Vaccine ready?

I’ve been representing the RCN on the London clinical reference group looking at the COVID-19 vaccination programme, acting as a voice for members on the ground, and considering the support we can offer while it’s rolled out.

Part of my role has been to press the importance of considering the practicalities of delivering the vaccines. There are well-publicised logistical challenges. As a nurse with many years’ experience in vaccination, I’m helping to think through how to make the vaccination programme work in practice.

Part of my role has been to press the importance of considering the practicalities of delivering the vaccines

People now know the vaccine is coming – it’s imminent, there is understandable excitement and high expectations. This poses additional pressures on practice nursing colleagues nationally, facing a daily myriad of questions, many of which can’t be answered. As yet we don’t have an authorised vaccine and therefore don’t have the details on when exactly the programme will start, what vaccine will be used, how delivery and storage of stock will be managed and how quickly it needs to be used.

It’s a difficult situation to be in with parameters constantly shifting. Nursing colleagues are also asking: how can we reassure patients, when we don’t have the details ourselves?

Communication void

While this is in some ways understandable, there is a communication void right now and practice nurses haven’t been asked to join the conversation in the way they should have. As experts in our field, we should have been part of vaccination programme discussions from day one. In general practice we’re used to adapting and changing very quickly but to do that effectively we need to be kept updated and informed.

As practice nurses, we also have a crucial role in giving advice and information to the public. Many people are concerned about the speed the vaccines have been developed. Nurses are in an ideal position to help provide information on the vaccine with confidence and help allay these fears. We’ve built up relationships with people – as nurses, people trust and rely on us.

But it all comes back to limited communication: we really need more information ourselves to be able to advise and talk to our patients.
Some of the key areas of concern for me include the below.

Estates

Each primary care network (PCN) must decide upon an appropriate estate to deliver the vaccine in and we’ve been told the site must be open 8am to 8pm, seven days a week. There’s a lot of logistics to consider – getting people in and out, ensuring they can keep a safe distance from each other. The requirements are changing as more details on the vaccines become available.

Continuity of other services

How can we continue to provide GP nursing services in each area, while also managing a large-scale COVID-19 vaccination programme? We need to figure out how we can still deliver childhood vaccinations and smear tests while supporting people with long-term conditions, diabetes, respiratory conditions and other acute presentations that can’t always be effectively monitored virtually.

Workforce 

This is my biggest concern. How do we have the staff ready, and appropriately trained, to deliver a vaccination programme like this? Who manages the rota for the staff needed? What about staff sickness – if one person is off, who are they replaced by? We need people, trained and ready, not only to deliver the vaccines but also to co-ordinate the staff required.

IT systems

There is a national standardised system being developed, but again we haven’t seen the details.

Informed consent

We need to consider those whose first language isn’t English, those with learning disabilities, people who have dementia – how do we make sure that they have given their informed consent to have the vaccine?

Going forward 

Things are obviously coming together. Hopefully once the vaccines get their temporary license and authorisation, we can get clear, factual communication on which ones we’ll be using, the requirements associated with each, and potentially if there will be a choice of which one is used.

I’d also like some assurances about how we, in general practice, are going to be supported in providing a continued service to our population and dealing with another “new norm”.  

The fact is that GPs don’t generally deliver or administer vaccines – nurses do – so whenever there’s discussion about vaccines, government officials need not to just be talking about, or to GPs, but to all general practice staff. Our role is pivotal. We need recognition for this and to be actively included in planning.