The noise around community pharmacy delivering COVID-19 vaccines rose to a roar this week. The sector has been calling for a greater role in vaccine delivery plans since the approval of the Pfizer/BioNTech jab in December, but only 200 out of more than 11,000 eligible pharmacies in England are set to administer vaccines, according to NHS England and NHS Improvement (NHSE&I).
Calls for pharmacy vaccinations became more urgent due to the combination of the approval of the Oxford/AstraZeneca vaccine, which, unlike the Pfizer/BioNTech vaccine, can be stored in fridges, and the announcement of a third national lockdown starting on Tuesday, January 5.
On January 6, The Telegraph published a front-page spread saying pharmacy teams had been “snubbed” by the government over the COVID-19 vaccines. The article featured Simon Dukes, chief executive of the Pharmaceutical Negotiating Services Committee (PSNC), saying the proffered support of the sector had been met with “silence”.
The story was accompanied by related content across several mainstream media outlets, including BBC Radio 4, The Times, The Guardian and The Sun, featuring statements from PSNC and the Royal Pharmaceutical Society (RPS).
The media furore peaked later that day, with Prime Minister Boris Johnson telling parliament how “a vital role can be played by pharmacies” alongside GPs, hospitals and the army. The next day, health secretary Matt Hancock acknowledged how pharmacies could help spread vaccine access to all corners of the country.
“Community pharmacies…are highly engaged in their local communities, often more local than any other healthcare setting and therefore will be able to support right into the communities that we need to reach [with the COVID-19 vaccine],” Mr Hancock said.
NPA: “Get started immediately”
Pharmacy joined the clamour with aplomb. C+D launched a petition urging NHSE&I to let more pharmacy teams across England pitch in with national COVID-19 vaccination efforts, which had more than 800 signatures at the time of publication, and wrote an open letter to NHSE&I chief executive Simon Stevens.
The National Pharmacy Association (NPA) chair Andrew Lane says the issue should be a “no-brainer” for vaccine leads. He asks: “What on earth is stopping the NHS from mobilising more pharmacies for this vital task?
“Pharmacies can play a significant role in the COVID-19 vaccination programme, and we’re well equipped to get started immediately. We have been on the health service frontline throughout the pandemic and now we want to join this latest, decisive, battle against this deadly virus.”
To be eligible to host a vaccine site, community pharmacies have to be able to meet criteria including having the capacity to deliver 1,000 vaccines a week, an impossible standard for many businesses.
Mr Lane continues: “The process for signing up to give vaccines needs to be as agile as the workforce and should allow pharmacy teams to come on board rapidly.”
CCA worried about NHS flexibility
The Company Chemists’ Association (CCA), which represents the UK’s largest multiples and supermarket pharmacies, has been unequivocal in its support for commissioning more pharmacies to offer the vaccines.
“The Oxford/AstraZeneca vaccine should help the NHS unleash the full potential of pharmacy teams up and down the country,” the CCA says.
“We are concerned that the NHS could miss the opportunity to use [the community pharmacy] network at its full capacity unless lessons are learnt from the planning of the Pfizer/BioNTech vaccine programme.”
Some CCA members, including Boots, Superdrug and Morrisons, are running sites to provide COVID-19 vaccine, but the association estimates that if all other community pharmacies were involved as well, they could provide up to a million vaccines a week.
“The delivery of the Oxford/AstraZeneca vaccine does not need to be established from the ground up,” the CCA says. “There are tried and tested logistical and clinical networks that can easily be used to deliver what is needed with very little lead time.
“We urge the NHS to adopt a flexible approach to providing accessible vaccinations by working with the CCA and our pharmacy partners to find solutions to the challenges we face. We must leave no stone unturned in our efforts to ensure the COVID-19 vaccine programme is a success, without any unnecessary delay.”
“Do not delay”
Many pharmacies want to see a response from the government immediately. The Cambrian Alliance Group, a pharmacy support organisation with approximately 1,200 members, claims that the sector could deliver more than one million vaccines per week.
“It is imperative that the government does not delay, ask community pharmacy for support now and you will get it.”
The sector could be a crucial part of the national effort, the group says. “It is important that government now turns its attention to adopting a new approach and seeks support and assistance from those who can help. Community pharmacy stands ready, willing and able.
“Community pharmacies are situated in high street locations, in neighbourhood centres, and are often in some of the most deprived communities. Crucially, 89% of the population in England has access to a community pharmacy within a 20-minute walk.”
“Public health disgrace”
The Healthcare Distribution Association, which represents the UK's largest medicine wholesalers, “couldn’t agree more” with the idea of more pharmacies supporting COVID-19 vaccine delivery, executive director Martin Sawer tweeted. He stressed how the sector already has distribution mechanisms that could be used for vaccines.
Administering 100 vaccines a week per pharmacy is “realistic”, North of Tyne local pharmaceutical committee (LPC) tweeted, amounting to over one million vaccines a week if every pharmacy in England was involved.
“It’s a public health disgrace that community pharmacies are not being engaged to support the COVID-19 vaccination programme,” the LPC said.
Rifat Asghar-Hussain, superintendent pharmacist of Evergreen Pharmacy and Green Cross Pharmacy in Birmingham, said in a tweet that it was “absolutely unbelievable” that the majority of pharmacies had been snubbed by the government because patients want the vaccines from pharmacies.
Thorrun Govind, RPS English Pharmacy Board member, echoed this refrain when she tweeted “pharmacists are ready and able to vaccinate”.
Last but not least came politician Rory Stewart, former secretary of state for international development, who summed up the mood of many when he tweeted that the government’s overlooking of pharmacy for COVID-19 vaccines “seems so bizarre”.
While pharmacies have made it clear that they are ready to join the vaccination programme, the battle is far from won, as the government have yet to commit to commissioning more than 200 pharmacy-led vaccination sites.
Sign C+D’s petition urging NHSE&I to let more pharmacy teams across England pitch in with national COVID-19 vaccination efforts here