GPs hit out at lack of guidance after flu campaign expanded

Plans for this year’s flu campaign are unclear and lack detail, with practices in the dark over how they can obtain extra vaccines, what PPE measures will be necessary and whether additional costs will be covered, GPs have warned.

PPE concerns (Photo: zoranm/Getty Images)
PPE concerns (Photo: zoranm/Getty Images)

A GPonline poll found that 44% of GPs were concerned about the profession being able to deliver the 2020 programme successfully against the backdrop of COVID-19, with just 16% saying they were ‘very confident’ about the campaign.

The survey of 542 GPs – conducted before the government’s decision to expand this year's flu campaign to over 30m people in total – revealed that 91% were worried about the additional staff time and workload involved in this year's campaign, with 54% ‘very concerned’ about this issue.

An overwhelming 89% said they were worried about how social distancing measures would impact efforts and 81% were concerned about additional running costs.

Flu clinic preparations

GPs have called on the government to be more transparent about plans to give them adequate time to procure jabs and prepare sites.They have also asked for clarity around PPE requirements and whether additional funding will be forthcoming.

Doctors have pointed out that the logistics of organising the campaign, and the fact that social distancing and PPE measures will increase the length of time vaccinations take, mean staff costs will be significantly higher than in previous years even without factoring in the campaign's expansion.

Flu cohorts have been expanded in a bid to reduce pressure on the NHS this winter as the government prepares for a potential second spike of COVID-19.

This means that jabs will be offered to people aged 50-64 for the first time, increasing the list of eligible patients by more than 12m. Those living in a household with patients who are on the shielded list will also be covered by this year's campaign.

GPs previously warned that they could face a workload crisis if cohorts were expanded - and they now say that a lack of guidance is hampering preparations.

Expanded cohort

The DHSC told GPonline that NHS England and the BMA are still in discussions about this year's flu campaign and that guidance would be provided to practices ‘in the usual way shortly’.

However, Surrey Hills GP Dr Dave Triska said that the ‘challenge is enormous’ for GPs this year. He said uncertainty around when extra flu jabs would be available was affecting preparations.

‘We can’t plan [for the additional cohort] at the moment because all we’ve been told is to use the stocks that we’ve ordered for our normal cohort. So I haven’t got a clue when we are going to be doing the rest of them.

‘If I need to borrow a school hall, which I’m going to have to, when should I arrange that? These are not things that you can book on a whim. We’re going to have to get the CQC to check we can use these sites as clinical areas. I think that’s a significant difficulty for everyone.’

Ealing GP Dr Vasu Siva told GPonline that her practice faced the prospect of jabbing an additional 1,900 patients. She revealed her main worry was securing enough vaccines.

Vaccine stocks

She said: ‘Our practice manager looked earlier in the pandemic to get an increased supply because we were expecting a bigger uptake than normal.

‘We managed to get an extra 500 vaccines, but since the announcement we haven’t been able to get any further supply of vaccines. So I'm worried about if there will be enough supply of vaccines.

She continued: We’ve asked lots of different companies and they’ve said they haven’t got the supply. Hopefully the government will help us out.’

The DHSC told GPonline that there was ‘sufficient vaccine to meet expected demand’ in all cohorts. It said GPs and pharmacies were responsible for ordering flu vaccines for adults directly from manufacturers.

However, it added that it had secured around 6.5m extra doses to help increase uptake in existing groups and extend the programme and that guidance on how practices could access this stock would be 'issued in due course'.

The DHSC has previously said that vaccinations for patients aged 50-64 would be rolled out 'once vaccination of the most at-risk groups is well underway' - promising to 'work with clinicians to decide' when the rollout to this group should go ahead.

PPE requirements

Watford GP Dr Simon Hodes also pointed out that PPE rules would make a significant difference to how long it wuld take clinicians to jab patients and said GPs needed clarity on what the requirements would be.

‘We are not quite sure what PPE we will have to change between patients… some people are saying you will have to change aprons and gloves for each patient - that takes time.

‘We need guidance around PPE and what’s needed, because that really isn’t clear - and it will make a difference in terms of ordering stocks of PPE and how long it takes.’

The RCGP recently warned that flu jabs could take twice as long to administer during the pandemic due to PPE and social distancing rules.

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