Now that spring is here and the Easter holidays have arrived, patients will no doubt be turning their attention to holidays – bringing the requirement for travel vaccinations and the provision of travel clinics to the fore.

For years, these clinics have been a healthy way of generating additional revenue for practices but now, due to several factors, practice managers are beginning to think twice about their benefits and whether or not they are worth the time and effort and whether there’s actually any return on investment.

Time is money

Increasingly, many practices are deciding to close their travel clinics, mostly due to staff pressures.

One practice manager, commenting on the Practice Index Forum, said: “We have given up on travel and insist patients go to the local travel clinic. The travel clinic charges £25 for a first appointment and give the patient a vaccination schedule of what they need. Once the patient has this document, we book them into a nurse appointment(s) for any vaccines that are free on NHS, and the patient attends the travel clinic for the others.”

There’s no getting away from the fact that GPs and travel medicine trained practice nurses can spend considerable time giving pre-travel advice and administering vaccines to travellers. Time costs money, with additional costs spent providing advice to travellers over the phone, making appointments, stocktaking, ordering and claiming for the vaccines. And, as one practice told us, while some of the costs of providing a travel health service are readily identifiable, such as the purchase cost of vaccines, other operating costs are not so transparent.

Adequate charges

For practices that do still provide travel services, ensuring that all costs are charged for is essential. BMA guidance points out that the process of administration of relevant immunisations is chargeable as well. Further, detailed guidance can be found here.

Another useful post on the Practice Index Forum said: “[Providing chargeable vaccinations] is a private service and you have to cost it properly like a private service. There’s nothing to say you must provide private vaccines at cost. You are allowed to make a profit so look at other practices nearby, and private travel clinics to see what they offer the same vaccinations for.”

It’s worth remembering that patients travelling to parts of the world that require travel vaccinations will likely have spent a decent sum on their holiday already, so quibbling over an extra tenner for a vaccination might not be high on their agenda – so don’t undersell your services.

Payment in advance

Another reason cited by practices for closing their travel clinic is the high volume of DNAs – and the associated costs practices are burdened with.

To overcome this PMs suggest charging in advance for vaccinations. “We make patients pay for their vaccinations at the time of booking the appointment – they have a quick phone chat with a nurse first, who advises what they need,” one PM told us. “This has drastically reduced our DNAs.”

Pros and cons

While the above can help make travel clinics more profitable, their value versus staff time is still debateable. So how can you work out whether you should continue offering the paid for services or walk away from them?

Answering a few key questions can steer you in the right direction:

Do enough patients have travel vaccination needs?

An audit of the past three to six months should provide an answer. Do also factor in changes such as the yellow fever vaccination becoming a lifetime one, rather than being needed every ten years, which will reduce demand.

Do you know the exact cost of providing private travel vaccinations?

Staff time, costs related to running the clinic and treatment room, equipment and the vaccinations themselves all must be factored in.

Will investment be required in training, equipment such as vaccine fridges and systems or software going forward?

What are these costs and is it worth doing?

There’s no one size fits all answer for practices, so it pays to do your own sums.

Further advice

If you are planning to continue with your travel clinic (or indeed set up a new one if a local practice is closing theirs), here are a few more handy hints:

• Try not to mix travel vaccinations in with other nurse clinics
• Hold a dedicated session if you have demand
• Is it worth work with neighbouring practices to host a centralised travel clinic?
• Could you team up with neighbouring practices to buy vaccines in bulk and get a bigger discount?
• Ensure a list of charges are clearly displayed in the reception area
• Market your services in order to maximise uptake – a very useful, cost-effective marketing guide is available here

And finally…

Finally, it’s worth sharing some information shared with a practice manager who pointed out that if you are contracted to deliver Additional Services through the core contract you have to provide the NHS funded vaccinations. You can’t opt out of some vaccinations and not others. If you opt out you also stop doing childhood vaccinations etc.

It’s also worth noting that travel advice is an essential service so practices still must see patients and give them geographic specific advice about their trip.

As mentioned above, whether or not you provide private travel vaccinations is a matter of practice choice – the secret is to make it an informed choice.

What are your thoughts on travel clinics? Is there enough demand? Can practices make enough money? Or is it time to ditch them? Let us know by commenting below or on the forum thread here.

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