- Posted Wednesday November 11, 2020
I am writing this a few days after the 2nd lockdown came into operation. As front-line workers we are all aware of the impact of coronavirus, and the extra pressures bought on Primary Care.
I have always said in these blogs, that I do not want them to be political and I do accept that the challenges faced by those in power are immense, and not something I would like to be involved with.
I feel that the delivery of the updates, and the promises made to the public, so far, are not giving confidence to a population affected by the situation, and the continual backtracking makes people wonder why they should comply with any of the continual changing of regulations, that is if they can even be understood.
Looking at how it is being handled elsewhere, it seems clearer and seems to have the population buying into the action needed.
I am dismayed here to see demonstrations against the lockdown, or the wearing of masks, or even hearing that the pandemic does not exist and that it is all a conspiracy theory.
I see there have been several press briefings and leaks, on the rollout of the vaccine from December 2020, and that primary care is 'ready and organised' to deliver the work.
Unless I have missed this (and I know I haven’t), there has been no contact with grassroots surgeries, and it seems the BMA has agreed on a role out using Primary care but possibly without consulting those that will be doing the work? It looks as though we will need to give two vaccines, 3 or 4 weeks apart, and we will get paid £25.16 for the two claimable after the second jab. They have now said that if the second dose cannot be given then a claim for the first one is acceptable.
The fact that the vaccines need to be stored at -70 degrees is baffling, and even more so is that we will get a delivery of enough for 1,000 doses which will have a shelf life of only 5 days. They are also saying that we will have to mix it with saline so one assumes that there is a fair amount of work to do before giving.
We are then finding out that each patient will need to remain in practice for 15 minutes after the jab for any reaction. This will be a logistical nightmare with social distancing and throughput of patients. It is then thought that perhaps we should do the clinics PCN based, again making a recording in the patient's record impossible. Where are we going to hold such large clinics in the depth of winter? Surely each practice should vaccinate their own population.
With a shelf life of only 5 days, there will be an expectation that we work 7 days a week, again not feasible with the current workforce and the routine pressures already in place. Then, it raises another issue, if the NHS is going to deliver enough for 1000 doses to each PCN are we going to be able to distribute the vaccine to each surgery in the PCN, safely? Administering vaccines from one location is going to deter some patients from attending due to numbers, and transportation issues. So, vaccinations at individual surgeries would in my view lead to a higher uptake.
Again, promises have been made with little idea as to how they will be delivered, by people who have little idea as to how General Practice works. We have already had patients phoning for appointments and getting angry when we say we have no firm details of what is happening. Naturally, it is going to be impossible to vaccinate the whole population in one go.
It has been said that there will be an official list of cohorts and when the vaccine can be administered to them. Let us hope that this is publicised in a clear way to reduce the risk of patients becoming angry and abusive and demanding a jab before they are due. This is a time for the Government, BMA, LMC, NHS, and the media, to come together and do the right thing, and ensure only the correct details are given out. Rather than overpromising and underdelivering and leaving primary care to sort it out and pick up the pieces.
IT and Clinical Systems
Turning to a linked issue when will the IT and clinical systems be fit for purpose? During this unprecedented period having the numbers of IT issues is just not on. With us in primary care being asked to work 8am-8pm and weekends at least give us the systems that work and having help desks open to sort out issues.
Social media has been reporting the number of issues over the last few weekends when clinical systems have been down. This has affected flu clinics and have stopped staff from getting work done to catch up and keep on top off. We have plans in place to get some of our staff working at home, but incredibly there are not enough licences to allow home working for all that need it. As well as that the system is temperamental and can be difficult to access.
Last week we had our clinical system on a Monday morning down for several hours and as our NHS phone system is linked, we had no phone. There does not seem to be any accountability and we must make the best we can of the system each day.
So, as we all battle with all this, remember to look after yourself in this stressful period, and if you can take a few days off to recharge the batteries.