Urgent preparations are under way across the UK for the rollout of the Covid vaccine, after the momentous news on Monday that the Pfizer/BioNTech vaccine had proven 90% effective. Jonathan Van-Tam, England’s deputy chief medical officer, has said the country and the NHS is gearing up for the “most important vaccination programme we’ve done for decades”. But that has raised questions about which organisations inside and outside government will be doing what to speed delivery.
Q: Who is in charge of the rollout of the Covid vaccine?
A: Politically, the government is responsible. But operationally, in England, the NHS is in charge of delivering an unprecedented logistical challenge – immunising the country against the coronavirus.
A Whitehall official explains: “Ultimately the government is in charge of the vaccine rollout. It’s a Department of Health and Social Care (DHSC) programme. We lead on the policy and the NHS leads on the operational delivery of that plan. So it’s an NHS vaccination programme – it will be delivered by the NHS. But who’s responsible for it? Ultimately ministers are responsible for it.”
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So if things go wrong as the rollout unfolds – for example, if parts of the country don’t receive enough doses of the vaccine – then ministers will be held to account for that by parliament, just as they have been for the many failures of the government’s £12bn test and trace programme.
Neither the DHSC or NHS England have formally announced that this is the division of responsibilities involved in the rollout, however.
It is not yet known how the vaccine rollout will happen in Scotland, Wales and Northern Ireland, though the NHS there is likely to also play the lead role. The 40m doses of the Pfizer vaccine are for the whole of the UK and the DHSC has spoken to the devolved administrations about this, but nothing has been decided yet.
Q: When will we get full details of how the rollout will work?
A: NHS England is finalising the details of its and the DHSC’s “deployment plan” for England. That may emerge as soon as next week, but it is understood that delays have occurred, so publication may slip until later in November.
The plan is likely to outline the different but overlapping roles to be played by community-based vaccinating sites, run by GPs, which will administer 200-500 jabs a day; mass vaccination sites, where 2,000-5,000 people a day will be immunised; and the third model of vaccine delivery planned, namely pop-up sites and healthcare professionals in vehicles, who will bring the vaccine to places such as care homes and prisons.
However, one source with knowledge of the plan said that it was unlikely to specify how many people each of these types of methods should be vaccinating every day. “The government is not using targets for this, given what’s happened with all the different targets [around coronavirus testing and PPE delivery] around the Covid pandemic this year”, the source said.
Quick guide Who in the UK will get the new Covid-19 vaccine first?
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The UK government’s joint committee on vaccination and immunisation has published a list of groups of people who will be prioritised to receive a vaccine for Covid-19. The list is:
1. All those 80 years of age and over and health and social care workers.
2. All those 75 years of age and over.
3. All those 70 years of age and over.
4. All those 65 years of age and over.
5. Adults under 65 years of age at high at risk of serious disease and mortality from Covid-19.
6. Adults under 65 years of age at moderate risk of at risk of serious disease and mortality from Covid-19.
7. All those 60 years of age and over.
8. All those 55 years of age and over.
9. All those 50 years of age and over.
10. Rest of the population
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Q: Is the NHS the right organisation to do this?
A: Yes, for several reasons. GP surgeries, health centres and hospitals already deliver immunisations, such as the MMR and six-in-one jabs that most young children have. The NHS is the only organisation with the personnel, expertise and premises needed, given the scale of the task, although the service, especially in England, is short-staffed. And lastly, the public generally trust the NHS in a way they are unlikely to trust any private firm that ends up doing immunisations. Serco and Sitel’s very poor performance in delivering test and trace is prominent in ministerial thinking.
Q: What parts of the NHS will be involved?
A: Almost all of them, one way or the other. The task in hand – to give two jabs, several weeks apart, to tens of millions of people as soon as possible – is so enormous that all kinds of NHS staff will be involved. NHS England calls this their “all hands to the pump” approach. Paramedics, podiatrists, physiotherapists and many others will be involved, not just doctors and nurses. They will come from GP surgeries, hospitals and community-based health services. Hospitals will lose some of their personnel, potentially for months, when they are seconded to the vaccine drive.
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Hospital bosses admit privately that this is not ideal, and that their services may be impaired at a time when they will still be tackling winter pressures and the second wave of Covid-19. But they say the job of vaccinating the population is so urgent and life-savingly important that the temporary disruption to normal care is justified in the longer-run.
Q: Will GPs will play a key role?
A: Yes, especially initially, when the first task will be vaccinating the ten different groups deemed the greatest priority. They include care home residents, NHS and social care staff, over-80s and the 2.2 million people on the “shielding” list because they have serious underlying health conditions.
In England, the 1,260 primary care networks – groups of GP practices – have to quickly identify at least one site in their area that will be open for vaccinations between 8am and 8pm seven days a week, including bank holidays, and deliver a minimum of 975 jabs a week.
However, many other healthcare professionals – and even student nurses and doctors – will become involved, especially once the mass vaccination sites start opening.
The Army will be involved, too. They will help with the creation of pop-up sites and also the transportation and delivery of supplies across the UK of whatever vaccines are available.
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