Will NHS meet the end December booster challenge? Incredibly stretching & ambitious target. Huge logistical issues that are much more complex than many realise. But vital to protect the nation’s health given what's coming. So NHS will do everything we can to meet it. New🧵1/25
Thread sets out 1. Why this scale of ambition is so vital. 2. What NHS is currently doing, at pace, to meet this ambition. 3. Elements of mission NHS leaders think will be most difficult to deliver. 4. Best current guess on likelihood of meeting target. 5. Advice for public. 2/25
1. Omicron spreading much faster than delta, quickly becoming dominant variant. Much greater protection from two vaccine doses plus booster jab than two doses alone. Irrespective of symptom severity, NHS looking at very large numbers of hospitalised patients... 3/25
A small percentage of patients needing hospital care from a very big number of omicron infections means a large number of hospitalisations. Every extra booster administered before omicron takes hold therefore vital. Don’t want to reach mid Jan and say “wish we’d gone faster” 4/25
2. Hugely impressive mass mobilisation across NHS and local government. 10 things NHS/local government and our armed forces, third sector and public service partners are currently doing to deliver this vital mission. Detail provided to show complexity of task…5/25
Work requires high quality partnership between national and local leaders. National leaders set framework, run national booking service, ensure vaccine and wider supply (200 pop up site kits ready to go), recruit workforce, set clinical standards and manage contracts… 6/25
System (ICS) & trust leaders in best position to plan and deliver capacity expansion. Key to work with local communities to get best plans which is why local government is so key. They have staff, know how, facilities, vital public health directors and link to social care... 7/25
Trusts & ICSs working at pace to: * Plan for massive capacity expansion as fast as possible. Better to create new sites inc. pop-ups or grow existing ones? What's best geographical coverage? What pattern maximises take up, tackles inequalities & matches staff availability?…8/25
* Extend opening hours/days on existing sites. Requires new staff rosters & ensure third party buildings remain open. Also need to answer important questions like which bank holidays will sites be open for & what are best opening hours to maximise take up and use of staff… 9/25
* Extend physical capacity in existing sites including ensuring appropriate cold / wet weather coverage and queueing arrangements given likely much higher volumes of patients being jabbed. Ensuring appropriate patient safety / comfort in any extended capacity…10/25
* For any new centre: find staff and create staff rosters including appropriate clinical skills; ensure IT works as needed; add capacity to the National Booking System as quickly as possible; ensure appropriate marshalling / queueing arrangements are in place… 11/25
* Identify which staff can be reassigned from current work to vaccination work. Including making difficult clinical prioritisation decisions on what work can be de-prioritised and creating interim arrangements to manage impact on, and communicate with, affected patients… 12/25
* Stand up training arrangements to train new staff. * Identify, train and integrate volunteers into vaccination operations. * Identify how to prioritise those residing and working in care homes, health & care staff, housebound, and severely immunosuppressed patients…13/25
* Work with police, fire service, local government and other wider public service colleagues to identify, train and then allocate any staff for re-deployment to vaccination effort. * Run great local communications campaigns so communities know where/when to get jabbed. 14/25
All in the context of a very pressured NHS which must continue providing care to all who need it. GPs, for example, are doing an amazing job balancing their normal and vaccination workloads. Similar great work in community pharmacy. Difficult judgements needed at pace. 15/25
3. We’ve spoken to trust chief executives over last 24 hours and they highlight following three big challenges to overcome to achieve end December target. Local NHS and partners now working flat out to address them but they are significant and will take time to address…16/25
Workforce. NHS really struggling with workforce shortages & will need to rely heavily on others inc. volunteers. Particular worries about potential loss of staff when omicron takes hold in community. Infection control vital in healthcare settings to avoid cross infection... 17/25
Speed of capacity build required. NHS has rapidly built capacity to vaccinate new cohorts e.g. 30-39s. Record level of booster vaccines delivered this weekend. But capacity build inevitably takes time and only 18 days left to 31 December 2021 including the Xmas period… 18/25
Scale of capacity increase needed. To reach the target NHS will need to regain its March 2021 record vaccination day of over 800k vaccinations as quickly as possible. And then consistently go beyond it every day, day after day. Saturday’s figure was 550k vaccinations. 19/25
4. Can the NHS do it? When the ambition was announced 36 hours ago it felt undeliverable. Too big a capacity ramp up too quickly. But hugely impressive work now underway. The idea of creating 34,000 beds for coronavirus patients at start of pandemic felt impossible…20/25
As did idea of coping with 40k simultaneously hospitalised UK covid patients in Jan 2021. But NHS did both. This ambition will be incredibly stretching to deliver – many think it’s biggest challenge of the three. But if we do fall short, it won’t be for want of trying. 21/25
Three key things. NHS can’t force people to come forward for boosters so there is a big element of achieving the goal NHS can’t control. Ministers need to constantly point, in background media briefing as well as in public, what/how much NHS is doing to achieve target…22/25
Right for Ministers to set big ambitious goals. But they also have a duty to calibrate expectations of what is realistic and how difficult the goals are to achieve. Their failure to do so for Test and Trace was a very significant mistake that mustn’t be repeated here. 23/25
5. Public health advice. Get your booster as quickly as possible. Book via National Booking Service. Capacity added all the time. Try walk-in centres but they'll prioritise bookings. Walk-in capacity varies across country. Unacceptable to abuse NHS staff if there’s a wait. 24/25
SUMMARY NHS doing all it can to deliver this vital new national mission. We understand how important it is. We are mobilising rapidly, with our partners, as we have done throughout the pandemic. It’s too early to tell whether we will hit target but we will do our very best. 25/25
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