How to optimise the COVID-19 vaccination service in your pharmacy
Four industry insiders explain why they are providing NHS COVID-19 vaccines this season – despite a challenging backdrop of funding pressures and capacity constraints
This year, almost double the number of community pharmacies are offering the NHS COVID-19 vaccination service compared to the previous season.
Last month (September 27), NHS England (NHSE) exclusively revealed to C+D that more than 3,000 community pharmacies had been “designated” to offer the jabs in the upcoming season, and that the figure may continue to grow.This compares to the 2022/23 season, when 1,655 pharmacies were designated to offer the service.
Industry insiders offering COVID-19 jabs have told C+D they see the service as an opportunity to help ease pressure on the NHS, support their communities and increase their revenue. But they all agree that the process has not been an easy one.
Setting up the service
Jonathan Power, chief executive at Avicenna Pharmacy, says his team put forward 93 applications to offer COVID-19 jabs for all of the chain’s pharmacies in England and were accepted for 63, allocating two clinical rooms in each pharmacy dedicated to vaccinations.
He says Avicenna Pharmacy is investing in “additional resources to get through the season”, with a view to helping patients “as much as possible”. But he’s aware that demand for the service is likely to increase in the future.
“We’re actively trying to recruit many pharmacists across the country,” he tells C+D. “We need others in the store to help with the paperwork side and vaccines, and we also need technicians.”
But there have been roadblocks along the way, he says. “I think the biggest challenge – and we've had real challenges – is getting all the stock…and getting things set up on the booking system.”
He also highlights finding the time to offer the service as “a real challenge”. “If you're in a pharmacy that's dispensing about 10,000 items every month, and you've got to set aside a few hours for training, when do you do that,” he asks. “You can’t do it when the pharmacies are open.”
For pharmacy teams taking on the service for the first time, Mr Power says the process draws on the experience pharmacy teams already have around delivering flu vaccines, although he concedes that offering COVID-19 jabs is a “major operation”.
Owners of Exmouth's Lewis Pharmacy, Jackie Lewis and Martyn Lewis, have set up three consulting rooms to provide the service. They’ve been offering NHS COVID-19 vaccines since January 2021, and they think the service is a good thing for community pharmacies to take on.
“Making money has been essential to keep our pharmacy going – we struggle to keep our heads above water, and it is an income stream that we need,” Mr Lewis says.
Meanwhile, Wicker Pharmacy in Sheffield started offering NHS COVID-19 vaccines in May 2021.
Ellie Bennett, the managing director, says: “We have a pharmacist every day that is dedicated to being in the vaccination clinic. We also have at least three other members of staff to train vaccinators, and one that greets the patients.”
She admits that offering the service is “an undertaking”, as teams have got to make sure there is enough staff to run the clinic, as well as ensuring they have enough stock of the vaccine itself to meet demand.
“It's very full on and if we're not fully booked, we will accept people walking in as well,” Ms Bennett says.
A challenging environment
Although offering the NHS COVID-19 vaccination service presents an opportunity for community pharmacists, it does have its challenges.
Although Ms Bennett believes offering the service is “an important public health intervention” and “something that pharmacists should be doing”, she’s not blind to the financial barriers leading many contractors to opt out of offering COVID-19 jabs this season.
While pharmacies that deliver both a COVID-19 and a flu jab to a patient in a single appointment will be a paid a “double-jab” fee of £17.12, NHS England (NHSE) has this year reduced the fee for COVID-19 jabs by a whopping 25%, in a move that Community Pharmacy England (CPE) says “defies logic”.
Indeed, Ms Bennett says that her team “were very close to not doing it when the funding was reduced”.
For Mr Power, it was “very disappointing that the NHS initially reduced the fee points substantially.”
He says: “It’s concerning how a pharmacy is going to be able to cope with the extra volume, unless that funding comes straight along with it to give us the ability to invest.”
As contractors know only too well, funding constraints have only made it more difficult to offer certain clinical services. “I think at the moment community pharmacy is operating very tightly, there is rarely the cash to invest in developing this type of service,” Mr Power says. “It’s through an increase in the amount of resources that we've received [that] we’ve been able to deal with the higher volume of activity.”
And if funding wasn’t enough of a headache, the reams of paperwork that come with offering clinical services can feel prohibitive.
Mr Lewis says: “The NHS admin is boring – they are weeks, if not months, behind, and the admin burden is massive.
“It’s a shame because I know that the public love [the service] and our patients love it too.”
A rewarding experience
Despite the obstacles that have come with providing the NHS COVID-19 vaccination service, all four community pharmacy insiders say they are keen to continue providing the service.
Ms and Mr Lewis say they like offering vaccines at their pharmacy and vaccinating for COVID-19 only adds to the list of other NHS vaccinations they offer, including hepatitis A, tetanus, typhoid and measles, mumps and rubella (MMR).
They say: “We think as a community pharmacy, we should be serving our community. [By providing the service], patients don’t have to queue at the GP or go to a mass vaccination site.”
Mr Power says the service takes a lot of energy – although it’s worth it. “We want to get in a position with our patients where we are providing more than their prescriptions,” he says.
“We’re going beyond dispensing and we’re building a reputation for being a place to go for vaccinations. Thinking ahead to Pharmacy First, we want patients to consider their pharmacy and their pharmacist to be a provider of their wider healthcare needs and we want to remove pressure from other parts of the NHS.”
While he concedes that Avicenna’s pharmacists “are all very busy at full capacity” they are “super keen” to provide clinical services. “Largely speaking, they don’t want to be chained to the dispensary. They want to use their clinical skills and they have gone through that process over the least 10 years of embracing [flu jabs],” he explains.
More than anything, though, he points out, the pharmacy’s frontline role during the COVID-19 pandemic has allowed the sector to show what it can do.
Ms Bennett says the hard work feels worthwhile. “Talking to the people you're vaccinating is lovely. A lot of people come in and some vulnerable patients may have not seen anybody for a while, because they’re isolating and things like that, and it’s very lovely to speak to them,” she explains.
“They're very happy that you can vaccinate them and generally, it's a really nice experience. Once you get past all the mechanics, the actual vaccinating is lovely.”
But on plans for next year, she says: “Who knows? In my head, we will be doing them next spring. But we’ll see.”