Scottish GPs to play 'key role' in COVID vaccine programme run by health boards

GPs in Scotland are to play a 'key role' in a COVID-19 vaccination programme expected to start next month and finish by spring, but health boards will have overall responsibility for its roll-out and delivery.

Scottish health secretary Jeane Freeman (Photo: Pete Hill)
Scottish health secretary Jeane Freeman (Photo: Pete Hill)

In a statement to the Scottish parliament on Thursday 19 November health secretary Jeane Freeman said the government had 'concluded an agreement with the BMA on terms and conditions for GP involvement in the programme'.

Full details on the agreement are expected to be set out shortly, but GPonline understands it will be a directed enhanced service and practices will be paid an item of service fee of £12.58 per vaccine dose, the same rate as agreed in England.

However, health boards will be responsible for identifying locations for vaccinating patients and 'they will undertake recruitment and deployment of staff, and the management of local vaccination clinics', Ms Freeman said.

GP involvement

BMA Scotland GP committee chair Dr Andrew Buist said that it would be up to boards to determine how much GP involvement they need and 'practices will then have the flexibility to determine how much they offer to take on based on their current capacity and core commitments'.

He added: 'Certain groups have been identified as both high risk for complications with COVID-19 and as "hard to reach" such as the very elderly and the agreement means locally GPs may be asked specifically to vaccinate these groups. However, the core principle is that practices will therefore be able to agree with health boards how much or little they take on, balancing local needs with their own circumstances and those of their patients.'

Dr Buist said that GPs may also be asked to offer their services to staff board-run mass vaccination centres.

'Given the shortages of GPs in Scotland and the huge pressures on their time, it was obviously not possible for GPs to run this programme single-handedly so I welcome the agreement we have reached that GPs will play a key role, while health boards will have overall responsibility for planning and delivery in their areas,' he said.

Everyone over the age of 18 will be covered by the Scottish programme. Ms Freeman said that she expected 1m people to have been vaccinated by the end of January, depending on vaccine availability, and that 2,000 'vaccinators and support staff' would be needed to achieve this. She added that the programme could be complete by 'spring next year' if the vaccines were approved and arrived in December.

COVID-19 vaccines

Scotland, Wales and Northern Ireland will receive a share of the vaccine doses ordered by the UK government based on population size. UK vaccine taskforce chair Kate Bingham told MPs earlier this month that 14m doses of COVID-19 vaccine could be available before the end of 2020 - 10m of the Pfizer/BioNtech vaccine, which the company plans to submit for authorisation 'within days', and 4m of the Oxford/AstraZeneca vaccine, which is expected to publish phase 3 trial data shortly.

Ms Freeman said she was 'hopeful that over the coming weeks into 2021, we will have more than one vaccine available to us, so that we can vaccinate as many people as possible, as quickly as possible'.

She added: 'In the first wave of our plan – from December through to February, we will vaccinate frontline health and social care staff, older residents in care homes, care home staff, all those aged 80 and over, unpaid carers and personal assistants, and those who will be delivering the vaccination programme.

'The current interim advice from the Joint Committee on Vaccination and Immunisation (JCVI) is that we then work through those aged over 65 and those under 65 who are at an additional clinical risk, and we then move to the wider population.'

Patients covered by the first wave of the programme, including GPs and other healthcare workers, would be contacted during December and January and told where they will receive the vaccine.

Ms Freeman said that much was still unknown about how long the vaccines would offer protection for and she said that further booster doses or an annual vaccination programme might be required. However, she added: 'For now, the important thing is that when we start to deliver these first vaccines, it will be on the basis that they offer some form of protection, even if we don’t at this stage, know exactly how much protection that is.'

Vaccination in Wales

Earlier this week Wales confirmed that its COVID-19 vaccination programme will be led by health boards and trusts and full details are due to be provided shortly.

In a written statement Welsh health minister Vaughan Gething said that each health board and trust had been assessed to ensure they had 'appropriate facilities and equipment to receive, store, prepare and administer vaccines in a safe and controlled manner and plans for rapid deployment through a variety of means (mass immunisation, mobile, occupational and wider primary care).'

He said the CMO would be writing to health boards and trusts soon with full detail on how the programme should be implemented.

Mr Gething said that Wales would be following guidance from the Joint Committee on Vaccination and Immunisation (JCVI) on which people are vaccinated first. He highlighted that if the vaccines were approved there would be limited supplies at first 'so it will be offered to those at highest risk'.

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