Since the start of the COVID-19 pandemic, teams of scientists across the world have been working to develop potential vaccines against the virus. The Pfizer/BioNTech vaccine has now been authorised for use in the UK and more are expected to follow.
Primary care is now being primed to start a programme vaccinating against coronavirus from mid December 2020. This page provides a summary of the current situation, but plans for the vaccination programme are moving at pace and the situation is changing on a frequent basis.
Page last updated 3rd December 2020.
Several potential vaccines for COVID-19 are in the late stages of phase III trials and one has now been authorised for use in the UK. The NHS was asked to be ready to start immediate vaccination from the start of December 2020.
The characteristics of many of the vaccines are yet to be confirmed, but some information is available. For example, the Pfizer/BioNTech vaccine, which has been authorised for use in the UK, requires two doses to be administered 21 days apart and it must be stored at -70°C until it is thawed, ahead of use. Once thawed, it can be be stored between 2-8°C for up to 5 days and prior to administration it needs to be reconstituted. The vaccine is delivered in an outer pack which contains 975 doses. This therefore means that distribution and use of the vaccine needs to be carefully controlled to maintain its efficacy and to ensure there is minimal wastage.
Other potential vaccines are likely to be able to be stored for relatively long periods between 2-8°C.
The number of vaccines available at any one time will also have an impact on how they are used, in line with the prioritisation guidance issued by the Joint Committee on Vaccination and Immunisation (JCVI). The JCVI advice recommends that older adults resident in care homes, care home workers, all those 80 years of age and over and healthcare and social care workers are the early priority cohorts for vaccination.
Priority groups for coronavirus (COVID-19) vaccination: advice from the JCVI (2nd December 2020)
NHS England and NHS Improvement (NHSE&I) are setting up several approaches to vaccination of the population:
- NHS Trust vaccination, focused on Trust staff, eligible patients in the Trust and potentially other health and care workers;
- Mass vaccination sites; and
- General practice/Primary Care Network (PCN) and community pharmacy sites.
Public Health England (PHE) has published resources for the COVID-19 vaccination programme, including:
A COVID-19 vaccination training slide set, e-learning programme, vaccinator training requirements and a vaccinator competency assessment tool have also been published and they can be accessed from the following GOV.UK hub page:
How can community pharmacy get involved?
NHSE&I expect community pharmacy to have a role in the COVID-19 vaccination programme, but contractors should be aware that, due to the complexity surrounding its unprecedented mass rollout and the storage requirements for some of the vaccines, their involvement will be very different from any they have had in other vaccination programmes.
At this time, there are two ways in which contractors could play a part in the programme:
Option 1: They work with the general practices in their PCN (or a neighbouring one) to support the PCN vaccination site (there will generally be one per PCN) and any outreach into care homes etc. necessary from that site. This could involve pharmacy contractors providing staff, under a private sub-contracting arrangement, to support the GP/PCN-led service; or
Option 2: They provide a COVID-19 vaccination service under the terms of the Enhanced service (which is currently being drafted) where NHSE&I want to commission that service, either because they have no existing provision in an area or they need additional provision. Such a service could be provided at a pharmacy, but it is more likely that an off-site location would be more appropriate. Any agreed location for provision of the service would be described as a designated vaccination site.
Both general practice/PCN and community pharmacy designated sites will be expected to be able to operate from 8am to 8pm, seven days a week, vaccinating a minimum of around 1000 people per week.
The NHSE&I documents linked to below provide further information on this option. Having read the documents, where contractors believe they can provide such a site and they have the necessary capacity to provide the service, they should engage with their NHSE&I regional team and an expression of interest must be submitted as soon as possible and by 4pm on Sunday 6th December 2020 at the latest.
NHSE&I currently only want expressions of interest from pharmacy contractors that want to provide a designated vaccination site and believe that they can meet all the requirements from early January 2021. If contractors think they can provide such a site, but they can’t operationalise it by early January 2021, they can submit an expression of interest, but they must annotate it to identify when they think they would be able to commence service provision.
NHSE&I will consider the expressions of interest received from contractors, but they will prioritise those that are able to start in early January 2021. In time, if they require additional designated sites in an area, they may then approach the contractors that said they could provide a site, but after the start of January 2021.
The majority of pharmacy contractors are unlikely to have the capacity to provide a designated vaccination site on their own. Where contractors do have the capacity and desire to get involved in the vaccination programme, but they don’t have the capacity to run a designated vaccination site, Option one is likely to be the best for them to pursue. In that circumstance, contractors should contact their PCN and they may also want to seek advice on any local developments from their Local Pharmaceutical Committee.
Information for contractors interested in providing a designated vaccination site (Option 2)
On 27th November 2020, NHSE&I published documents aimed at pharmacy contractors that are interested in providing a designated vaccination site:
- Letter to pharmacy contractors
- Information on the COVID-19 vaccination Enhanced service for community pharmacies
- Information on the community pharmacy C-19 vaccination site designation process
- Site designation form
NHSE&I has also issued further guidance to general practices/Primary Care Networks on the vaccination programme, including the Enhanced service specification for general practices/PCNs, which is worth reading if you are considering providing a pharmacy designated vaccination site, as the pharmacy Enhanced service specification is likely to be similar:
Vaccination of pharmacy staff
Health and Care workers, including community pharmacy staff, are an early priority for vaccination, as set out in the JVCI’s advice on priority groups for coronavirus (COVID-19) vaccination. Once they are eligible for vaccination, they will be able to choose to get vaccinated at a designated site of their choice, which could be a pharmacy site, if one is operational in their area.
COVID-19 vaccination programme hub (FutureNHS collaboration platform)
If you do not have access to the platform, you can register using an NHS or similar professional email address by emailing P_C_Nemail@example.com.
Future developments in the vaccination programme
It is expected that further vaccines will shortly be authorised for use in the UK which have less complex handling characteristics when compared to the Pfizer/BioNTech vaccine. That would theoretically mean they would be more suitable for use in a business as usual primary care vaccination programme. However, due to the need to vaccinate many millions of patients in as short a time as possible, we understand that the main push on population vaccination in the first half of 2021 is expected to be via mass vaccination sites and designated primary care sites, not a wider primary care model.
A primary care model could potentially be used later in 2021, for example to mop-up patients who missed their vaccination in the main part of the programme, however no decisions on this have yet been taken.
It may also be necessary for the population to be vaccinated on an annual basis, similar to the flu vaccination programme, but researchers require more time to determine whether that is the case. If it is needed, a primary care-led model could be part of the solution, but that is all for future consideration. If NHSE&I wish to use a primary care model at any time in the future, there would be a new process to select providers.