Guidance published by NHS England says health systems should prepare to deliver booster COVID-19 vaccination ‘between 6 September and 17 December 2021′ in line with the two-stage plan outlined by the Joint Committee on Vaccination and Immunisation (JCVI).
Flu vaccination should be ‘co-administered in a single appointment where supply and eligibility of cohorts align’, the guidance confirms – although final advice on this from the JCVI could yet change.
GP practices in England have delivered the vast majority of COVID-19 jabs in the first phases of the vaccination programme, but the NHS England advice says that in most areas ‘it may be hard for general practice to deliver more than around 75% of vaccinations’.
The guidance says: ‘In the majority of cases, local systems should therefore prudently plan for a minimum of 40% of COVID-19 booster vaccination through general practice and a maximum of 75%, drawing on the expertise of local authorities and subject to any agreement with local PCNs.’
GP practices and pharmacies will be invited to opt in to take part in the delivery of COVID-19 booster vaccination in ‘mid to late July’, with a full service specification to be published ‘in the first part of July’.
BMA GP committee chair Dr Richard Vautrey said it was important for practices to be able to deliver vaccinations on their own premises and in line with the model they use every year for flu vaccination – a message the association has made clear to government ministers.
He criticised plans for ‘a maximum of 75%’ of booster jabs to be delivered by GP practices – calling it an ‘arbitrary limit’ that failed to recognise local variation.
Dr Vautrey said: ‘GP practices have shown every year that they are well placed to protect their communities from various diseases, not least through the annual flu jab campaign – last year delivered successfully in the midst of a pandemic, yet achieving significant uptake among patients. On top of this they led the COVID-19 vaccination programme right from the start, delivering around 75% of jabs.
‘GPs are already preparing for this winter’s flu campaign, and will be keen to continue play a pivotal role in protecting their patients against COVID-19 with booster jabs alongside this. As the profession and the public are acutely aware, GP practices are under intense pressure and they must therefore be given support and the flexibility to take part in the booster campaign in a way that works best for their patients.
‘It’s positive that the JCVI is already discussing administering COVID booster jabs during the same appointment as flu vaccines, but crucially, GP teams must be able to do this within their own practice buildings if they wish – which has not always been the case for COVID vaccines. This would allow patients to be vaccinated at their local practice as they are used to for their flu jabs each year, while also reducing admin, workload and bureaucracy for staff, while limiting the impact on other GP services that are just as important.’
Dr Vautrey said vaccination on practice premises had worked well in parts of the UK – adding that practices in England should not be expected to work together across PCN areas to deliver jabs if it is ‘not the right choice for them’.
He added: ‘Given the achievements of the first round of vaccinations, it makes no sense for NHS England to suggest limiting the proportion of vaccines delivered locally by practice sites – and we’d be concerned that this will be interpreted as a cap on general practice’s involvement in the programme, and placing barriers in the way of patients being vaccinated by their local, trusted surgery team.
‘On the one hand the letter proposes a “pull” model in which sites can request supplies to meet their communities’ needs – something we have persistently called for – while at the same time suggesting arbitrary limits that take no account of local variations.’
The NHS England letter also sets out plans to fund a ‘centrally sourced workforce’ that providers delivering booster jabs will be able to call upon – and says guidance for workforce and training for phase 3 of the COVID-19 vaccination programme will be published soon.
It adds that the programme will move to a ‘capped pull’ ordering model to help sites ‘have visibility and influence over the supply of COVID-19 vaccine’.
The move is intended to help practices and other providers involved in the programme ‘align COVID-19 vaccine with their flu vaccine supply for joint clinics’, the guidance says.
Dr Vautrey backed the staffing commitment, but warned NHS England against micromanaging practices involved in the delivery of vaccines. He said: ‘While it’s good to see a commitment to continue funding additional staff to support the programme, GPs may be concerned at further hints of a bureaucratic and restrictive approach from NHS England – something that has been far too commonplace during the pandemic, and which has caused severe frustration among family doctors and their colleagues.
“If we are to “learn to live with” COVID-19 in the long-term and vaccinations are to become routine, practices need to be trusted and empowered to build on their expertise, proven track record and knowledge of their communities to lead the way in ensuring the public is protected.’