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Some Welsh GP practices opt not to carry out Covid boosters because of logistical difficulties

by Beth Gault
17 August 2022

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Exclusive Some GP practices in Wales will not be delivering Covid vaccination boosters this autumn due to campaign arrangements being unfeasible for practices, they have said.

Problems include not being able to co-administer the booster with flu vaccinations due to how patient groups have been segregated, the use of a different system for booking booster and flu appointments, as well as the deadline to start giving boosters by 1 September.

GPs had been invited to express interest in providing autumn Covid boosters by Health Boards in early summer.

However, a letter from Bro Taf LMC to GP practices in the Cwm Taf Morgannwg University Health Board and Cardiff and Vale University Health Board areas, dated 5 July, said the arrangements put forward did not make running the campaign ‘feasible for practices’ and had not been agreed by the LMC.

The letter said: ‘We have particular concerns about the segregation of patient groups compared to the flu vaccination cohorts that practices will be calling in. We have made it clear that it is vital for the Covid booster doses to be given simultaneously with flu vaccinations and have explained the difficulties that targeting separate groups will incur.

‘We have also opposed the mandatory use of the WIS [Welsh Immunisation System] for booking booster appointments, as this again is likely to cause problems with normal practice arrangements when booking flu vaccination clinics.’

The LMC said it was up to individual practices to decide whether they would be involved in delivering the autumn booster vaccinations. And that while it has, to date, been keen to encourage participation Covid immunisation it ‘unfortunately cannot support the proposal by the Health Board in its current form’.

GPs are being paid £12.58 per vaccine and £400 per 1,000 vaccines delivered for 2022/23.

A spokesperson for Cardiff and Vale University Health Board said that 19 practices would be taking part in delivering autumn boosters in their area to the over 80s cohort from early September.

There are more than 50 practices in the area, according to the NHS Wales directory.

The spokesperson added that all GMC contractors have been invited to take part, but practices have made their own decision on whether to opt in.

‘GMS practices will have considered the offer making their own decision on capacity, ability to deliver to the directed cohort in line with the national specification and within the timeframes required,’ said the spokesperson.

‘Detrimental impact’

IGPM associate director for Wales, Gareth Thomas, whose practice West Quay Medical Centre in Barry is not delivering Covid boosters, said that the September deadline would also have a detrimental impact on the delivery of core GP services and patient access.

‘The letter sent by Bro Taf LMC to constituent GP practices regarding autumn Covid boosters was absolutely correct. The decision not to participate in the delivery of the vaccination programme would not have been taken lightly,’ said Mr Thomas.  

‘Unfortunately, the logistical aspects and commitment required to start in September at a time where there is already huge patient demand for GP services, would have a detrimental impact on the delivery of core General Medical Services and patient access.’

He added the inability to align the Covid and flu vaccination programmes and the need to separately enter information onto the WIS would have been ‘very inefficient’.

‘Every year GP practices organise and deliver very efficient and successful flu vaccination programmes for their patient populations. I very much hope that GP practices will not see a loss of income due to this,’ added Mr Thomas.

However, Dr Gareth Oelmann, BMA GPC Wales chair, said he believed practices were ‘well placed’ to provide Covid vaccinations as part of the wider Health Board strategy.

He added that: ‘Health boards across Wales will manage the delivery of the vaccine through a variety of healthcare settings including GP surgeries, hospitals and mass vaccination centres. This will be planned alongside the delivery of the winter flu vaccine and so will be up to practices to best manage this in their own setting.’

The BMA also said that though co-administration is possible, the chief medical officer in Wales, Sir Frank Atherton, had previously asked for the priority to be protecting as many people as possible as quickly as possible.

In a letter on 15 August, Sir Atherton said: ‘Both programmes are vitally important for the health of the people of Wales. Therefore, while co-administration is important, the absolute priority is protecting as many people as possible as quickly as possible from both viruses.

‘As such, there should be no delay to deployment of one vaccine in the event that deliveries of the other are pending. Co-administration should not take precedence over protecting vulnerable citizens as early in the autumn as possible.’