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Insight: Jabs fiasco should be no surprise

With only weeks to go before the seasonal vaccination campaign was due to start, we were first told to hold fire for a month as the date was pushed back – only for it then to be brought forward. It was pharmacy’s twisted version of the hokey cokey

I really get why people have been spitting feathers over the date for the start of the flu campaign being chopped and changed.

It takes a lot of time to plan large-scale programmes of this type. NHSE/JCVI/DHSC (insert whichever one you fancy here) really have no idea how anything works in the real world. 

Had they announced the October start date in January or February, I don’t think anyone would have got upset about it. But leaving it to only a few weeks before the programme was due to launch is poor form. And then to change it again with even less notice – well, heads should roll (they won’t).

While I don’t have a crystal ball to predict what flu vaccine uptake will be, I think there is a very good chance that it will be significantly down on the previous year – particularly now that those between 50 and 64 years no longer qualify for a free vaccine. 

Who pays for the wasted stock? What incentive do providers have to take all of the risk on this in the future? Yes, I know we might be able to get some ‘sale or return’ arrangements in place but the sums of money here can be very big. Our own small pharmacy spent around £30,000 on vaccines last year, but some companies will spend millions and could end up taking a big hit.

Bereft of sense

Clinically speaking, given the state of the NHS, I find the decision to restrict flu vaccinations to the over-65s to be utterly bereft of sense. For a very modest investment, by widening the cohorts, we potentially reduce the load on already overburdened services in the winter. 

In most times the NHS would struggle to cope with a bad flu season, but I’m not sure in its present state it can even cope with ‘normal’ levels of flu incidence. We should be prioritising every possible preventative measure. 

“The decision to open the Covid programme up to all pharmacies makes no sense”

Sorry, I know I’m a snob...

Meanwhile, the decision to open up the Covid vaccination programme to all pharmacies makes no sense. There, I’ve said it. I know this has been a point of contention for a lot of pharmacies through the pandemic, and there may well be examples where commissioners have chosen their mate down the road because they were their mate down the road – but that is not my experience.

The pharmacies that were delivering the programme (successfully) were the ones with a stable workforce, the best premises and the clinical expertise to make a success of it. 

I look at the state of some of the pharmacies that were excluded and I think “thank God”. Many can’t even cope with the day job, let alone being asked to manage hundreds or even thousands of patients each week, juggle vaccine availability, sort staff cover and deal with the more complex cases. And if that sounds like I’m being an awful snob, then, sorry – so be it. 

Pharmacy has gained a lot of respect because of the success of the Covid programme, but that has largely been down to the fact that the best operators have been leading on it. Bringing in new pharmacies now is madness. Not only is there less support available to deal with the myriad systems involved, but there will be unnecessary duplication, more missed appointments and wasted resource. 

The original fee cut was massively unwelcome at a time when services are already struggling to meet their overheads. And then there’s the added problem of having no idea what scale of service we are trying to provide, with serious implications for staff and resource planning. 

With both Covid and flu services, trying to shoehorn them into a really tight time window, at our busiest time of the year, is likely to be a recipe for disaster. Someone has to take accountability.

How are you managing the vaccines fiasco? Email pm@1530.com

*Alexander Humphries is the pen name of a practising community pharmacist. The views in this article are not necessarily those of Pharmacy Magazine

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