Covid-19 vaccinations in the community: five minutes with . . . Anuj PatelBMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n79 (Published 11 January 2021) Cite this as: BMJ 2021;372:n79
“Our practice is one of the vaccination sites in north Barnet. We’ve got a collaboration of 22 practices across two PCNs [primary care networks] for which we provide the vaccination programme. We’re in a population with a lot of elderly people and a lot of care homes, so the logistics is quite hard. Across 22 practices we’ve got 6000 over 80s who are mobile and around 45 care homes to cover.
“We set up the clinic in a marquee in the practice garden, because we didn’t want it to affect the normal daily running of our general practice. We still have to run normal services for our patients as well as doing this, and it takes a lot of time and effort—not just to find staff but to free them up from their day-to-day working. It’s a real commitment, seven days a week, 8 am to 8 pm.
“We’re very organised as a team, and we have daily calls with our clinical commissioning group to coordinate some of the difficulties. For example, we generate a lot of sharps, and our sharps weren’t previously being collected regularly, so there are little details that people don’t recognise but make a big difference. But we’re now getting to a stage where we’ve got a real idea of who manages which bit of our operation.
“It's getting easier, but it’s still hard because we’ve got to fill the rotas. We estimate that we need six clinicians, six to eight people entering information on a computer, and then about a dozen marshals to get us through 1000 vaccinations in three days. So, each session, each shift, we need that many people to be present to do all of the work to make it run smoothly.
“We’ve had to do a lot of overtime. We’ve been fortunate in that we’ve had a lot of volunteers from the 22 practices, and that helps because they understand the system. We’ve got medical students and retired doctors volunteering, and the voluntary sector and other organisations coming in, which is really good because our practice staff need a bit of a rest.
“Not knowing when the vaccine is going to be delivered has been challenging when trying to book patients in. Our vaccine this week was due to come on Thursday [7 January]. We normally expect it in the morning, but on the Tuesday we found out that they might send the delivery at any time up until 6 pm. We had clinics booked from 2 pm, so you can see the logistical nightmare if suddenly we don’t get the delivery and we’ve got to start pushing patients back or cancelling them.
“We’ve run two programmes of 975 doses. We’ve kept a cohort of people who we can call in at short notice at the end of the day to make sure that we don’t waste any doses. Some people don’t turn up; some people turn up and try to sneak in, and we don’t like turning them away. By the end of the day, you’re trying to tot up numbers. But we really are keen to make sure that every single dose is used up. It’s a real balancing act.”
Anuj Patel is a GP partner at Wentworth Medical Practice and chair of Barnet Federated GPs.