Vaccine targets in QOF

Is it right that Vaccine targets in QOF are not on a scale and there is no way to exempt a person who refuses to be vaccinated? 1st MMR target is 95% – we have over 90% done but only 1/18 points as the indicator does not allow us to exclude those with informed dissent or other valid reasons. We have taken on a load of Afghan refugees and registered them fully and providing all health care to them but we stand to loose £30K income because they didn’t have mmr in their country in the right time scale! – thats a nurse we might have to sack… is this fair?

GPs in deprived areas tell me this is a common thing for them – that they constantly suffer because their population doesn’t attend for these things. They work harder to achieve and fail to be rewarded than more affluent areas – is this how we reduce health inequalities? Perhaps its just easier to not bother at all for anyone is that right?

We urgently need the ability to exclude those that either have informed dissent or just refuse to engage despite trying (most other indicators have this).