1/24 @MartinRCGP and I have highlighted the need for an Autumn covid-19 vaccination plan. Together our organisations represent almost the entire NHS frontline and we wanted to celebrate what's been achieved so far and highlight forthcoming challenges: bbc.co.uk/news/uk-575487….
2/24 There's huge focus on COVID-19 vaccinations as the NHS seeks to vaccinate as many people as possible so we can ease social restrictions. This is the latest step in an extraordinary NHS achievement. In six months our defences against the virus have been transformed.
3/24 Vaccines aren't just saving thousands of lives, they also offer a vital route back to freedoms we all miss so much. It's been a triumph of detailed planning, collaboration & commitment. Hugely ambitious in scale, speed and complexity involving tens of thousands of people.
4/24 It highlights, yet again, the enormous mobilising power of our entire National Health Service. In England alone, for example, more than 60 million vaccinations have been delivered, including double-doses for 60 per cent of the population. Since December 2020...
5/24 …We’ve gone from just 1 vaccine in c250 locations to 4 vaccines across thousands of locations. That’s needed unprecedented close working between trusts, GPs, new Primary Care networks, local authorities, pharmacies, volunteers and the national team leading the campaign.
6/24 There's been much use of the description “world class” over the last 15 months. The NHS’s delivery of the vaccination campaign genuinely and fully deserves the description of world class. It has been an amazing team effort across a very complex delivery chain at huge speed.
7/24 But we need to recognise the 19 July target to offer a first vaccine dose to all adults is both a finishing line and a staging post. We will have to live with the covid virus for a long time to come. That means building a long term set of defences, as we’ve done with flu.
8/24 This will require a sustainable approach to covid vaccination. One that enables GPs & trusts to carry on vaccinating whilst meeting other pressures. EG tackling care backlogs, treating new mental health/long covid patients and coping with huge workforce pressures.
9/24 The Prime Minister recently spoke of a planned autumn booster campaign. This, and the possibility of an annual COVID-19 vaccination approach, will bring new and different challenges and significant added complexity for NHS frontline. Details set out below.
10/24 First task is to rapidly complete current scientific work to answer three basic questions around what vaccinations should be administered to whom, when, in the next stage, to maximise protection. Question 1. How long will protection from the original double doses last?...
11/24 ...Will boosters be necessary and, if so, should we administer a different vaccine to the original double dose? How do we incorporate new vaccines, once approved? And how will the process of tweaking the vaccines to meet emerging variants of concern actually work?...
12/24 ...Influenza vaccines are currently tweaked annually – will we do the same with covid-19 jabs or should we be ready to move faster and more frequently? Question 2. We also need to know the extent to which we can combine covid-19 and flu vaccination campaigns....
13/24 ...Combining – for example a covid-19 jab in one arm and a flu jab in the other – would make a massive difference. Question 3. We need to decide whether we should be vaccinating children. The Delta variant has shown they are a strong vector of transmission...
14/24 ...And vaccinating children could help keep them in school without the disruption of periodic home isolation and the educational/other problems this causes. But vaccinating children will bring the added complexity of obtaining, recording and storing the required consent.
15/24 Any of these changes – for example adopting a mix and match approach to vaccines, or adding more new vaccines to our supply roster, or combining flu and covid-19 jabs, or vaccinating children – will add significant complexity to the NHS frontline's delivery task.
16/24 The NHS wouldn’t be able to start any booster or re-vaccination campaign until these questions have been fully answered by JCVI. Science will help determine who gets what, and when. But with flu jab campaign due to start in September, decisions will be needed soon.
17/24 We’ll also need to make COVID-19 vaccination part of NHS “business as usual”, building on strong work done so far. Government and @NHSEngland will need to ensure we have enough supply of right vaccines and set the framework for the way they are distributed....
18/24 ...They also need to ensure as much advanced notice of vaccine supplies as possible. Moving from a one off emergency response to ensuring the NHS vaccinates everyone who needs a covid-19 jab year in year out, means empowering local NHS bodies too...
19/24 ...Covid vaccination needs to become part of everyday NHS business with infrastructure, resources and control fully embedded at local level. Integrated Care Systems could have a key role here, bringing GPs/Primary Care Networks, trusts, local govt / vol sector together.
20/24 We’ll need to create right sustainable workforce approach, maximising use of volunteers but ensuring NHS professionals can also deliver their other work and have a reasonable, as opposed to emergency sized, workload. We’ll also need to invest in appropriate NHS premises...
21/24 ...Since we won’t be able to rely on borrowing other community facilities as we’ve done over the last few months. The pandemic has shown the importance of having safe, modern, accessible premises available in general practice and across the NHS. Sufficient NHS capital key!
22/24 It is inspiring to see how much has been achieved in so short a time. This gives confidence that the NHS will surmount these new challenges to build a successful, sustainable, long term COVID-19 vaccination programme that sits alongside our other vital work.
23/24 GPs and trust leaders are determined to tackle this challenge together. But we will need the right resources and support. As we move to the next phase of covid vaccinations, we need to recognise the reality of what continuing covid-19 vaccination success will require.
24/24 SUMMARY. Amazing achievement of NHS covid-19 vaccination campaign continues with current sprint to July 19 at full pelt. But a huge amount of complex work to come to deliver the sustainable, year in year out, approach we will need if we're to live with covid-19 long term.
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