Data lowdown: one in five PCNs opted out of Covid vaccination programme

The UK Covid vaccination programme has been a roaring success, largely due to GPs’ efforts, but exclusive figures obtained by Pulse have revealed the extent to which primary care networks (PCNs) in England have exited the programme.

Over 45 million people have received their first dose of the vaccine, and more than 33 million having had their second so far, the latest UK Government data show.

General practice has played a crucial role, with primary care teams having delivered the bulk of the jabs between December and April, as the first phase of the programme – aimed at vulnerable groups and over-50s – got underway.

But this ‘monumental effort’ from the sector – as ex-health secretary Matt Hancock himself put it – hasn’t come without a price for GP practices, with many balancing vaccinations with increasing routine care demands, meaning workload pressures are now at an all-time high.

GPs saw more patients in March than in any other month since records began, according to official statistics, with the latest figures, for April, showing practices continued to be under ‘immense’ strain, according to the BMA.

As expected, NHS England has since confirmed it has ‘no plans’ to suspend QOF or income-protect it for GP practices this year, as had previously been the case.

In March, NHS England wrote to PCNs enrolled in phase 1 of the Covid vaccination programme, asking them if they would like to take part in phase 2 (patients aged 18 to 50). It provided the chance to opt out from the contract altogether. 

GPs were at a crunch point, balancing vaccinations with increasing demand. For many, this forced them to reconsider their involvement in the second phase.

NHS England previously declined to reveal how many PCNs had signed up to phase 2 and how many opted out – but Pulse has now obtained the official figures through a freedom of information (FOI) request. 

The results show 1,032 PCNs took part in the first phase of the programme – but 22% of those opted out of the second phase, beginning in mid-April.

In its FOI response, NHS England said it did not decline ‘any expressions of interest on the basis of requirements not being met by sites’ for phase 2.

These official figures broadly reflect the picture painted by a Pulse survey carried out in May, which found 24% of GP partners involved in the vaccination programme said their PCN had opted out of phase 2. 

In that survey, eight in 10 (79%) of those who said their PCN was not taking part in phase 2, and who stated a reason, put this decision down to ‘workload pressures’ in general practice, while 5% said they left because they were unable to administer vaccines from their own sites, and 10% gave other reasons. 

As for practices wanting to deliver the vaccine at their own practices, this is something that has been discussed for months, but no new guidelines have been announced.

Pulse’s survey found almost 60% of GP partners taking part in the Covid vaccination programme want to administer the jabs from their own site but have not had the opportunity.

However, NHS England appears to be preparing for the opposite scenario. In its recent announcement on preparations for the planned autumn Covid booster jab programme it suggested that the Covid vaccines will continue to take place at PCN group level.

Flu vaccines will likely be given at the same time, with GPs ‘actively encouraged’ to pool flu vaccines between practices to enable co-administration with the Covid vaccine at a PCN grouping level, it said.

This third phase of the programme will see GPs deliver a maximum of 75% of jabs – while an additional 1,000 community pharmacy sites will be onboarded ‘in the run-up to September to support phase three delivery’, said NHS England.

GPs’ core workload is unlikely to reduce in the coming months, yet flu vaccinations are their territory; PCNs face another difficult decision about participating in the final stage of the Covid vaccination programme this year.