A letter being sent out to primary care networks (PCNs) and CCGs to confirm approval of designated sites for delivering COVID-19 vaccination confirms that a full specification for the enhanced service deal that will define how practices deliver the campaign will be made available 'imminently'.
It makes clear that PCN groups delivering the vaccination campaign will be expected to cover patients in care homes, housebound patients and to 'co-ordinate roving approaches' to ensure patients unable to attend a designated site are covered.
Practices will have seven days to confirm their participation, the letter says. It confirms that there will be a £20m fund available to support practices with 'one-off costs of setup' as they prepare designated sites to deliver the COVID-19 vaccination campaign.
The letter says vaccinations 'will not commence in PCN grouping sites during the week of 30 November' - meaning the earliest vaccinations could start to be administered is the week beginning Monday 7 December.
It adds that NHS England 'will aim to give all sites at least 10 days notice of the first vaccines becoming available to ensure sites can be stood-up and clinics arranged' - and suggests that practices may wish to use patients from the extended flu vaccination campaign to carry out a test run of premises for COVID-19 vaccination.
The government confirmed on 20 November that it had secured enough doses of flu vaccine to roll out vaccination to patients aged 50-64 from 1 December - increasing the population GPs need to cover by around 11.5m people.
With COVID-19 vaccination not due to start until 7 December at the earliest, the NHS England letter says: 'PCN groupings may wish to use this opportunity to invite this [flu] cohort to their single designated site, both to test arrangements whilst ensuring the best sequencing of the two programmes.'
The letter from NHS England medical director for primary care Dr Nikki Kanani and primary care director Ed Waller hails the 'fantastic response from general practice' to plans for a COVID-19 vaccination campaign.
It adds: 'We know general practice is already busy and we are hugely grateful for your commitment to ensuring your patients are vaccinated as soon as possible.'
In addition to the enhanced service agreement that practices will be asked to sign up to, the letter highlights a 'collaboration agreement' that will be published, along with 'full details of the technology and payment solutions that need to be used, supply and logistics arrangements and support around workforce and training'.
PCNs will be asked to request 'equipment their site requires from a national inventory which will be provided free of charge', and the letter says 'we are now able to confirm that PPE will be supplied as part of the consumables drop to each site ahead of vaccine deliveries and PCNs do not need to source this via the DHSC portal'.
Vaccines have yet to be approved, although the Pfizer/BioNTech vaccine is currently going through an authorisation process with the MHRA and initial results from the Oxford/Astra Zeneca vaccine have proven promising.
The letter says: 'As details of the vaccine characteristics and supply dates continue to become clearer we will provide further information, including on the mechanism for vaccine allocation'.
It continues: 'PCN sites will be an essential part of a wider, integrated NHS programme for delivery of the vaccine.
'As a default, PCN groupings will be expected to carry out vaccination for the care homes linked to them under the PCN DES and to ensure that housebound patients receive a vaccination. Guidance on the vaccination of these patient cohorts will follow once further vaccine efficacy data for specific cohorts is available.
'In areas of high care home or housebound patient density, and more generally, we would expect systems to co-ordinate roving approaches to these and other settings to ensure maximum vaccination coverage. Systems will want to have in place a clear plan on how different providers will collaborate locally to achieve the best outcomes.'