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Some regions face prospect of no GP-led Covid vaccinations

by Nicola Merrifield
18 November 2020

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Around 5% of primary care network clinical directors in England have said their PCN will not be signing up to the Covid vaccination enhanced service contract, a new survey by Pulse has revealed.

The news comes as local GP leaders have warned of ‘impossible’ requirements of the enhanced service offered by NHS England.

Two PCNs told Management in Practice’s sister title, Pulse, there were no other GP organisations feeling able to take over the programme in their region so far.

The Pulse survey of 205 PCN clinical directors also revealed just over 25% are still undecided about whether to take part – right up to yesterday’s deadline to nominate a vaccination site for the area.

The programme is going to be delivered by ‘PCN groupings’, which will broadly align to PCNs. NHS England has said that there will be areas where PCNs will collaborate to offer a single vaccination site between them.

Among the nine PCNs that have taken the decision not to take part in the enhanced service, some told Pulse they were aware of neighbouring PCNs or GP federations that would step in to provide the vaccinations for their patients instead.

However, in Sittingbourne in Kent, the PCN will not be signing up to the DES and the LMC has said there is no other PCN that will be taking on the vaccination programme for them.

NHS Kent and Medway CCG said it ‘will make sure all eligible patients are offered a vaccination’.

Sittingbourne PCN joint clinical director Dr Reshma Syed told Pulse there were problems with finding a designated site, as well as workloads and providing care to other patients. She said: ‘We are not signing up due to the logistics of administration and organisation of this mass Covid vaccination and not being able to deliver it from individual GP practices.’

She said if the PCN had signed up to the enhanced service, its practices would have to stop doing QOF work, day-to-day GP services and the rest of the PCN DES work.

Kent LMC medical director Dr John Allingham said that practices in the region are concerned about delivering the vaccine at a loss.

He added: ‘The commissioners – either NHS England or the CCG – are going to have to find an alternative provider to deliver the service for that group of patients in that area.’

But he warned it would be difficult for another organisation – such as a community trust – to get access to the practices’ patient records.

Another PCN clinical director whose network will also not be signing up to the enhanced service – and in a region where no other local GPs have said they can step in – said it was ‘almost an impossible task.’

The GP, who asked to remain anonymous, told Pulse: ‘We decided not to take on the DES due to the logistics, managerial time, organising it all at short notice, having to work at weekends, bank holidays, staff time – and that’s with everyone fit and well and not having to self isolate.’

‘You can imagine the chaos. Overall if you look at the delivery of it, it was almost an impossible task and probably needs to be done at scale.’

Pulse’s survey, which took place between 12 and 17 November, revealed 69% of clinical directors will sign up their PCN to the national Covid-19 vaccination programme.

But around 59% of all respondents said the item of service fee – of £12.58 per vaccine dose – is not appropriate, with most of those saying it would not cover their costs and the rest saying they would only break even from the enhanced service.

Meanwhile, 66% warned their PCN’s practices would have to stop other GP work to deliver the vaccination programme.

When asked about what concerns they had about the programme, clinical directors cited extra workload as the issue they worried about the most, followed by lack of staff and the estimated five-day shelf life of the vaccine.

A spokesperson for NHS Kent and Medway CCG said: ‘GP practices are working on proposals for how they are able to take part in the Covid vaccination programme and these will be submitted to the CCG.

‘This detail will be used to develop a Kent and Medway plan that will make sure all eligible patients are offered a vaccination.’

An NHS England spokesperson said: ‘It’s unsurprising but extremely encouraging that the vast majority of GPs and PCNs are stepping up to play their part in Covid vaccination, in line with the deal agreed with the BMA, and alongside other local providers including pharmacists and NHS trusts.’

This article first appeared on our sister title Pulse.