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The pain of turning away flu patients because of the Fluad shortage

"I'm having to turn people away and I feel that pain deep in my heart"

The manager of an independent pharmacy reflects on this season’s disrupted flu service, and considers how health professionals can come together to prevent a repeat next year

It’s only October and I'm tired. I'm tired and frustrated at having to turn away business in my pharmacy, because I can't order any Fluad vaccines for Mr and Mrs Jones who live down the road.

Why can’t I order the only UK approved adjuvanted trivalent vaccine (aTIV) that pharmacies can administer to patients over 65 years? All the signs on the ground suggest it is in short supply [despite the pharmacy minister’s insistence that it is not].

So, what is the actual cause of the disrupted service this year and what can we do to stop it from ever happening again? Who do we as a pharmacy collective need to campaign to?

Perhaps the pharmacy community, together with GP surgeries, could band together and let our grievances be known to those at the Department of Health and Social Care (DH) and NHS, who dictate to us who can have which vaccine and when. I don’t blame Fluad's manufacturer Seqirus, but I doubt they will be allowed to have the same monopoly on the market again.

We all know the hard place pharmacy is in now and we need all our revenue sources to work out for us. Not to mention our tireless efforts to keep our patients safe and healthy. This is my pharmacy’s fourth week of administering flu jabs and to date we’ve completed 253 vaccinations – but now I’m having to turn people away, and I feel that pain deep in my heart.

The only saving grace in this situation that makes me feel a bit better is that I’m not alone. Up and down the country, pharmacies and GP surgeries are running out of Fluad vaccines and can’t replenish their stock.

So, I’m left wondering: what happens to the over-65s when the stock is all extinguished? Will we be able to use the amended patient group direction to vaccinate them with the supposedly inferior quadrivalent vaccine? And how do I reassure my patients that the quad vaccines are good enough for them?

Kate Adjei is manager at Nories Pharmacy in Horsham, West Sussex

10 Comments

Karen Gingell, Senior Management

This years flu vaccine problems stem from Public Health England not knowing how the ordering process has historically and currently run. The majority of Doctors surgeries order the flu vaccine for the following season in October / November for the following year. At which point last year the advice was for quad vaccine for patients up to 75 and the Fluad for those over 75 as per WHO guidance at the time. The final decsion to change the Fluad to include patients from 65 came out at the end of January/ beginning of February which led to a couple of companies withdrawing from the flu supply chain. So many surgeries had to change thier orders if they spotted the update and the Seqirus had to obtain/ make extra doses. The result has been the confusion and resulting level of disatisfaction expressed by patients both to practice staff and pharmacy's. Already surgeries are being asked to place next years orders based on the current guidance which hopefully won't be changed last minute.

As with many issues those involved in goverment bodies at the top along with thier administrative teams have very little understanding of how things work on the front line.

Charles Whitfield Bott, Pharmacist Director

I am interested to know how you ordered so far and what orders you are expecting?

 

Kate Adjei, Community pharmacist

We originally preordered 300 Fluads for our pharmacy back in spring, but we haven't received it all and have stopped providing the service. We also do not have a guaranteed delivery in November for the new batch to be sent out to pharmacies, which means, we are done for this year. I'm just waiting for an updated pgd to come out, most likely in the end of November that allows us to give the quad to over 65s. 

Kevin Western, Community pharmacist

Im willing to bet there will be no Pharmacy representative stood up in front of  the press telling the world about the shambles it has been this year because of the DOH s ppp and what have we got to lose? its not as if they were going to offer us bags of money next year.

Pharma Tron , Community pharmacist

This article is so pithy, sorry to say. I'd rather use the time to do MURs or NMSs than something that a tech could do. One of our GPs couldn't believe I was expected to do it on top of everything else. So I'm glad for the respite- but yes, the whole thing has been a shambles!

Leon The Apothecary, Student

Private PGDs used to allows Techs to administer several years back.

Leon The Apothecary, Student

The level of abuse I've heard from patients in regards to the shortage as well towards Pharmacy Staff, as well as our colleagues in Surgery, has been completely unacceptable, in my opinion.

Chris Locum, Locum pharmacist

Unfortunately, abuse has become the norm towards pharmacy staff over the last few years with various incidents of supply interruptions. If this is your chosen career, then you will experience the feedback from sudden price increases affecting stock sourcing decisions (amongst other issues as NHS spine temporarily down and eps scripts late etc.). There will be a freeze in the next financial year, so it is a cut in reality.

Leon The Apothecary, Student

Was my chosen career would be an accurate wording. Ten years has made me rather hard-shelled, to say the least. Although, I have found not pandering to patient's tantrums has had a positive affect.

Kate Adjei, Community pharmacist

It is unacceptable and I hope in the future that closer working relationships between different health providers in the primary care sector can help avoid these problems from arising. 

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