Primary care sites have now received the green light to start vaccinating in care homes from this week, where residents and staff will be eligible for vaccines. It is understood that the programme will begin in larger care homes first.
Scotland and Wales began vaccinating care home residents last week.
A letter to primary care network (PCN) vaccination sites from NHS England primary care medical director Dr Nikki Kanani and director of primary care Ed Waller said that that the roll out to care homes would begin from 21 December through Wave 1, Wave 2 and Wave 3 local vaccination sites.
Care home vaccines
The letter said: ‘During the last week, the first care home residents have been vaccinated, and supervised walk throughs of the care home vaccination model have been underway, which included GP led pack down of vaccine to take in to care homes. It has been successful for the care homes and the local vaccination sites involved. Care home residents have welcomed the opportunity to receive the vaccine.
‘Over the next few days we will initiate the delivery of the vaccine through local vaccination services to care home residents and their staff, starting with larger care homes. The roll out will begin during week commencing 21 December through Wave 1, Wave 2 and Wave 3 LVS sites, followed in short order by local vaccination service sites in later waves.’
Practices can order a full pack of the Pfizer/BioNTech vaccine (975 doses) and pack down themselves, or they can order packs of 75 doses to take straight to the care homes they will vaccinate. NHS England has said that sites will be supplied with equipment free of charge, with deliveries scheduled between 21 and 23 December. But officials have encouraged sites who have appropriate equipment to begin vaccinating earlier if they can.
PCNs have been asked to operate ‘additional roving teams’ that will be responsible for vaccinating in care homes. NHS England has said that this will require additional workforce capacity for some sites, who should work with their local STP to come up with a solution, which could include providing staff to back-fill where required.
The standard operating procedure for COVID-19 vaccination in community settings, which has been updated to include advice on delivering the vaccine in care homes, recommends that each ‘roving team’ should have two vaccinators (one lead and one support), one vaccine manager (a nurse or pharmacist leading vaccine reconstitution and cold chain management), one post vaccine observer (a paramedic or nurse), and one team admin.
It adds that teams should be adjusted depending on the size of the care home and care home staff available to help, but advises one vaccinator should look to achieve 60 vaccinations each day.
The roll-out of vaccines in care homes begins after the MHRA gave permission for the transport of vaccines from primary care sites to care homes, with data from Pfizer suggesting ‘no adverse impact on the vaccine’.
PCN sites will be provided a freezer for cooling of gel packs, while the vaccines will have to be transported in cool boxes, which keep the vaccine between 2-8 degrees celsius. This will then have to be placed ‘as close as possible’ to the care home fridge.
Last week GPs rejected NHS England calls for sites delivering COVID-19 vaccination to administer more doses this week – warning of intense pressure on staff and the impact on day-to-day services.
But NHS England stressed that delivering extra vaccines was optional for practices in a tweet, and should only be carried out if it is ‘safe and practical’