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Supply and reluctance: What’s delaying a pharmacy COVID vax service?

NHSE&I: Pharmacies need to be able to offer all approved vaccines

More than 200 pharmacies are expected to start vaccinating by the end of January, but questions remain as to why less than 2% of the sector has been commissioned to do so thus far.

Speaking at the Downing Street coronavirus briefing last week (January 11), health secretary Matt Hancock said that pharmacies will play a bigger role in the government’s vaccination campaign when the need comes to “persuade people…who are less certain that they want the vaccine to get the vaccine” and simplify access to it for those who “find it difficult to travel”.

Several pharmacy bodies have urged the government to commission community pharmacies more widely to deliver the COVID-19 vaccination programme, and yet just 200 – less than 2% of the circa 11,500 pharmacies in England – are expected to go live by the end of January.

So, what are the reasons for NHSE&I’s slowness to commission the whole sector to step up its vaccination efforts?

Vaccines in limited supply?

An NHS England and NHS Improvement (NHSE&I) spokesperson told C+D last week that, while six pharmacy sites have begun offering the vaccinations, more will follow soon – which is the same process the commissioner followed with hospital hubs, GPs and large-scale sites, they stressed.

However, welcoming the six pharmacies vaccinating eligible patients in their localities last week, NHSE&I deputy chief pharmaceutical officer Dr Bruce Warner said that “more [pharmacies] will come on stream as supplies allow” – suggesting that a limited supply of vaccines could currently be preventing a greater number of pharmacies from delivering the COVID-19 jabs within their communities.

Speaking to Sky News today (January 18), vaccine deployment minister Nadhim Zahawi laid out plans for a 24-hour COVID-19 vaccination pilot, which will initially involve hospitals in London – a service that the Labour party said community pharmacies should lead on.

But Mr Zahawi added that “at the moment, the challenge is obviously supply, limited supply of vaccine that needs to get into the arms of the most vulnerable four cohorts […] so we can protect them by mid-February”.

NHSE&I CEO Simon Stevens also told BBC yesterday (January 17) that 140 people a minute are being given the COVID-19 jab and that, at the moment, the NHS is “vaccinating four times faster than people are newly catching coronavirus”.

The NHS could go faster and vaccinate even more adults as soon as it has “more vaccines supply”, he added.

C+D has asked NHSE&I whether a lack of consistent supply is the reason why it has not commissioned a national pharmacy COVID-19 vaccination service so far.

More than 3.8 million people were administered their first dose of COVID-19 vaccine in the UK, the Department of Health and Social Care (DH) said in a statement today, as the NHS begins the rollout of the vaccines to those aged over 70 and people who are clinically extremely vulnerable to COVID-19.

Supply chain issues?

A DH spokesperson told C+D that “vaccines are being distributed fairly across the UK to ensure the most vulnerable are immunised first and all GPs will continue to receive deliveries as planned”.

However, a few GPs reported last week that they had not received their orders of COVID-19 vaccines – an issue that NHSE&I medical director for primary care Nikita Kanani said was due to a “temperature excursion at one of our specialist pharma logistic providers”, according to a message to vaccinators, seen by C+D.

An NHSE&I spokesperson told C+D last week (January 15) that “a small number of vaccines” were affected and that it had informed “all sites of the delay and should receive it [that day] or overnight”.

Healthcare Distribution Association (HDA) executive director Martin Sawer told C+D that wholesalers “are not experiencing problems in the supply chain”.

“What will be the rate-limiting factor is the manufacturing of enough vaccines in a timely way to satisfy the demand of the vaccination centres,” he said.

HDA members “are distributing all the stock they get almost as soon as they get it”, he added.

“The supply chain is flexible and has the capacity to do more and deliver more; I don’t think we’ve always got, necessarily, as much as we could deal with. We could cope with more supplies if they were there,” Mr Sawer said.

C+D has asked both AstraZeneca and Pfizer for comment.

Reluctance over vaccine requirements

Earlier this month, C+D launched a petition – which, at time of writing, has amassed almost 4,000 signatures – urging NHSE&I to allow more community pharmacies to vaccinate by forfeiting the requirement for them to deliver 1,000 vaccinations per week.

An NHSE&I spokesperson told C+D today (January 18) that all local vaccination sites, including community pharmacies, must be able to deliver all approved vaccines, including Moderna’s when it is introduced to the supply chain later this year.

An anonymous pharmacy owner told C+D earlier this month (January 5) that contractors were reluctant to put themselves forward to take part in the vaccination programme because of the need to be able to deliver either vaccine – Pfizer/BioNTech or Oxford/AstraZeneca.

The requirement of being able to offer the Pfizer/BioNTech COVID-19 vaccine – which is logistically more difficult for the sector to deliver – coupled with NHSE&I’s ask for pharmacies to administer 1,000 vaccines a week, could prevent many more from joining the national vaccination efforts in the future.

Sign C+D’s petition urging NHSE&I to let more pharmacy teams across England pitch in with national COVID-19 vaccination efforts here

5 Comments
Question: 
Will your pharmacy offer the COVID-19 vaccination service?

Kevin Western, Community pharmacist

Our biggest problem is decades of poor representation by all the so called representative bodies who wouldnt say boo to the NHS as they were all far too comfortable on the gravy train,  coupled with a Pharmacy dept at NHSE which is rabidly anti Community Pharmacy. 

Its amazing what a little media pressure achieved but it was all far too polite - we need to rip out a few jugulars starting with our "friend" Keith and not ignoring the rest.

Ashley Pharmacist , Pharmacy owner/ Proprietor

We are members of AIMp and they have been brilliant in raising the profile of community pharmacy, leading the way and representing us. 

Richard Judge, Manager

The expectation that pharmacies can do 1000 per week is too great. But even 100 per week at 10000 pharmacies is 1 million vaccinations in a week. We could target housebound patients who are being missed by the current system as they cannot access the vaccination centres. Community Care workers who are not in nursing homes yet may visit several vulnerable households each day. Or just our own staff who are facing patients in the pharmacy every day and precription delivery drivers who deliver to sheilding patients.

Axed Locum, Locum pharmacist

DOH told a "white lie" citing supply issues as not been able to commision the services through the community pharmacy (CP) sector. The truth is that the CP sector lacks the infrastructure,space and organisation skills to deliver the high volume of injections that is the key requirement. The CP sector is looking to chase the money rather than the reality. They will chase everything available, deliver a compromised service, stretch the staff to the maximum, and laugh all the way to the bank. Do not offer a contract for such a service, until a plan for a "dedicated stand alone" service is deposited with the commisioners.

 

Benie Locum, Locum pharmacist

Hit the nail on the head but your opinion will be unpopular on this platform. Contractors and multiples alike will mostly be expecting the pharmacist who is already being flogged to death to take on this extra task with minimal assistance and most certainly no remuneration.

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