The pressures on GPs to roll the vaccine out are huge – here’s how to alleviate them
Last week, the London School of Hygiene and Tropical Medicine shared a paper with Sage that warned the UK must dramatically increase its vaccination target to two million a week in order to help halt the spread of the virus.
In response, the prime minister announced the army will be brought in to boost the nation’s vaccination drive to 200,000 jabs a day. This was welcome news of course, offering a much-needed ray of hope amidst the current lockdown. Yet to achieve these ambitious goals, a systematic and integrated approach to the vaccination programme is desperately needed.
From a logistics perspective, rolling out a large scale programme at rapid pace is a mammoth undertaking. Indeed, the army commander in charge of the operation compared the task to setting up a major supermarket chain in less than a month. From contacting patients to arrange appropriate appointments, to ensuring social distancing and monitoring individual reactions to the drug, the process extends far beyond simply administering the vaccination itself.
Vaccine supply and practitioner availability are also additional stumbling blocks. Already hundreds of GPs, nurses, pharmacists and medical practitioners have been redirected to support the vaccination programme. However, the stark reality is we simply do not have enough medically trained professionals to support the demand the NHS is now facing, alongside this mass rollout.
The UK already has one of the highest patient to doctor ratios in Europe, and we are expecting a 7,000 GP shortfall by 2023/24. Although the government is providing support through a revived recruitment programme, much more needs to be done, and without delay.
Despite 200 pharmacies being lined up by NHS England to deliver the Oxford-AstraZeneca jab, other community pharmacies are still being left out of the programme. Engaging these sites, alongside training non-medical practitioners to deliver the vaccination, could go a long way to help plug the staffing gap.
While the vaccination programme quite rightly takes centre stage, we cannot overlook the significant pressures GPs are facing in dealing with a full remit of health needs. During the first wave, patients were hesitant to contact GPs out of fear of taking up resources and reluctant to travel to surgeries for fear of contracting the virus. Unfortunately, there is a sting in the tail and this backlog is starting to take effect. Not only are GPs seeing more patients for normal health concerns and assisting with the vaccination programme, they are also treating an increasing number of patients for long-Covid symptoms and offering additional support as hospitals fill up.
As the UK tries to get the vaccine rollout up and running as quickly as possible, we need to ensure GPs are still appropriately supported. For example, administering jabs off-site will help to keep the footfall at doctor’s surgeries down. This will not only ensure social distancing measures can be maintained but also help to prevent the transmission of other winter illnesses and give patients the confidence to seek treatment for a full range of conditions.
Putting more weight behind the rise of a digital first approach to the delivery of primary care would also be instrumental. This is something I have been advocating to my colleagues for over 20 years. This has been a tough argument, being all but ignored until very recently. Boosting digital capabilities and take-up, alongside the rise of asynchronous consultations, will help alleviate pressures on healthcare practitioners and open up greater resources for the vaccine rollout.
The adoption and acceptance of technology within healthcare has advanced dramatically in the last nine months, but still only a fraction of the 4 billion patient-doctor consultations which take place in Europe are handled remotely.
These digital administration systems are a key part of helping to meet crucial vaccine targets, but much of their potential remains untapped. There is huge scope, for example, to streamline the communication between GPs and vaccination centres, and booking appointments digitally. Such systems could also help provide greater clarity on when groups can reasonably expect to receive their vaccine. This would help alleviate some of the uncertainty and offer increased hope for the future.
Being a GP is incredibly rewarding and I feel extremely fortunate to help in our nation’s fight against the pandemic. However, as the practicalities of the mass vaccination programme are showing, we need to rethink how we administer healthcare.
Despite hundreds of medical professionals being ready and raring to drive the vaccine rollout forward, there are still significant challenges ahead. In response, we need to ensure that we continue to adapt current healthcare practices to meet the changing day-to-day health needs of our nation. Not only will this help to alleviate pressures in the short-term, but it will help to shape a far more integrated and effective healthcare system in the long-term.
Dr Chris Morris, a practicing GP and medical director at telemedicine company HealthHero
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