- Posted Wednesday March 3, 2021
I watched the news on 8th December 2020 thinking to myself that there is finally an end to be reached - I didn’t really think what this would mean for me as a Practice Manager or Primary Care.
Arriving in to work the day after this first vaccination, our admin team were being bombarded with requests about when we would be getting the vaccine, how would we deliver it, patients telling us why they should be on the clinically extremely vulnerable list, more registrations for carers than we’ve seen in the last 24 months (despite numerous communications encouraging carers to register). These queries and requests for information turned out to be a sign of things to come - not just from patients, but from other NHS organisations.
We knew immediately that as a surgery, we wouldn’t logistically be able to handle storage of the Pfizer BioNTech vaccine, but based on what we knew about the Oxford AstraZeneca vaccine, we could store and distribute this and roll it out like the flu vaccine we already deliver every year. Based on having no information for us to work with, we decided not to over-plan and just wait for further information (also accepting that any information would be late in coming and sparse with detail).
Planning on a wider scale
We are extremely fortunate to have a very proactive and involved PCN, we finally received some direction from our CCG, and we started to plan, looking at availability and suitability of buildings, assessing whether our Covid ‘hot’ and ‘warm’ site would be viable options. Whilst assessing sites, our Clinical Directors approached the CCG asking what support we would receive for infrastructure changes that were required at our shortlisted sites. Tasks were distributed amongst the practices and our extended access service that we run as a PCN was scaled back to support vaccination planning.
The collective opinion of the Practice Managers within our PCN is that our CCG has not been the most supportive throughout the pandemic, and this limited support was evident throughout our planning phase – slow, delayed or no response at all, lack of clarity and direction. Almost every email we received seemed to point towards the CCG wanting to provide some cover for themselves, and these additional queries that needed an immediate response just created unnecessary work and pressure. I always aim to deliver information within a reasonable time frame, especially during this national crisis, however these requests did become too much and along with other PM colleagues we started to push back on these requests.
We are incredibly lucky to have an engaged PPG - they offer ‘polite criticism’ when we need it, but they also support us within the community. From the start they have been feeding back relevant information and managing patient communications with our guidance. We are a rural practice and serve several smaller communities each with a different need, and this diversity can be challenging to provide for the majority. Our PPG have continued to support us and the PCN throughout the pandemic; as a small surgery we offer more volunteers at our PCN vaccination centre than the much larger surgeries in our network, which has really allowed our PPG to come in to its own.
Our patient population on the whole has been excellent - they did not contact the surgery unnecessarily, instead using e-consult, email, website, and our Facebook page to communicate with us. Our less ‘IT savvy’ staff had to get quickly up to speed on our new digital access, but we’ve had to deal with our regular patients (aka “frequent fliers”) having to adjust as well; they’ve complained about us requesting they use online services more, not being able to get a face-to-face appointment without going through a “tiresome question and answer gameshow” and complaining that we are sending our clinicians to support the vaccine roll out.
Practice (Patient?) Pressures
My personal struggle has not been late nights, responding to emails constantly, organising our clinicians to support the vaccination centre, or trying to manage the Practice as normal. I have really struggled with those patients that do not (or don’t want to) understand what we as a team are going through. As PMs we are charged with running a business, ensuring that it remains viable whilst having an exceptionally large shelf with an untold number of hats we need to wear. I sometimes feel an answer to some complaints should be “walk a mile in my shoes and then decide if your complaint is valid”.
This rollout has brought our surgery team together, the PCN has pulled together and something I initially thought of as a veiled attempt to undermine General Practice has turned out to be an organisation that has worked well - able to react and support each other and our combined patient population. I can no longer remember what I did pre-Covid, I seemed to be constantly busy then, so when there is an end, and we resume business as usual I may be able to consider semi-retirement!
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