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Covid Vaccination Programme update 27 November 2020

Date published: 27/11/2020

Dear Colleague,

There has been widespread coverage of the results of the trials of three of the Covid-19 vaccines which is really positive.

We are expecting the Pfizer BioNTech and the Oxford AstraZeneca vaccines to be licensed in the near future but these vaccines will not become widely available until 2021.

The plans to deliver the vaccine programme will be determined by the characteristics of the vaccine and its mobility. The current planning assumptions are that it is likely that the first vaccine to be available (Pfizer/ Courageous) has limited mobility which is unlikely to lend itself to roving or local vaccination sites.

The expectation is that the Pfizer vaccine will initially be used to vaccinate Acute Trust staff and would then be made available in the Mass Vaccination Sites to immunise the Health and Social Care staff.

We anticipate that primary care and roving delivery models will mobilise once a more mobile vaccine (the Oxford AstraZeneca one) becomes available which we hope will follow shortly after the Pfizer BioNTech vaccine. It is expected that the vaccination of the Care Homes and their staff, the people aged 80 and over and the housebound will follow, the details of who administers the vaccine to every cohort has not yet been decided locally, plans and discussions are currently taking place.

This is a positive development for general practices as the AstraZeneca vaccine can be stored in our vaccine fridges for up to 6 months, is mobile and comes in packs of 80-100 doses. We still need to focus our efforts on one site per PCN population initially because of the logistics of delivering the vaccines and technology. This may change as vaccines are approved and more details become available.

The NHS has been asked to be ready to start vaccinating as soon as the vaccines are licensed and become available. We should be given 10 days’ notice of the first delivery.

The NHS Enhanced Service contract will be sent to practices imminently and you will have 7 days to sign up to the enhanced service.

The additional consumables needed will be supplied. PPE will be included in the consumables drop to vaccination sites.

We would expect a significant number of documents to become available shortly which should include:

The consent

Pre and post vaccination information

PGDs for each vaccine

Draft temporary staff contracts

MOUs for sharing staff

Details of the local workforce contacts

Kent LMC have met with Kent Community Health NHS Foundation Trust who are the Lead Provider for the Mass and Roving COVID Vaccination Programme. Their role is to co-ordinate the vaccination programme. They have been working to recruit staff and prepare mass vaccination sites. There are currently two sites identified, we are advised one of them will be capable of going live on the 1st December, however, we must remember currently there is no vaccine which has been approved. It has been agreed that a Kent and Medway COVID Vaccination Steering Group will be set up and the LMC will be a part of this group.

The NHSE Webinar on 26th November updated us regarding the following points:

Vaccines will be centrally supplied and guidance will be issued shortly on the ordering process, 2 doses will need to be administered per patient

JCVI has confirmed that no post vaccination observation is required, but patients should wait 15 minutes before driving

PHE will produce pre and post vaccination materials that practices will be able to make available to patients by email or hard copy

Designated sites – these are being led by the supply chain of the vaccine, as more vaccines come on line and supply increases it is anticipated the number of sites will expand

Practices will need to deliver a minimum of 975 vaccines over a 7 day period from each designated site, ensuring that they are administered within the appropriate shelf life

As vaccines come into the country NHSE need to distribute them at pace with minimum wastage, this is why they are asking for practices to have the ability to deliver vaccinations between 8-8, 7 days per week

The National Booking Service (NBS) will book appointments at other mass delivery sites, not general practice– this will run alongside the GP call/recall

GPs will run the local call/recall service, be responsible for appointment booking at their designated site, there will need to be a PCN agreed booking system between practices in the grouping, national guidance will determine cohorts and process

GPs are not required to vaccinate care home staff/health and social care workers

Recording of the vaccination will be through the systems Pinnacle and Sonar, which will integrate into the GP patient record in a similar way to how the flu vaccinations flow from community pharmacy, it will not require duplicate data entry, the digital solution behind this is currently being worked on by NHSE and the GP system providers and they will keep us updated

Mobilisation will include training for pinnacle and sonar, these tools are web based so the designated site will need good internet access

Equipment required for the delivery of the programme e.g. fridges, barcode scanners – NHSE will publish an approved list of items which will be supplied centrally, do not purchase equipment now as it will not be reimbursed

Systems such as Accurx are being looked into and may come online later

Payment – practices record via pinnacle/sonar – payment is made to the lead practice identified in the PCN, the PCN grouping will need to ensure the ODS code of the Host practice is inputted into the Pinnacle and Sonar systems to generate payment for patients vaccinated by the PCN grouping, the host practice will receive the data to determine which practices patients have been vaccinated

Practice staff can vaccinate patients who are registered with another practice in the PCN grouping, and unregistered patients, payment for a single vaccination dose will be in exceptional circumstances as set out in the ES service specification (due to be published in the next 7 days)

The designated site must make all reasonable effort to ensure that patients who are physically unable to attend the designated site (e.g. housebound) are vaccinated. Commissioners should support practices to work with community partners and other local providers to identify pragmatic local solutions to vaccinating these patients that take into account the particular vaccine characteristics

NHSE/I will contact designated sites to confirm their current access to equipment and supplies and start establishing the vaccine supply chain

The PCN grouping should continue to plan for mobilisation identifying any shortfalls in workforce capacity and making contact with relevant organisations to identify additional workforce

We will keep you informed of development but as I am sure you are aware this is a fast moving and ever changing topic.

Yours sincerely

Caroline Rickard

Medical Director