Coronavirus: Warning of delays to rollout of Covid jags to over-80s

Dr Andy Mcintosh, who runs the online forum GP Survival Scotland, described the situation as an “utter debacle”.

The problem is widespread across the country, with initial Pfizer doses having been targeted to frontline hospital and care home staff while the majority of GPs and associated practice staff, such as nurses, remain unsure when they will get their first jag.

A key plank of the Pfizer rollout was to "vaccinate the vaccinators", in preparation for community immunisations.

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Dr Mcintosh, whose practice in the Borders has around 200 patients over-80, said: ”We are about as patient-facing as it gets, but we seem to be at the bottom of the heap.

“It’s a problem everywhere, it’s not isolated to one board or management group.

“No GP would ever have an issue with doing the vaccinations, but the core thing is that we’re not protected. They’re asking us to do something without adequate protection.

“So we can’t roll it out. We can’t start doing it.

“The majority of GPs are rightly saying they’re not going to do this until they’re properly protected.

“It was bad enough getting low quality PPE, but previously we were trying to limit the numbers of people physically visiting the practice. And even then we had people telling us over the phone they were fine, then coming in with symptoms.

“Now we would be expected to have hundreds of people over-80 coming through and no one’s protected - not them from us, or us from them.”

Dr McIntosh said he had heard of staff working in non-patient facing roles, such as in medical records departments, who have been vaccinated already.

Under the terms of Scotland’s GP contract - which differs from England - health boards, rather than GPs, are responsible for delivering the Covid immunisation programme.

Most GPs have offered to take part in the rollout of the new Oxford vaccine to over-80s, however, with other health professionals, such as dentists and pharmacists, also being recruited to staff community vaccination hubs, where younger age groups are expected to be sent.

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However, GPs in the NHS Highland region have opted to deliver the bulk of the vaccination programme directly, across all age and priority groups.

Dr Iain Kennedy, a GP in Inverness and Secretary of the Highland Local Medical Committee, said he is due to be given his first dose of the Pfizer vaccine today, but many others are still waiting.

He said: “Many of my GP colleagues in Highland feel very let down by our health board as were promised we would be vaccinated along with our hospital colleagues but this did not happen - despite numerous requests from us that we get vaccinated.

“We want to get on and vaccinate our patients safely as soon as possible.”

Dr Iain Kennedy

A spokesman for NHS Highland they had followed national guidance by “initially targeting the key priority groups including care home residents and staff and health and care staff who are working with Covid positive patients”, which has included some GPs.

He added: “The scale of vaccination for the primary care workforce will progress with pace this week with the aim of having all of this workforce vaccinated.

“The first doses of AstraZeneca vaccine were estimated to be with NHS Highland on the January 9, however we are pleased to say that those doses arrived on January 5 and we will proceed to expedite the use of the vaccine as a result.”

In Glasgow, Dr John Montgomery, the lead clinician at the David Elder Medical Practice and chair of the south Glasgow GP committee, said the “vast majority” of GPs in the city had not yet been vaccinated.

His practice, based in Govan health centre, has been told it will receive 100 doses of the Astra-Zeneca vaccine for patients today.

Dr John Montgomery

The practice, which has 5,500 patients on its list, is in one of Scotland’s most deprived areas where comparatively few people live into their 80s and 90s.

He said: “We’ve got about 170 over-80s on our list and, of those, just over 100 are mobile and the others will either be housebound or in care homes.

"The care homes will be done separately, so in effect we’ve got just over 100 over-80s who we will contact and give a dedicated appointment time.

“We’ll do it in the same way as we did with the flu jags, with them coming in one end of the health centre and leaving through another exit. They’ll be straight in and out. We’ll probably do it at weekends.”

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Dr Montgomery said he hope to be vaccinated himself with the next one to two weeks.

He said: “I think the hope is that there will be sufficient numbers of vaccinated staff in general practice so that patients can have the confidence that when they come for their jag.

“You don’t have to be vaccinated to deliver the vaccine but I think both the vaccinators and vaccinated would feel safer if they knew the staff that were administering it had been vaccinated themselves.”

Dr Lewis Morrison, chair of BMA Scotland, said the trade union had been hearing reports back in December of “huge variability between health boards” for which healthcare staff were being prioritised for the Pfizer vaccine.

He said: “That was labelled as ‘teething troubles’, but the degree of variability I think went beyond local flexibility.

“We know that in some areas staff who have no patient-facing role have managed to access vaccine.

"Obviously I appreciate that from their individual perspective they’re very grateful, but a system that did not properly prioritise frontline staff - patient-facing staff - that has been an issue.”

It comes amid controversy over recommendations by the UK's Joint Committee on Vaccination and Immunisation (JCVI) to stagger the vaccination schedule at 12 weeks, instead of the planned 21 day gap, meaning that healthcare staff who had received one dose of the Pfizer vaccine in December have now had their second dose appointment cancelled.

BMA Scotland has urged the Scottish Government to reinstate second dose appointments for NHS staff who have already had their first dose.

The JCVI said the move will allow more people to get protection from a first dose, helping to limit hospitalisations and deaths from Covid, but the World Health Organisation said on Tuesday that there is "very little empiric data from the trials that underpin this type of recommendation" in relation to the Pfizer-BioNTech vaccine.

A Scottish Government spokesman said: "Delivery of the NHS Scotland Covid-19 vaccination programme is well underway.

"We are working our way at pace through the priority list devised by the independent expert Joint Committee on Vaccination and Immunisation (JCVI), which has been designed to specifically target those at greatest risk from this virus.

“The Health Secretary will update parliament next week on the next steps and further logistical detail of the vaccination programme, and has committed to giving as much detail as we can while rightly allowing our teams to focus on the task of delivering the biggest vaccination programme ever seen in Scotland.”