PCNs opt out of phase 2 of COVID-19 vaccination programme over workload pressure

Some PCNs have opted out of phase 2 of the COVID-19 vaccination programme, with others warning that they may be forced to follow suit, because of mounting workload pressures and workforce concerns.

(Photo: Cavan Images/Getty Images)

The next phase of the vaccination programme – vaccinating those under 50 – began this week, although PCN sites are expected to be focusing on second doses for those from phase 1 of the programme in the coming weeks.

GPonline reported in March that the majority of practices were expected to sign up to the second phase of the programme, which required them to 'opt-in' to continue delivering first dose vaccines to under 50s by 19 March.

NHS England has told GPonline it does not have up to date information on the number of PCNs that will remain involved in phase 2 of the campaign. However, Kent LMC has said that seven out of 41 networks in the county have opted not to continue to take part in phase 2 and GPonline understands that PCNs from other parts of England have also decided not to continue.

GP workload concerns

Kent LMC medical director Dr John Allingham said that workload and lack of resources had been the key reason behind the seven networks in Kent deciding to opt out of phase 2 of the programme.

‘The patchiness of [vaccine] delivery is a continuing concern and a lack of resources has led to the non sign ups,' he said. 'Money is an issue, but some just don't have the staff to keep going. Demand is off the scale and running a vaccine service as well is too much.’

Meanwhile, clinical directors from PCNs that have signed up to phase 2 have said networks could struggle to cope with the demands of running vaccination clinics in addition to performing the day job and resuming most tasks associated with the GP contract and other local requirements from this month.

Recent analysis by GPonline showed that GPs delivered hundreds of thousands more appointments and a third more clinical admin work in the first weeks of 2021 compared with last year.

PCN leaders also say that a lack of funding is making it difficult for networks to juggle responsibilities – insiting that they must protect fatigued staff.

Central and Thistlemoor PCN in Peterborough, Cambridgeshire, is continuing with phase 2 of the campaign, although Dr Neil Modha, the network's co-clinical director, said some other networks in the area have opted out.

COVID vaccination programme

Dr Modha said the return of QOF and long-term condition management work, which has resumed after being suspended for most of 2020/21, had stretched his team.

‘The first phase of the vaccine programme took an amazing amount of organisational effort and energy… none of us have got new magic staff to continue this programme while delivering core services.

‘So how do you deliver the service that you want to deliver to patients – that the NHS expects – and deliver a vaccine programme alongside that? Also, how do you make sure that by doing these good things you don't lead to staff burnout and low morale?'

Dr Modha admitted that his PCN had found it hard to find ‘consistent support’ to bolster existing network staff and said tough decisions about prioritising work would have to be made soon.

‘We're having deep conversations within the PCN, approaching other PCNs that have already opted out to see whether they may be willing to share workforce. We're strongly evaluating the options, but I think our fundamental concern is how do we protect our staff,’ he said.

The BMA said that it was vital that PCNs taking part in this next phase of the programme were provided with 'proper support and resources' to undertake the work involved.

Funding issues

Clinical director of Kingston PCN in London Dr Richard Van Mellaerts also voiced concerns about the knock-on effects to staff. He said: ‘We have signed up. It's a sense of wanting to see the job through to the end, and the fact that we have the systems in place after much effort. It would be a shame to close down now.

‘But it’s true to say we have concerns about staff and workload. The funding is too little and the workload too great. Extra workload is continuously added without recognition of the implications. We can just about make it work’.

BMA GP committee chair Dr Richard Vautrey said: 'It is up to individual practices and PCN groups to decide if they want to participate in this next phase while also continuing to provide second doses and, at the same time, providing other important services that they have been delivering as best as they can throughout the pandemic.

'However, with rising workload pressures, not least with the reintroduction of QOF, it is understandable that some practice groups will not have the capacity to do everything asked of them. It is therefore crucial that proper support and resources are available to those who do decide to play a part in the vaccination programme, that local schemes continue to be suspended, and that the support that has been provided since the start of the rollout both nationally and locally is not removed.'

Primary care has been the driving force behind the vaccination campagin in England so far, with the vast majotity of first doses during phase 1 being delivered in PCN sites.

Last month NHS England announced that GP practices will be supported with an extra £120m between April and September this year through an expansion of the COVID-19 support fund that aims to boost capacity to help deliver the vaccination programme.

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