• New NHS England document warns vaccination sites not to book patients in relying on on-the-day delivery
  • Document outlines strict restrictions on “mutual aid”
  • Vaccines should only be passed between providers as a “last resort”

Covid vaccination sites should not book patients relying on vaccine which is due to be delivered on the same day, and should not be bailed out by neighbours in this event, NHS England has warned.

NHSE published a document today which outlines restrictions on sharing covid vaccine supply among different vaccination sites.

This is permitted among the different sites of a single trust and, for the Oxford/AstraZeneca vaccine, between different practices within a primary care network. But beyond this it is generally not allowed, other than as a “last resort” such as where there would otherwise be “significant vaccine wastage” through no fault of the providers.

Transfer is approved if batches have not been delivered to a site as they had been promised, or if equipment failure means doses “became unsuitable for administration”.

However, the guidance indicates that booking people in for the same day as a delivery, and it not arriving in time, is not a justification for “mutual aid” transfer of vaccine.

It says: “Note: Vaccination sites must not book patients in for vaccinations on the day of vaccine delivery unless existing vaccine stocks have been agreed to be sufficient to meet that day’s demand.

“Requests for mutual aid to vaccinate patients that have been booked despite this advice will NOT be permitted.”

NHS England stressed that generally “there should be no” transfer of vaccinations between sites. This is due to regulatory constraints to protect safety and to ensure the planned supply in each area. The document says: “It is important that each region has fair and equitable access to the limited supply of vaccines. Restrictions on mutual aid support this aim by enabling NHS England and NHS Improvement to allocate stock according to a nationally determined allocation process. Central oversight of vaccine stocks will also help to ensure appropriate distributions are made for second doses.”

NHSE and government have said they will direct supplies to areas and regions as necessary to try to cover as many of the priority cohorts as possible, with a target date for the top four cohorts to all be offered vaccination of 15 February.

Providers have been told that all options must be considered before they put in a request for mutual aid, such as whether a vaccine delivery can be brought forward or if staff or patients can be redirected.

NHSE may itself redirect doses “to rebalance stock in the system” subject to “the stringent temporary authorisation criteria attached to each vaccine” from the Medicines and Healthcare products Regulatory Agency.

HSJ last week reported that the vaccine supply to GPs in the North East and Yorkshire region will this week be half what it was last week, largely because it is ahead of other areas in vaccinating its eligible population — but also because of limited supply nationally, and because it is dividing scare supply with more “mass” community vaccination centres, and pharmacies, as well as hospital “hubs”.

STP breakdowns of covid vaccination data published last week revealed there was huge variation across the country in vaccine delivery.