The first phase of the Covid-19 vaccination campaign has been a success, practice managers have said, but uncertainties surrounding IT systems and volunteer retention remain unaddressed.
The Covid vaccination rollout has progressed at pace in the UK – more than 25 million people have now been vaccinated against Covid-19, and over 2.5 million have received a second dose.
The latest figures also show that three-in-four 50-54-year-olds – who were invited for vaccination from 17 March – have already received the vaccine.
From today (29 March), pharmacies and mass vaccination sites have been told to close unfilled bookings due to a ‘significant reduction’ in supply expected to last around four weeks, during which time GP-led sites will continue to book in patients from cohorts one to nine for first and second doses.
It comes just before the country is about to progress into the next phase of the programme, which under guidance from the Joint Committee on Vaccination and Immunisation (JCVI) will continue to prioritise patients by age group, starting with those aged 40-49.
It remains unclear when cohorts 10 to 12 will have access to vaccines, but preparations are already under way in practices across the country both for phase two – and for the restart of all QOF activity from next month.
Management in Practice spoke to three practice managers about their expectations and concerns as general practice moves into this next phase of the pandemic.
Caroline O’Dwyer, business and strategic management lead and partner at Oak Lodge Medical Centre, Edgware
Caroline O’Dwyer told Management in Practice that although primary care has ‘hit the ground running’, there are still logistical and IT issues that need to be addressed as the NHS enters phase two of the vaccination programme.
This includes duplicated invites from the national booking system, she said, which has been impacting on the number of people her practice is vaccinating and caused patient confusion.
‘They [other vaccination sites] are downloading patient information and inviting them in, patients are receiving this text and they’re not quite sure where it’s coming from – and then primary care hubs are sending out messages saying you’re to come back,’ she said.
‘Remember it’s a push model, so whoever we vaccinated 12 weeks ago, ideally should be coming back to us – but a lot of patients are booking into the national booking system and getting their vaccines ahead of time.’
Ms O’Dwyer said that despite this, her PCN – of which, Oak Lodge is the hub – has successfully taken a collaborative approach to working through these cohorts.
‘We’re coming down each group, one by one, getting through them using a shared workforce, so that’s a real positive from the work,’ she said.
She added that practices have had to ‘mobilise very quickly, in the space of three months, and it’s been an amazing piece of work’.
Kelly Vines, practice manager at Littleborough Group Practice, Littleborough
Kelly Vines, who is one of six managers running the Covid vaccination site in the Pennines, said there have been some difficulties managing bookings for the different vaccines – which is particularly important as many patients are now in the twelfth week since their first dose.
‘We were in that situation where we had done a first dose of different vaccines, and it was very, very confusing and very difficult to manage,’ she said.
The PCN has adapted its approach to make this easier by only administering one vaccine on a given day – for example, one day might be dedicated to first doses of AstraZeneca, while another is booked up for second doses of the Pfizer/BioNTech vaccine.
‘It’s all labelled on the computer, so receptionists don’t need to get confused or worried about what we’re doing,’ she said.
She added that this has potentially put ‘a little bit more pressure’ on the teams doing so many vaccinations, but it has also reduced how many clinics they need to have.
Ms Vines said the PCN has also already started planning how it will carry out the flu programme alongside Covid vaccinations this winter – which could involve using single vaccination sites again to make it more accessible for all patients – and she’s hopeful that the practices will be able to maintain the same collaborative approach.
‘We’re in that planning stage at the minute and we’re just waiting for guidance on what the flu cohorts are going to be,’ she said.
Jo Wadey, practice business manager at St Lawrence Surgery, Worthing
Jo Wadey, who is also a director of the Institute of General Practice Management (IGPM), said that her PCN currently runs its vaccine clinics on weekends, so not to impact the running of the practice – but her main concern is whether they will still be able to staff them when lockdown ends and summer arrives.
Not only might staff or volunteers be tired after having volunteered ‘every weekend since January’, Ms Wadey said, but the easing of restrictions may also impact their personal and work schedules.
‘A lot of our volunteers are people that have been furloughed, but as they go back to work – at their pubs or restaurants or hotels or shops – are we then going to have the same amount of volunteers to man it?’ she said.
‘At the moment, we’ve got so much goodwill and so many amazing clinicians and incredible volunteers, but I just wonder whether that’s going to be sustainable when people can actually have a life again, really.’
Ms Wadey also told Management in Practice that there will be some work to do to bring newer staff up to speed as the QOF is restarted.
‘There’s a lot of new staff that we’ve taken on through this pandemic in the last year, that have never known it to be any other way,’ she said.
‘You know, [we’re going to be] having to train our staff in the fact that we’re going to be opening our doors, small things like that.’
She added that there’s ‘always a fear’ that there might be someone with Covid coming through the doors when services fully resume, but this is probably why everyone is ‘really anxious’ to work on weekends and work overtime ‘just so that they feel we can get back to normal as a community’.
