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PCN site vaccinates third of learning disability patients in two days

by Jess Hacker
3 March 2021

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A Primary Care Network (PCN) has vaccinated a third of the 360 patients on its learning disability register in two days, a practice manager has confirmed.

The Healthier South Wirral PCN vaccinated 69 patients with learning disabilities and 42 carers on 17 February and a further 48 patients and another 15 carers on 23 February, Rachel Stott, practice manager at Eastham Group Practice, told Management in Practice.

This comes as the Government announced last week (24 February) that practices should invite all patients on the learning disability register for Covid vaccination as part of priority group six – increasing the cohort by ‘at least’ 150,000 patients.

Ms Stott, whose practice is one of six covered by the PCN, said the team working on the day were nurses who had been looking after this patient group for the last 10 years.

‘The nurses are really familiar to them and had really good relationships and good rapport with them, which helped facilitate it [vaccinations] on the day really,’ she added.

‘It helped make vaccination a little bit easier for them.’

‘Friendly, comfortable and positive’

A case study published by the local GP Federation – Primary Care Wirral – last week (22 February) said the PCN had previously found it ‘notoriously difficult’ to encourage vaccination uptake among many patients with learning disabilities and patients with autism.

This is due to the patient group struggling with clinical environments, fear of needles, disruption to routine and close contact with people they are not familiar, it said.

The GP Federation said a series of adaptations were implanted to make the vaccination experience as ‘friendly, comfortable and positive as possible’.

The dedicated clinic was also aimed at helping patients become more desensitised to stressful stimulus and improving their outlook on future vaccinations, it added.

The PCN was also supported by Primary Care Wirral to recruit and train staff to provide care specifically for patients with learning disabilities.

Of the 75 patients booked into the first clinic, four didn’t attend and two opted out of having the vaccination on the day, while 48 out of 50 patients booked into the second clinic were vaccinated.

Adjustments and reassurance

The PCN made a number of adaptations and reasonable adjustments for the clinic, the case study said, including increasing appointment times to allow staff to have longer conversations with patients ‘to generate positive rapport, answer questions and reassure them.

The clinic also had fewer vaccination stations, spaced further apart, and was staffed with a smaller number of people to create a sense of privacy, it said.

This was facilitated in addition to an outdoor clinical unit for those preferring to be vaccinated outside – with five patients choosing this option on the day of the first clinic.

The learning disability team, which was present for the vaccination clinics, also offered pre-appointment conversations over the phone to support patients, the case study said.

Improving future uptake

Ms Stott told Management in Practice that the clinic staff were able to demonstrate that vaccination is a ‘relatively painless process’ and she thinks ‘this alone will help encourage patients to come back’ and to help their carers feel reassured as well.

‘It’s definitely made patients with autism or learning disabilities more aware that vaccinations aren’t as scary as they seem,’ she said.

‘I think it will certainly encourage more uptake of vaccination, such as the flu, shingles, and pneumonia.’

Ms Stott also welcomed the Government’s move to prioritise more people with learning disabilities for the Covid jab but added that this prioritisation ‘should have been there in the first place’.

‘Prior to the 17 February [the first clinic], our regional teams were telling us that our priority focus had to be those patients that were in residential care homes, so we were able to vaccinate some of them a little bit earlier on,’ she said.

‘But for me, that inequality should never have been created amongst the cohort of patients with learning disabilities. In my opinion it should have been offered at the start.’

Under the Joint Committee on Vaccination and Immunisation’s (JCVI) advice, only those with ‘severe’ and ‘profound’ learning disabilities and those with learning disabilities in long-stay nursing and residential care settings should be prioritised for the vaccine.

The Government said last week that the recent announcement that all patients on the learning disability register should be vaccinated was ‘not a change’ in the JCVI’s advice, but instead an ‘operational clarification’ to ensure those who are eligible receive their vaccination.