COVID-19 vaccinations

COVID-19 vaccinations

Since the start of the COVID-19 pandemic, teams of scientists across the world have been working to develop potential vaccines against the virus. Three vaccines have now been authorised for use in the UK and more are expected to follow.

Alongside vaccination centres and hospitals, Primary Care Network (PCN) and community pharmacy sites are now vaccinating patients and health and care workers against coronavirus.

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 24th February 2021.


Introduction

Three vaccines for COVID-19 have been authorised for use in the UK and others are in the late stages of clinical trials.

The characteristics of the vaccines vary, with some, such as the Oxford University/AstraZeneca vaccine requiring “standard” storage between 2-8°C. Others, notably the Pfizer/BioNTech vaccine, 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.

The quantity of vaccine 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 (updated 30th December 2020)

In England, there are three types of vaccination site:

  • Vaccination centres, using large-scale venues, such as football stadiums and accessed by a national booking service;
  • Hospital hubs, using NHS Trusts across the country; and
  • Local vaccination services (LVS), made up of sites led by general practice teams working together in Primary Care Networks (PCN) and community pharmacy sites.

The Government’s intention is that this mix of different places will allow people in different age groups, communities and households to get a vaccine in a way that suits them and their needs.

The Government’s overall plan for the COVID-19 vaccination programme is set out in its UK COVID-19 vaccines delivery plan.


The information below is aimed at community pharmacy contractors and their teams.

How can community pharmacy get involved?

Currently, community pharmacy can have a role in the COVID-19 vaccination programme in two ways:

Option 1: They work with the general practices in their PCN (or a neighbouring one) to support the PCN vaccination site 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 an Enhanced service 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 a suitable off-site location may also be used. 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 1000 people per week.

The NHSE&I documents, linked to in the next section, provide further information on option 2.

Where contractors believed they could provide such a site and they had the necessary capacity to provide the service, they were asked to engage with their NHSE&I regional team and submit an expression of interest by Sunday 6th December 2020. NHSE&I selected around 200 community pharmacy sites to go live in January and February 2021, with the first six commencing vaccinating on 14th January.

On 16th February 2021, issued a call for new applications from pharmacy contractors to become COVID-19 vaccination sites.

Read more about this call for new pharmacy LVS applications

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 at this time. 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.

PSNC is still seeking to ensure more pharmacy contractors can get involved in the vaccination programme; for more information on this, see the Future developments in the vaccination programme section below.

Information for contractors interested in providing a designated vaccination site (Option 2)

16th February 2021 call for new pharmacy LVS applications

Documents related to the original November 2020 request for interest in providing a pharmacy LVS 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

This was followed by publication of the community pharmacy Enhanced service specification in late December 2020.

Further information on the service is available on the NHSE&I website and on the FutureNHS platform (login required). If you do not have access to the FutureNHS platform, you can register using an NHS or similar professional email address by emailing P_C_N-manager@future.nhs.uk.

Considerations for contractors on providing a vaccination site

PSNC is undertaking work with the other national pharmacy bodies and NHSE&I to identify some of the issues that any pharmacy contractor planning to apply to be a COVID-19 vaccination centre needs to consider. This work has drawn upon the early experience of contractors who have already set up pharmacy LVS and it is informing ongoing discussions with NHSE&I about how a larger number of pharmacies could safely participate in the vaccination programme via and Advanced service.

The clear message from contractors already providing COVID-19 vaccination services is that this is not the same as flu vaccination – it is more complex, but pharmacies can provide a high quality COVID-19 vaccination service with appropriate planning and organisation.

The key areas identified so far that require consideration before applying to be a vaccination centre are detailed in a joint document developed by the national pharmacy bodies, and they include:

  • Suitability of the location of the pharmacy or vaccination site for easy patient access, including availability of car parking and public transport links, disabled access, and toilet facilities;
  • Sufficient space to maintain social distancing (in addition to any existing pharmacy activity) and to allow easy entry and exit from the building for vaccination patients;
  • Sufficient space for the administration of vaccines, e.g. second consultation room or areas within the pharmacy which can be screened off for sole use in the vaccination service;
  • Clear signage and marked pathways to guide patients, with staff or volunteers allocated to marshalling duties;
  • Space to allow for a 15-minute patient observation, when this is required;
  • Existing risk assessments will need to be updated and new ones developed for the new activity. Existing standard operating procedures may need to be updated and new ones will need to be developed for the vaccination service. Additionally, business continuity plans will need to be updated to ensure the normal work of the pharmacy and the vaccination service can both be sustained;
  • Adequate fridge space and the ability to ensure the security of stored vaccine;
  • Storage space for personal protective equipment and for clinical waste created by the vaccination service and awaiting collection;
  • Updated infection control procedures, cleaning rotas and availability of hand washing and sanitising facilities for staff and patients;
  • A clear understanding of the legal route which will be used for vaccination (PGD or national protocol) and the operational consequences of this;
  • Availability of additional staff (over and above the normal staffing contingent) to operate the vaccination service, all with appropriate training completed and competence evidenced. Staffing plans need to recognise the need for maintenance of the service over a long period and sustainability of staffing plans needs to account for the need for staff leave, illness etc. Ensure staff workloads and pressures have been considered and mitigated, including ability to have sufficient breaks (mental and physical) and access to additional wellbeing support, such as those provided by the NHS;
  • The need for local processes to minimise the wastage of vaccine, e.g. having reserve lists of patients that can attend for vaccination at short notice;
  • Ability to support patients with additional needs, e.g. accessible information, staff members with language skills relevant to the local population; and
  • Availability of adequate IT infrastructure and equipment, e.g. Wi-Fi, tablet devices.

Indemnity arrangements

NHSE&I, DHSC, and NHS Resolution have issued a joint letter to reassure healthcare professionals and others about the indemnity arrangements that are in place to cover the COVID-19 vaccination programme.

The letter confirms that COVID-19 vaccination activity undertaken in community pharmacy will be covered by the state indemnity schemes run by NHS Resolution until the end of March 2021 (this was subsequently extended until the end of June 2021).

The indemnity arrangements apply to all staff who are employed or engaged by a community pharmacy to deliver the LES vaccination service. The arrangements will also apply in any setting used by pharmacies to deliver the programme, including in care homes or domiciliary settings.

The letter lists a number of exceptions to coverage including, for example, any non-clinical vaccination activity undertaken by staff or locally recruited volunteers in community pharmacy: this must be covered under the pharmacy contractor’s own third-party liability insurance, and NHSE&I and DHSC recommend community pharmacies put in place local volunteer agreements, if relevant.

Read more, including the letter and pharmacy FAQs

Vaccination of pharmacy staff

NHSE&I have confirmed that community pharmacy staff are within the category of frontline health and social care staff eligible for a coronavirus vaccination.

On 7th January 2021, NHS England and NHS Improvement (NHSE&I) wrote to NHS Trusts and other NHS bodies to provide additional operational guidance on the vaccination of frontline health and social care workers.

We have summarised the key points for pharmacy contractors and their teams in the following questions and answers.


Q. Are community pharmacy staff included in the health and care workers cohort for vaccination?

Yes. Community pharmacy staff are included under the following grouping: ‘staff who have frequent face-to-face contact with patients and who are directly involved in patient care in either secondary or primary care, mental health, urgent and emergency care and community settings.’

 Q. Are community pharmacy locum staff also included in the cohort for vaccination?

Yes. The Pharmacists’ Defence Association (PDA) has developed a web portal to assist locum pharmacists with accessing a COVID-19 vaccination.

The PDA has highlighted the challenges faced by locums in relation to local processes to identify frontline healthcare staff and the fact that due to the nature of their work, locums cannot always easily engage with these arrangements.

The creation of the web portal will provide a mechanism to support identification of the most appropriate Clinical Commissioning Group (CCG) through which the locum could receive a vaccination. Information provided by the locum will be shared with NHSE&I to share with the selected CCG.

Read the PDA news story on the portal

Q. Who will be providing vaccination to health and care workers, including community pharmacy staff?

NHS Trusts (‘Hospital hubs’) will be the default provider of vaccinations for staff, but Primary Care Networks (PCN) or community pharmacy vaccination sites may also be used to offer vaccination, if that is agreed locally.

Q. Will vaccination of health and care staff be prioritised?

The Joint Committee on Vaccination and Immunisation (JCVI) have recommended that priority should be given to frontline staff “at high risk of acquiring infection, at high individual risk of developing serious disease, or at risk of transmitting infection to multiple vulnerable persons or other staff in a healthcare environment”. That principle will guide the approach to rolling out vaccination to health and care staff at a local level, as will availability of vaccine.

Q. When did vaccinations start to be offered to community pharmacy staff?

By mid-January NHS Trusts (including acute, mental health, community and ambulance trusts) were established as hospital hubs with a responsibility for COVID-19 vaccine delivery to all health and care staff. They started to provide vaccinations 7 days a week to complete vaccination of all frontline health and social care workers as quickly as possible.

Q. How has it been coordinated at a local level?

Hospital hubs coordinated local efforts to identify and prioritise staff, including those in primary care (including community pharmacy), working with Clinical Commissioning Groups (CCGs), who were responsible for collating information on eligible staff in primary care. CCGs shared information on the number of staff in these groups to help inform planning.

 Q. How will bookings for vaccination appointments be made?

Hospital hubs will decide which booking and scheduling mechanism will be used to manage clinic bookings and make sure this is accessible to all health and social care workers. Your LPC will communicate the local process to contractors once this information is available.

Q. Will pharmacy staff need NHS IDs to get vaccinated?

No. However, while NHS ID will not be required, it is advised that staff should be able to provide evidence of their employment status in a health or care organisation. Contractors could provide their staff with a letter identifying that they work at a pharmacy.

Q. How will I find out how this is going to work in my area?

While the process of vaccination of frontline healthcare staff, including pharmacy staff, has started in many areas, contractors are advised to stay up to date with communications from their LPC. LPCs are already working on this with NHS partners and they will provide their contractors with further local information as soon as they possibly can.

Q. What can contractors do now to get ready for vaccination of their staff?

Contractors are advised to provide information on COVID-19 vaccination to all their staff members, to ensure staff can make informed decisions about receiving the vaccine.

Contractors may wish to review the following materials to support this and provide their employees with access to the links or materials where appropriate:

Coronavirus (COVID-19) vaccine – NHS website

COVID-19 vaccination: guide for healthcare workers – GOV.UK

COVID-19 vaccination: women of childbearing age, currently pregnant or breastfeeding – GOV.UK

COVID-19 vaccination: what to expect after vaccination – GOV.UK

COVID-19 vaccination: consent form and letter for healthcare workers – GOV.UK

Where contractors use locum staff on a regular basis, they could also pass on local information about COVID-19 vaccination arrangements to those individuals, to ensure they are also able to access vaccination.

In order to ensure vaccine uptake, NHS England and NHS Improvement shared a letter for all primary care contractors, including community pharmacy contractors, to encourage participation in its assurance work around staff coronavirus vaccinations.

CCGs or regional teams have been asking contractors about the proportion of their frontline staff who have been given a first dose of COVID-19 vaccine. This is part of NHSE&I efforts to ensure that all those in the first four priority groups have been vaccinated by mid-February.

PSNC encourages contractors to complete these forms and return then, so far as they are able, to help provide the assurance that pharmacy staff have been vaccinated or have been given the opportunity to be vaccinated. This should also help to identify those members of staff who are still to receive a vaccination.

In many cases, LPCs have been notified in advance that the forms are being sent to contractors and may be able to assist with any local issues.

NHSE&I has indicated its thanks to all those who are helping to provide this information

Read the ‘Assurance of COVID-19 vaccination offer for all eligible health and social care workers’ letter

 

Future developments in the vaccination programme

The authorisation of the Oxford/AstraZeneca vaccine meant that it would be possible for the NHS to use a business as usual primary care vaccination programme for administration of the COVID-19 vaccine. However, due to the need to vaccinate many millions of patients in as short a time as possible, the Government and NHSE&I are currently focusing on use of mass vaccination sites, hospital hubs and designated primary care sites (including some community pharmacy sites), not a wider primary care model.

Like many community pharmacists, PSNC is keen to see the sector able to play a greater role in the vaccination programme; we have clearly communicated that message to the Department of Health and Social Care and NHSE&I and have worked with the other pharmacy bodies on generating press coverage, making it clear that we believe the skills of community pharmacists and their teams should be used by the NHS to help deliver this mass vaccination programme. This activity has prompted several meetings with Ministers and NHSE&I, where it was agreed to work together on plans to ensure that community pharmacies are used to maximum effect in the COVID-19 vaccination programme.

PSNC and the other pharmacy bodies have worked with NHSE&I on proposals for how community pharmacy could play a greater role in the vaccination programme and discussions between PSNC, NHSE&I and DHSC about an Advanced Service have commenced in preparation for a time when this may become possible and desirable. Further information will be provided on this work once there are any developments.

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.

Further information

The following links provide access to further information on the vaccination programme.

NHSE&I COVID-19 vaccination hub page

NHSE&I COVID-19 vaccination guidance for primary care

NHSE&I page containing links to vaccination information from other organisations

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_N-manager@future.nhs.uk.

Public Health England (PHE) COVID-19: vaccination programme guidance for healthcare practitioners

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:

GOV.UK COVID-19 vaccination programme hub page

Chapter 14a – The Green Book – C-19 vaccination

COVID-19: vaccination programme guidance for healthcare practitioners (PHE)

General Pharmaceutical Council guidance for pharmacy professionals involved in the COVID-19 vaccination programme

NHS website information for patients


Return to the main COVID-19 hub page.

 



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