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NHSE: Practices may need to ‘prioritise clinical activity’ to deliver Covid vaccinations

by Awil Mohamoud
11 November 2020

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GP practices may need to ‘prioritise clinical activity’ in response to the additional workload pressures that a Covid-19 vaccination programme will bring, NHS England has said

The new direct enhanced service (DES), announced this week (9 November), outlined preparations practices need to make for the programme, which could start as early as December.

Under the contract, practices will be expected to work together as part of primary care network (PCN) ‘groupings’ to ‘vaccinate the maximum number of patients in the minimum amount of time’.

NHS England said its ambition is for general practice to ‘remain fully open and accessible to all patients’ but that the additional workload may require practices to ‘prioritise clinical activity’.   

It added: ‘We recognise that running a potential Covid-19 vaccination programme requires ‘all hands to the pump’ and pragmatism. We encourage systems to maintain and develop local ways of maximising joint working between PCNs and their community partners.’

Seven days a week service

The DES requires practices to nominate a single local site to deliver vaccinations from by 17 November, which will then be assessed by CCGs for its suitability. 

The document said the designated site would need to deliver the vaccination service between 8am and 8pm ‘seven days per week, including bank holidays’ if vaccine supplies allow, and each site will be expected to administer ‘a minimum of 975 vaccinations’ every week.

NHS England has also confirmed that CCGs will receive £150m to support GP practices with managing routine demand, while they work to deliver the programme, with the expectation that this money is spent on boosting GP numbers and capacity and helping to tackle the backlog.  

‘Logistical challenges’

Professor Martin Marshall, RCGP chair, said in a statement on Monday (9 November) that general practice needed more clarity on which tasks should be prioritised to free up capacity for the vaccination programme. 

He said: ‘GPs and our teams are making more consultations than we were before the pandemic, delivering the largest flu vaccination programme ever, and preparing for usual winter pressures. 

‘We need to understand which tasks should be prioritised to make capacity for any involvement in the Covid vaccination programme – and how it should sit alongside the flu vaccination programme. There will also likely be logistical challenges to overcome, for example, around supply and storage of the vaccine – which may require new or additional equipment for some practices.’

He added: ‘GPs and our teams across the UK are hugely experienced in delivering vaccination programmes with high uptake rates. As long as our service is properly resourced, it makes sense for general practice to play a central role in delivering the Covid-19 vaccine.’

Workload prioritisation guidance

This comes as the RCGP and BMA last week (5 November) issued guidance to practices on how they should prioritise workload during the second wave of Covid-19. 

The guidance outlined a series of ‘response levels’ for workload prioritisation – ranging from zero, where all services would be running, to five, where all non-essential work should be stopped to allow general practice to cope with ‘potentially overwhelming’ demand relating to Covid.

The two bodies said that the pandemic was currently at the point where practices should stop some or ‘a significant volume’ of non-essential work – a level three or four response. 

The guidance also said that ‘at all levels of response’ practices must communicate that general practice is open and to help maintain public confidence.