all and have now changed to a walk-in service, having seen how well it works. The payment isn’t enough – it never is. But I would happily do more children’s flu vaccinations in future years.”

Community Pharmacy England has developed additional materials to promote the new flu vaccination service for toddlers. These materials include checklists, posters, social media content and an on-demand webinar – all available from the CPE’s Childhood Flu Vaccination Service page.

“We are confident that pharmacy teams will be able to increase vaccination rates by providing a convenient and accessible service to parents/guardians and their eligible children,” says Buxton.

“It represents another strategically important step towards community pharmacies being able to support the delivery of all NHS vaccination programmes. However, pharmacy owners will need to reflect on the relatively small (e.g. in comparison to the adult flu cohort) size of the eligible cohort of children before they decide to opt to provide the service.”

To support members to deliver a successful winter health services, Numark has also developed a range of resources.

“This year a number of our members are participating in the pilot childhood flu vaccination services, enabling them to complement their existing adult flu vaccination service and provide support for protection to more people within their communities,” says Lucy Morris, patient services pharmacist at Numark.

“Our resources include Standard Operating Procedures (SOPs), implementation checklists, training resources for all the pharmacy team and marketing resources. They also have access to the Numark information team, if the pharmacy teams have any clinical queries.”