GP practices in England have until midnight on Friday 19 March to opt in or out of remaining involved in the COVID-19 vaccination programme beyond the first nine priority groups identified by the Joint Committee on Vaccination and Immunisation (JCVI).
Speaking to GPonline, BMA GP committee chair Dr Richard Vautrey predicted that most practices would choose to remain involved in vaccinating patients in cohorts 10-12 - covering people aged between 18 and 49 years old. PCN clinical directors have also said they expect practices' involvement to continue.
Dr Vautrey admitted that a longer opt-out window would have been preferable after practices were given just a week to decide - but he said strong progress on the vaccination campaign meant the next phase of the campaign could begin sooner than expected.
COVID-19 vaccination campaign
The Leeds GP said it was 'quite reasonable' for practices to opt out if they felt unable to cope with vaccinating younger age groups on top of already heavy workload in general practice. But he said: 'I think the majority will want to be involved.'
Practices that opt in will need to provide a brief written statement to confirm they can 'fulfil the requirements of the 21/22 core primary medical services contract from April 2021'.
They will also need to set out in writing to commissioners details of extra staff brought in locally to support the vaccination programme, must have offered all patients in cohorts 1-9 a vaccination before starting the next three groups - and must demonstrate that they are capable of managing second-dose vaccinations for cohorts 1-9 on top of the extra work.
However, Dr Vautrey warned that commissioners should not be asking for 'detailed reports or reviews' from practices that choose to remain involved.
'That needs to be kept as simple as possible,' the GPC chair said. 'Most CCGs know their practices well and have been working closely with them - they shouldn’t require much more information than they are probably already aware of. Practices should not be expect to produce detailed reports.'
PCN clinical directors told GPonline they also expected practices to want to remain involved in vaccinations in patients aged under 50 - but warned that maintaining a volunteer workforce as lockdown restrictions eased could prove challenging.
Clinical director at Whitewater Loddon PCN in Hampshire, Dr Tim Cooper, said: 'If you've set your programme up or you've collaborated at a scale where you're able to maintain business as usual, then I think it's a no brainer that you carry on delivering vaccination. The local vaccination sites have demonstrated that patients trust it, they can be quickly mobilised, quickly organised - they've got a good local understanding, and they can respond to their cohorts pretty quickly.
'The flip side of that is that, if your business as usual is being affected, then actually you have to question at what point do you want GPs to continue doing vaccination.'
Local vaccination sites
Dr Cooper said the vaccination campaign locally was operating from a hotel, with a workforce recruited from outside general practice, and was well placed to continue.
But he added: 'I think our slight concerns are about the workforce when the world is a bit more open. So when there's more things that people can do, it's probably going to be slightly more challenging to fill shifts, and we'll have to cross that as we get there.'
Watford GP Dr Simon Hodes, joint PCN lead for his practice within Grand Union PCN, said GPs had been given 'quite short notice' to decide on whether to continue - but added: 'I think it will be a carefully balanced decision to carry on.
'The infrastructure is there for us now. It took a lot of work to get the clinics up and running, including moving other services around in our practice to make the space workable - we've not jeopardised any services to do it thus far,' he said.
'It is quite short notice, isn't it. It would be nice to given a little bit more time to make that decision because when you're working within a PCN, it's not the same as working just with your colleagues in practice. [It's] four or five different practices and you need to consolidate and read everything and talk to their colleagues and it affects a lot of people.'
He said the decision would be a collective one for PCN member practices - and would have to consider increased vaccine hesitancy and lower response rates to invites among younger patients.