Covid vaccination sites including those led by pharmacies could be paused or closed down permanently over the next few months if commissioners decide they no longer represent value for money, NHS England and Improvement has said.

In guidance to commissioners and healthcare providers, NHSE&I said local vaccination sites can continue to deliver services under enhanced service and local enhanced service contracts until September 30.

However, that extension came with the proviso that primary care network and community pharmacy-led sites remain viable. As well as providing value for money, they will need to demonstrate there is sufficient patient demand and no wastage of vaccines to justify keeping the site going.

There are 1,597 pharmacy sites according to NHSE&I’s latest figures as well as 1,079 GP-led sites. It said commissioners and providers “should mutually agree which sites will pause” but sites can put across their case as to why they should continue.

If a resolution is not found, disputes can be taken to NHSE&I regional teams or the relevant national vaccination programme team who will make a final decision.

Sites can be reactivated if they reach an agreement with commissioners but NHSE&I said the number of sites reactivated each week is likely to be capped.

Sites will be reactivated if they can show they are able to deliver vaccines and vaccinate hard-to-reach parts of the population. Uptake rates and numbers of people who are unvaccinated will also be taken into account.