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Vaccine programme needs direction



I had been going to explain that, despite the posturing, petulance and prevaricating around our role in the Great Covid Jab Project, I’m actually keen to get on and muck in. After all, I want to be able to say that, when science saved the masses and consigned coronavirus to microbiological history, I was at the sharp end. Or, rather, at the less pointy, plunger end.

And I had planned to suggest that the only bit needing ironing out for GPs is the tension between dull old job versus heroic new role. In that, on the one hand, we’re being told that it’s all hands to the pump and that, to quote the notice letter: ‘While urgent care will need to continue … this programme will be the top priority.’ And on the other, in the NHSE-scripted collaboration agreement, we’re supposed to agree that: ‘We acknowledge that nothing in this Agreement is intended to vary, relax or waive any rights or obligations contained in our primary medical services contracts.’

And in fact, I am going to say all that, but now with an increasing sense of urgency and desperation. Because, as of last night, I discovered something unbelievable: the Patient Group Directions/National Protocol to enable us to vaccinate en masse are – get this – NOT READY. So scientists can warp speed vaccine development beyond our wildest dreams while bureaucrats can’t find the time to produce and legally box-tick a formality document that no one is going to read anyway?

This means that, for an interim period, we have to go down the Patient Specific Directions route. I won’t bore you with the technical detail. The upshot is that the vaccinating process will be slower, more cumbersome and stupidly reliant on the presence of prescribers – two per pod according to some hurriedly updated guidance.

That causes big problems. Reduced throughput and potential vaccine wastage, for a start, although these can probably be worked around. But also doctors being dragged, in significant numbers, from their usual work to that sharp end of the process, whether they like it or not.

If that hits us GPs then we have to point out that we’re good, but not so good that we can be in two places at once. Something has to give, and that has to be the day job. Specifically, all routine work, income protected. Enough of the vague and contradictory messages. Do it now, NHSE, officially. Or it’ll be the entire programme, not just the vaccine, on ice.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield

READERS' COMMENTS [6]

Hello My name is 7 December, 2020 6:02 pm

The issue is, Copperfield, what is routine? Our receptionists have a daily battle with the punters over – ‘do you REALLY need to speak to a doctor today?’… One of my urgent calls last week was from a lady who was having her breast implants removed privately, and she wondered if the GP surgery could perform her pre-op assessment, to save her a 2 hour drive. Beggars belief.

Peter English 8 December, 2020 10:58 am

Is this perhaps because PGDs are not usually permitted for black triangle (new) drugs?

Patrufini Duffy 8 December, 2020 4:44 pm

Precisely Hello. Poignant UK issue.
What is UK “emergency” and “urgent” issue in swamped General Practice? Most issues can wait 2-3 days minimum, otherwise you’re calling an ambulance or ED.
Other comical “emergencies”:

“I broke up with my boyfriend”
“I need my coil changed…now”
“My flat is too noisy, I want a letter”.
“My baby’s clingy”
“I’ve had a cough for a week, I’m going on holiday tomorrow”.

David Turner 9 December, 2020 12:49 pm

Like you I am willing, able and ready to roll my sleeves up and administer the Covid vaccine.
But yes it is almost ( but not quite) unbelievable that some pen-pusher can’t cut and paste a few paragraphs together to make up a PGD before next week.
Maybe they have something better to do ( Xmas shopping? …cynical even for me)

Christopher Ho 10 December, 2020 4:13 pm

“Do it now, NHSE, officially.”

I’m sure they’ve taken your msg to heart and are rushing to do their UTMOST best, and surely not dithering to see what they can get away with. And they get away with much, simply because we let them.

Paul Cundy 15 December, 2020 11:04 am

Dear Dr Copperfield,
A bug bear of mine, “P”atient “S”pecific “D”irections do not exist, note the capitalisation. There is no such thing as a PSD. There are Prescriptions, Directions (about specific patients) and PGDs. The words patient specific direction do not appear anywhere in teh Human Medicines Act. A Direction under para 214)2)b) of the Act can be in any mutualy agreed form, a verbal instruction, a yellow post it, a computer list or even smoke signals. All of those Directions would constitute the different forms that generic patient specific directions can take. I wrote an article about it which Pulse published some time back. Apart from that keep your pecker up.
Regards
Paul C