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Managing the ‘biggest flu vaccination programme in history’

by in Coronavirus, COVID-19, Flu, GP Practice Management

This year’s flu vaccination season looks set to be the most important one in recent memory – and probably the most complex practice managers will have experienced.

With the threat of a catastrophic second wave of Covid-19 infections hanging over the health service, ensuring as many people as possible receive the required vaccination is critical. Plus, of course, GP practices will have the added headache of delivering a widespread programme against the backdrop of coronavirus restrictions. In short, flu season is going to be a headache.

While at the time of writing the government hadn’t confirmed any expansion to the vaccination cohort, take-up is expected to be high among patients already eligible because of health fears driven by the pandemic.

“Aside from the increased demand – we’re already fielding calls from patients asking about flu jabs, which is frankly unheard of – we’re also having to start planning our PPE requirements, which is a headache,” one PM from a practice in the north of England told us. “However, the biggest issue is time, when you also factor in the physical space we have available because of social distancing, and our predicted increase in numbers. We can’t get through everybody in a couple of Saturday mornings and the evening session we normally run.”

This practice, like so many up and down the country, will therefore have to get creative in order to deliver an effective vaccination campaign, something a thread on the Practice Index Forum discusses in more detail.

Here’s a selection of ideas and considerations to take into account when planning your 2020/21 flu clinics:

Time is a major factor

As the BMA commented, it will take a lot longer for practices to deliver the flu programme this year. “Social distancing will add time, the use of PPE will add time, and potentially increased numbers will add time,” they told us. PMs therefore need to factor this in and consider if previous arrangements provide sufficient time. If not, will extra sessions be needed, when will they run, how will they be staffed… the list of questions goes on.

It’s worth noting that BMA GP committee member, Dr Peter Holden, warned GPonline that rules around PPE could more than double the time per jab.

More sessions, fewer numbers?

One practice in south west London is planning to hold multiple, smaller sessions, rather than fewer busier ones. “We’ll be able to more easily manage contacts this way, and because they’re smaller we can rotate the staff who need to be present,” the assistant practice manager said. “We just need to ensure our booking system is working well!

“I read that one practice was thinking about running sessions based on alphabetical order of surnames – A to H one week, I to P the next. That might be an option for us too.”

One-way systems

Practices will have to work hard to ensure social distancing is maintained. Some practices will be able to work out safe one-way circuits for patients if their building layout permits and/or introduce queuing systems.

“Signage and communication will be absolutely vital if we’re to make this work,” a PM told us. “We’ll be using our PPG to test our plans – it’s great to have the opinion of people who aren’t in the practice day-in-day-out.”

One practice believes they will be able to vaccinate approximately 200 patients per session, working with a team of five or six clinicians, with an effective circuit in place.

Take the inside out

Gazebos in car parks seem like a popular solution this year – with plenty of practices hoping for kind weather!

External venues

A much-discussed topic on the forum thread is the use of additional venues such as school or church halls. There’s plenty of debate about informing CQCs when booking external venues, which is worth checking out.

One PM commented to us: “We’re looking at using a neighbouring school hall – the big open space will help with communication between staff and patients and between staff, as well as making distancing easier. We’re lucky in that it’s next door to the surgery so easy to manage – and it gives us car parking in addition to what’s at the school.”

Drive-through clinics

Some GP practices have made the headlines in recent weeks for setting up drive-throughs for things like children’s immunisations and blood tests. One of those GPs said they did so to take advantage of their large car park, and the need to take pressure off a relatively small waiting room.

There are clearly logistical and safety issues to deal with when setting up a drive-through service – something that is again discussed on the Forum.

Keep it simple

Another PM we spoke to suggested the best way to ensure success with flu vaccinations this year is to keep it simple.

“I know it’s a sweeping generalisation, but with flu jabs we’re dealing with people that aren’t perhaps the most adaptable. So, we’ll be doing all we can to retain as much of what has worked in the past as possible. We’ll evolve, not revolutionise, our service delivery.”

A partnership approach?

The sheer scale of this year’s vaccination process may require practices to work together to deliver vaccines. Additionally, it could be time for primary care networks (PCNs) to bring groups of practices together.

“I read in the press that some PCNs are working with local authorities to find larger premises and help manage some of the logistics required,” a London PM told us. “This would be great. To be honest, we need the help!”

Pharmacy support

While it has been reported that the BMA is in discussions with NHS England about GPs using sites other than practices to administer flu vaccinations this winter, similar negotiations between NHS England and pharmacists are also underway. These negotiations are believed to be around the use of marquees, town halls, community centres, car parks and sports stadiums for vaccinations.

This news comes after health secretary Matt Hancock said that this year will bring the ‘biggest flu vaccination programme in history’, requiring a joint effort between GPs and pharmacies.

Interestingly, The Pharmaceutical Services Negotiating Committee has drawn up early guidance for the 2020/21 flu season about the options it is discussing with health officials that ‘may provide additional opportunities to provide the community pharmacy flu vaccination service in other environments’.

And finally… the government needs to clarify any extensions quickly

While there has been speculation in recent weeks about the expansion of flu vaccines to cover all over-50s, nothing has been confirmed as we write this article. If this did happen, a further 10m vaccinations would have to be delivered – so it’s hoped any change would happen soon. With some practices already reporting difficulties in getting hold of vaccines, this could be another big headache to contend with!

While the above provides an overview of the measures practices are taking to deal with the pressures of delivering flu vaccinations in the shadow of Covid-19, it’s by no means an exhaustive list. We would love you to join the conversation and share your thoughts and experiences, either by commenting below or via the Practice Index Forum. Together, we can get through the season!

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