During an NHS England webinar on Tuesday 22 December primary care medical director Dr Nikki Kanani said she was aware that rolling out the vaccinations to care home ‘takes up a lot of time and energy and our staff are tired. So we’re really pleased that we’re able to say that you will be able to claim an extra £10 per vaccination, so first dose and then the second dose, to support you going into care homes next week and to get the staff in place to make sure we protect our most vulnerable residents.’
GPonline understands that the additional £10 will apply to each dose of the vaccine delivered in care homes, on top of the current item of service fee.
Under the COVID-19 vaccination programme enhanced service, PCNs currently receive £12.58 per jab administered. They are paid the £25.16 for each patient after both doses of the vaccine have been delivered, with a ‘host practice’ taking all payments for the PCN and then distributing it to other practices in the network. It is unclear if there will be a different process for payments for care home vaccinations.
Dr Kanani said: ‘We need to vaccinate our care home staff and residents as quickly as possible. We have a moral imperative now, especially with the change in tiers and the increasing rates of infection. The need to protect our care home residents is absolutely crucial.’
Dr Adrian Hayter, NHS England national clinical director for older people, told the webinar that it was NHS England’s ‘objective’ to vaccinate all residents in large care homes, with 50 beds or more, by the end the year.
Care home vaccination
He said vaccinations in care homes would be a ‘priority for this week and next week’.
NHS England will be using the CQC’s definition of a care home’s number of beds, rather than actual occupancy, in order to target vaccinations, Dr Hayter said. He said NHS England still had a ‘priority’ to get vaccinations into medium-sized care homes of between 25 and 49 beds and smaller care homes with under 25 beds.
‘But what we’re saying is that we’re putting our efforts into vaccinating these very large care homes for this week and next week,’ he said. ‘And we’re hoping to then be able to roll out to those smaller care homes in coming weeks.
‘There’s obviously the issue around packing down [the vaccines] and getting to the right number of vials, but we’re hoping that if there’s an opportunity to use the Oxford vaccine that comes up, then we’re going to have a better way of being able to roll out to smaller homes as well as the housebound in the coming weeks as well.’
An updated standard operating procedure and accompanying letter from NHS England published at the start of this week explained that local vaccination sites run by PCNs will either be able to order 975-dose packs of the Pfizer/BioNTech vaccine and break this down into smaller packs to take to care homes, or 75-dose packs specifically for use in care homes.
The webinar heard that wave 1 sites should have received their deliveries on 21 December, most of wave 2 sites were due to receive deliveries on 22 December, the remaining wave 2 and some of wave 3 sites would receive vaccines on 23 December and the final wave 3 sites would be getting a delivery on Christmas Eve.
The webinar also heard that vaccination teams will not be able to go into care homes where there has been a COVID-19 outbreak until four weeks after Public Health England has declared the outbreak over.
Dr Hayter said that PCN teams would need to liaise with local public health officials if they found themselves in this position, particularly if the outbreak occurred between doses. However, he highlighted that trials of the vaccines administered second doses less than 21 days after the first dose and up to 42 days later and the vaccine had still be shown to be effective.
NHS England has also said that local healthcare systems should be making staff available to help support the roll out of vaccination in care homes. Local workforce directors were told earlier this week that staff should be paid for their time by their current employer, but that reimbursement will then be made available.
NHS England will be providing vaccination sites with a support pack for rolling out the vaccine to care homes, including advice on how to plan the days leading up to vaccination day, based on what was learned from supervised run-throughs at seven sites last week. An FAQs document will also be regularly updated to address queries about care home vaccinations.