New staff and providers likely to be called in for mass vaccinations

The Department of Health and Social Care said in a letter this week that with more children, adults, and health and care workers set to receive the vaccine, “it is exploring options to expand the workforce that is able to administer vaccinations as part of the covid-19 response”.

HSJ  understands that senior NHS leaders involved in the work consider calling on new staff groups to deliver the vaccines is a very likely option. At present most flu vaccines are delivered by nurses, with community pharmacists also playing a part. It is not yet clear which other types of staff are under consideration. 

Delivering the vaccine to a much-expanded group — and with the aim of reaching higher proportions — is expected to be a major logistical challenge, and may also be compounded by the need to deliver a covid-19 vaccine to some before/during winter, if one becomes available in time.

Vaccination is seen as crucial way of keeping winter pressures under control and holding up health and care staffing levels if there is widespread covid infection; and of preventing flu compounding the impact of covid.

Government is aiming to have at least 75 per cent of all eligible patients vaccinated by the end of the flu season, and 100 per cent of health care workers. The programme has not reached that level of uptake in the past five years for either patients or staff.

The letter to primary care this week also said government was “considering supporting delivery through standing up alternative delivery approaches, to maximise coverage of the vaccine this winter”. Again, details are not yet clear.

This week the Royal College of Nursing said in new guidance for large-scale vaccination during covid-19: “The ‘usual’ vaccination premises and staff are unlikely to be able to cope with this increased need for capacity alone.”

Systems should develop “large scale vaccination plans” in conjunction with “multi-professional colleagues in “primary care, general practice, pharmacy, community services, care homes, school health and potentially linked to acute services, for example, A&E and outpatients”, it said. 

These plans must give “careful consideration” to “population needs, infrastructure availability, service capacity and demand”.

The chair of the Royal College of GPs, Martin Marshall, told HSJ the college has also produced guidance on delivering mass vaccination programmes during the pandemic.

It includes planning to deliver vaccines in “non-typical settings,” including “large community centres, where multiple stations can be set up in line with social distancing measures, or ‘drive-through’ clinics”.

GPs, however, will need “adequate resources to deliver the expanded vaccination programme, including a sufficient supply of appropriate PPE,” professor Marshall added. “And we need assurance that there will be a guaranteed supply of vaccine.”

The additional eligible groups this year are:

• People who live with those on the two million-strong shielded patient list and for whom “continuing close contact is unavoidable”;
• Children of school Year 7 (aged 11 on 31 August 2020);
• Health and care workers employed through patients’ private resources or personal health budgets; and
• People aged 50 to 64

These groups will be in addition to people over 65s, primary school children, infants aged 2 and 3, pregnant women, and people with serious long-term health conditions.

Vaccinating the 50 to 64-year-old cohort will require an additional 10m vaccine doses, as HSJ revealed in June. To prioritise at-risk groups, vaccines for this group will be rolled out from November and December, rather than September, “subject to vaccine supply”.

Update: this post was updated at 19.15 on 5 August 2020 to include a quote from Martin Marshall, RCGP chair.