Contractually we were required to nominate a single, so-called “designated site” per PCN that NHSE deliver all vaccines to for the PCN. As we are “wave one” PCNs, ie the first batch of PCNs to sign up to deliver the vaccine, the designated site had to be a general practice surgery that is both secure to store the vaccine (essential given its high value), and also clinically appropriate to administer the vaccines from. We have planned this collectively as a group of six practices.
There are strict clinical protocols regarding the handling and storage of both vaccines, particularly the Pfizer vaccine, which prohibit it from being moved from the designated site. The only exception to this is a single journey to a care home where it must then all be used. The protocols are marginally less stringent for the Astra Zeneca vaccine, which the District Nursing team are using to vaccinate the housebound patients in the area, but we are still not yet permitted to transport it to another practice for a clinic to be operated out of that practice. We hope this will change soon.
There are also clinical requirements around post-vaccination observation for the both vaccines (15 minute observation period for all patients receiving the Pfizer vaccine; 15 minutes wait before driving after the Astra Zeneca vaccine). This means that the Covid vaccine clinic must run in a fundamentally different way than e.g. a traditional flu clinic, to which the Arkenstall Centre is extremely well suited, as we all saw this flu season.
The logistical demands of safely vaccinating such large numbers of people in such short timeframes are enormous, even more so in light of the observation periods. The accessibility and car parking facilities of any vaccination site are key to enabling a smooth flow of patients through the building. The typical patient journey lasts many times longer than a typical flu jab which multiplies the parking requirements accordingly.
Staffing is of course a challenge. To give you a sense of the scale that we are dealing with, this week we have 7 clinic days operating in total, delivering approx 4,500 vaccinations, delivery of which was confirmed last Friday. The combined staffing demand is 1,480 hours, 605 hours of which are being provided by 99 volunteers. The rest are being provided by 100 staff from all six practices in addition to the ongoing demands of working in healthcare. The typical car flow is 60-90 cars per hour, most of which are carrying patients who have mobility or other health needs and need time and support to help them through the process comfortably. For these clinics to run smoothly, we need to communicate effectively with all 200 people who are scheduled to work / volunteer so that they know which site to go to and what they are doing in their scheduled role at that particular site. Next week we may receive only a fraction of the vaccines – this is decided centrally at the moment typically with a few days’ notice, and we adapt dynamically when we know what’s coming.
Notwithstanding the regulatory requirements around changing designated site, any viability assessment of alternative or additional vaccination sites would need to take into account all of the above factors.
This information is offered to Councillors so that they may better understand the context in which we are working at the moment. None of it is intended to diminish the fact that we fully appreciate that patients may find it daunting to come to a practice which is not their usual practice. Our reception teams are already signposting the Local Authority transport offer, but if the LA would like to share a script for them to follow we would gladly share it with the teams. We would like to reassure all councillors that we have made our strongest efforts to ensure that every single patient is well looked after from the moment they arrive to the moment they leave. All staff and volunteers have taken great pleasure and effort in making this occasion a special and comfortable one. This has been – and continues to be – an historic moment to share in our community and the mood music of the clinics very much reflects that. The overwhelming feedback when patients have left has been effusively thankful, and appreciative of the care they have received and how well organised the clinics are, including when it is not their usual practice.
I hope this goes some way to explaining some of the questions that have been raised, and reassuring Councillors that collectively the Ely North and South PCNs are doing an excellent job at getting their patients vaccinated as safely and quickly and comfortably as possible.