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COVID-19 Vaccination Programme 2020 2021After much speculation and discussion at the British Medical Association (BMA) General Practitioners Committee (GPC), an indicative COVID-19 Vaccination programme Directed Enhanced Service (DES) has been produced.
Understandably, there are concerns around how this will be delivered with considerations such as resources, buildings, IPC, longevity of the vaccine once made up, vaccine availability, and of course, costs.
Who is eligible for the vaccine?
Eligible Patients will be confirmed soon, but are expected to be in line with the latest JCVI (joint committee on vaccination and immunisation) recommendations.
Similar to the flu groups, they include:
- All over the age of 50
- Those at high risk
- Care home residents and staff
- All health and care workers (although it is unlikely that general practice will be required to deliver to all health and care staff who may get it from their employer)
The high priority groups will be vaccinated first, and as the vaccine becomes more available, practices will be able to provide this to increasing numbers.
The DES includes provision of vaccinations to housebound Patients via home visits, as well as staff and residents of care homes. Community service providers will be expected to play a role in this service, particularly with housebound Patients, as many do with flu immunisations using Practice stocks.
How will the vaccines be delivered?
Due to the logistics and delivery and characteristics of the vaccines, the service needs to be delivered at scale. Primary Care Networks (PCNs) are being offered to sign up for this service and deliver this through one practice 8am — 8pm, 7 days a week. It therefore makes sense that extended access clinics can be utilised to deliver this service.
Unlike the flu vaccine, this vaccine does not arrive ready prepared. Practices should plan on the assumption that vaccines will come in multi-dose vials, will need drawing up and may require dilution. Practices should also assume that there may be additional requirements, such as limits on time at ambient temperature and limits on time at 2 – 8 degrees Celsius before use.
The vaccine will be delivered as a two-step approach.
The joint committee on vaccination and immunisation (JCVI) will confirm details on this in due course but Practices should plan on the assumption that two doses of the same vaccination will be required. JCVI will also confirm the relevant maximum and minimum timescales for administration of each vaccine, where multiple doses are required.
What training and support is available?
All staff involved in administration of COVID-19 vaccines will need to complete the relevant training provided by Public Health England (PHE) and Health Education England (HEE). Practices will be expected to oversee and keep a record to confirm that all staff have undertaken the training prior to participating in vaccinations. Otherwise, the training requirements are expected to mirror those in the flu specification. There will be a COVID-19 vaccination programme overview pack for all staff which can be used for onboarding.
National e-learning will be available on e-learning for healthcare – it is likely that most practice staff will only be required to undertake COVID-19 vaccine-specific chapter(s) of the online training package. We anticipate that a chapter could take up to a maximum of 1.5 hours, but further details will be shared soon. If and when any additional vaccines become available, a new chapter will be added to the e-learning materials for each new vaccine.
What is the Item of Service (IoS) fee?
NHS England have agreed with the BMA GPC that the Item of Service fee will be £12.58 per vaccination, which is 25% more than the current fee for service for an influenza vaccination, at £10.06.
This additional 25% payment recognises the extended requirements around the COVID-19 vaccination, including training, the need for post-vaccine observation and any associated costs thereafter. The Item of Service fee will be paid on completion of the final dose (i.e. £25.16 if the vaccination requires two doses) unless in exceptional circumstances the final dose cannot be administered, e.g. because of intolerance/clinical agreement.
There will be no other national funding available, although local commissioners may be able to help with one-off costs. In particular, CCGs have provided additional support to general practice to support the flu programme (e.g. additional venue hire) and they expect to be able to make some limited funding available to extend these arrangements for a potential COVID vaccine programme.
What are the deadlines for PCNs to sign up?
| PCN groupings to advise CCGs of nominated site for designation | Tuesday 17 November |
| CCGs complete designation assessment process for nominated sites and submit recommendations to NHS England and NHS Improvement regional teams | Thursday 19 November |
| NHS England and NHS Improvement decision communicated to PCN groupings along with formal commissioner offer to Practices with access to an approved designated site to sign up to deliver the Enhanced Service | Monday 23 November |
| Final enhanced service specification published | Late November |
| Administration of the vaccinations | Start to be confirmed |
Full details can be found here, including the indicative service specification.