A GP practice is under investigation for administering leftover doses of the Pfizer Covid vaccine to patients outside current eligible cohorts.
NHS Derby and Derbyshire CCG held an investigation last week into a Derbyshire practice’s decision to vaccinate a local football player to avoid vaccine wastage in the last week of January.
The CCG told Pulse it was not a ‘formal’ investigation but that it has shared the report with NHS England, and the practice is expecting an outcome of the investigation.
It comes as NHS England last week updated its guidance to confirm that coronavirus vaccines should not be given to patients outside eligible cohorts.
Previously, it had said that GPs could offer Covid jabs outside the eligible priority cohorts if there is a ‘risk’ of vaccine wastage.
In a statement shared on its website earlier this month, Stubley Medical Centre in Dronfield said it ‘stands by’ its decision to vaccinate patients outside the cohorts as a ‘last resort’ to avoid vaccine wastage.
The vaccination site has ‘not thrown a single dose away’ to date, thanks to operating a reserve list of patients listed by ‘clinical priority’, it added.
The practice said: ‘At the end of every busy vaccination clinic, as is the case elsewhere, it is often the case that we have a small number of vaccines drawn up that we are very reluctant to throw away.
‘We have a list of possible recipients ready to call. This is a wide range of patients, starting with the existing target groups and listed in clinical priority.’
It added: ‘A further group is at increased risk but may not fall into the current target groups, they are there because they have made reasoned representations to us to be considered as reserves.
‘This final group of patients are a last resort before the vaccine would have to be thrown away and they need to be able to respond instantly if called.’
A ‘small number’ of Chesterfield FC employees who had ‘existing conditions with consultant letters requesting their vaccination’ are included on the reserve list, the practice said.
It added: ‘One, who lived close to the surgery, attended without such correspondence at the very end a vaccine clinic and a decision was taken to use the vaccine rather than throw it away. We stand by this decision.’
The practice has been working with the football club on plans for a drive-through vaccination service at the Technique Stadium, it said.
Stubley Medical Centre added that it is ‘justifiably proud’ of its performance since the start of the Covid vaccination campaign, with high uptake achieved across priority groups including 100% of over 80s, care home residents and housebound patients.
It said: ‘By careful use of the vaccine product in accordance with approved guidelines, we have managed to vaccinate more than 5,000 more people than for whom the vaccine quantity supplied to us was originally intended.
‘It is probable that a number of extra lives therefore may have been saved by our rapid response to the callup, and our efficiency.’
U-turning wastage guidance has been a source of contention throughout the vaccination programme, with unclear guidance creating a catch-22 situation that has led some sites to throw vaccines away.
Last week, new guidance said that Covid vaccines ‘should not be given to people outside of cohorts one to six’ but only to those from eligible cohorts on reserve lists – contradicting advice given last month.
But this week, an update to the enhanced service again said vaccination ‘will be permitted to patients outside of the announced cohort’ where ‘clinically appropriate’, there are ‘exceptional circumstances’ and vaccine ‘would otherwise have been wasted’.
When approached for comment, NHS England refused to clarify the guidance.
Dr Peter Flann, Chesterfield and Dronfield PCN clinical director, told Pulse: ‘My perspective is that the investigation never should have taken place, and that we have not done anything out of the ordinary.
‘We’re talking about two people who received a vaccine at the end of a clinic when the vaccine would have been wasted. Considering that we have provided around 35,000 vaccines in the PCN… It is rather disproportionate that two vaccines are questioned.’
He added: ‘We weren’t happy that an investigation was underway in any way at all. We provided the vaccines in the same circumstances as anyone else would have done – if the priority is not to waste the vaccine.’
An NHS Derby and Derbyshire CCG spokesperson said: ‘We have been working with all providers of vaccinations to ensure that the programme is delivered in line with the clear national policy on vaccinations. We are reviewing this particular issue with the local vaccination service concerned.’