Coronavirus: Postcode lottery and confusion over vaccine rollout to over-70s

But there is widespread confusion over the rollout to the over-70s population with some health boards using a centralised booking system for vaccination hubs while others will leave it to GPs.

READ MORE: GPs seek greater role in Covid vaccine rollout 

It came as Ms Sturgeon she said the Scottish Government is “looking at piloting” 24/7 vaccination hubs, especially as immunisation is extended to younger people from May onwards.

The First Minister confirmed that 415,402 people in Scotland have now had a first dose, including 95 per cent of elderly care home residents, 46% of over-80s in the community, and 95% of health and social care workers.

The share of Scotland's population who have received at least one vaccine dose is the lowest in the UK

However, overall, Scotland continues to lag behind other parts of the UK, with 7.6% of the population having had a first dose, compared to 10.2% in England, 8.6% in Wales, and 8.4% in Northern Ireland.

Ms Sturgeon said Scotland is “well on track” to meet the target of vaccinating everyone over 70 and anyone in the shielding category by mid-February.

It came as people aged 70 to 79 began receiving letters inviting them for their inoculation, with Ms Sturgeon urging recipients “to accept the appointment and get vaccinated as soon as possible”.

Patients who receive one of these letters will be invited to a mass vaccination centre for their jag - not to their own GP practice.

READ MORE: Flu vaccine 'shambles' as recall system prioritises youngest first 

The Scottish Government announced on Sunday that the over-70s in six health board areas - Fife, Forth Valley, Ayrshire and Arran, Lanarkshire, Greater Glasgow and Clyde, and Lothian - would begin receiving the letters this week “in blue envelopes”, as part of a new booking system.

It was later clarified that initial batches will be delivered in white envelopes with the NHS logo, as blue envelopes are not yet ready.

However, the announcement caused confusion for some GPs and has raised the prospect that in some areas over 75s will be going to their GP surgery while under 75s will be going to mass vaccination hubs.

In Scotland, the immunisation programme is health board-led, with varying GP involvement in different regions.

In Tayside and Highland, for example, GPs have struck an agreement to deliver the vaccinations directly through their own practices to all over-65s and the “clinically extremely vulnerable” shielded patients, although individual practices can opt out.

In Glasgow, there has been widespread support among family doctors for a greater role in Covid vaccinations, beyond the over-80s cohort.

Only last week GPs agreed opt-in with NHS Greater Glasgow and Clyde to enable those practices who wanted to to deliver the jags to all over-75s and shielding patients on their lists.

There was also an appetite among many GP practices to handle vaccinations for patients aged over 70, but this was never consulted on. 

Dr John Montgomery, a GP partner at the David Elder Medical Practice in Govan and chair of the south Glasgow GP committee, said 53 out of 55 practices in the area had signed up to vaccinate the 75 to 79 age group, with 49 practices agreeing to also vaccinate their shielded patients.

He said doctors were surprised by Sunday's announcement.

Dr Montgomery said: "It's all a bit up in the air to be honest. All we know is, we opted in, along with virtually every other practice in Glasgow to do the 75-79s and the shielded group, and we expected to be organising the appointments ourselves as soon as we know when the vaccines are coming.

"Now GGC and five other health boards are using some kind of centralised appointments system that is a mystery to us."

Dr Montgomery said he was also disappointed that GPs had not been given the opportunity to vaccinate their 70 to 74-year-olds. 

"For us that would have meant an additional 200 patients, which we would have been happy to do," he said.

Inside the NHS Louisa Jordan, one of 16 mass vaccination hubs for patients living in Greater Glasgow and Clyde

In a statement last night, NHS GGC said the "vast majority" of GP practices in the region would be offering vaccinations to their patients aged 75 to 79, while those aged 70 to 74 will be invited to attend one of the 16 mass vaccination centres.

It said: "People 75 years and over and individuals who have been shielding will not be invited through the central booking system but will be contacted by their local GP or Health and Social Care Partnership, by early February, with details of when and where they will receive their vaccination.

"Those aged 70-74 years of age will start receiving letters from Monday 25th January with information about their vaccination appointment, which is expected to take place at a community vaccination clinic next month.

"The clinic they will be invited to attend will in the majority of cases be the one closest to their home, and in some cases that may be in a neighbouring local authority area."

The statement added that local authorities are "currently looking at a range of options to support members of the public to attend vaccination centres in their area".

Priority groups for vaccine rollout, as recommended by the UK Joint Committee on Vaccination and Immunisation

This follows complaints during the winter flu programme of pensioners having to catch multiple buses to get to and from community vaccination hubs.

In Lothian, most 75-79-year-olds and shielding patients will be contacted with an appointment by their own GP - not through the new centralised recall system.

Dr Iain Morrison, chair of the Lothian local medical committee (LMC), said: "In Lothian we had very rapid discussions about 'did general practice want to be further involved?' - the answer, unequivocally, was yes.

"The health board had to decide what would the mass centres cover, and what would general practice cover.

"We opted to cover the 75-79 and the shielding group in general practice.

"As a consequence, those two cohorts have been removed from the national recall in Lothian, so they will not receive mass centre invitations."

READ MORE: Exiting lockdown requires more than speeding up vaccine rollout

However, Dr Morrison, a partner at Newbattle Medical Centre, added that some GPs had opted out due to workload pressures or inadequate practice space.

These GP practices will hand their patient lists to their local mass vaccination site who will invite eligible patients aged 75 to 79 or shielding patients to attend.

Patients aged 70-74 in Lothian will also be vaccinated through these community hubs.

However, concerns are already surfacing over vulnerable people having to journey much further than they would if they were being vaccinated through their GP surgery.

The Edinburgh International Conference Centre, in the centre of the capital, is being used as vaccination hub for patients in Lothian

One Twitter user wrote: "My 70-plus in-laws received a letter today saying they are to travel from West Lothian to Edinburgh [International Conference Centre] to receive vaccine.

"What about those who don't have cars? Are they expected to put themselves at risk by taking train."

Some frail people in Fauldhouse in Bathgate have also reportedly received letters telling them to travel nearly 15 miles to a vaccination hub in Broxburn.

In Fife - one of the other 'blue envelope' health boards - GPs are not participating in the rollout of the vaccine to over-70s. 

In Fife, all 70-79-year-olds will be invited to one of the region's 12 community vaccination sites, with the first appointments scheduled to begin on February 1. 

The picture is similar in Lanarkshire, where GPs will no longer be involved once the over-80s are completed. Lanarkshire residents aged 70 to 79 will be asked to attend one of the region's mass vaccination sites from February 1, and should look out for an invite in the post. 

In Ayrshire and Arran, GPs will support in the delivery of vaccinations to shielding patients (the "clinically extremely vulnerable") and housebound patients, but everyone else aged 65 to 79 will be asked to attend a mass vaccination centre. 

Invites have begun going out to those aged 70-79, with the first vaccinations for this age group set to begin on February 1 at the Galleon Centre in Kilmarnock, the Greenwood Centre in Dreghorn and at the Citadel in Ayr, with other venues to follow. 

NHS Ayrshire & Arran Chief Executive John Burns said: "We will continue to work with our GP practices to support the vaccinations for the shielded group and housebound patients, in addition to the over 80s cohort.

"We also welcome support from practices to help with vaccinations in the mass vaccination centres."

The situation is less clear in NHS Forth Valley, although it appears that some GP practices are opting to vaccinate their own patients and these practices will issue their own appointments to patients. 

The arrangement appears to be on a practice-by-practice basis, as opposed to covering particular patient priority groups. 

A spokeswoman said: "GPs who are vaccinating their own patients will be making their own arrangements to invite people for their immunisation. 

"Those attending community hubs will receive appointment letters which are being sent out nationally."

READ MORE: Are we prioritising the Covid vaccine fairly? - and why is Indonesia vaccinating its working age adults first 

Meanwhile, the First Minister confirmed that that 24/7 vaccination hubs could be trialled in Scotland.

Ms Sturgeon said this would likely have the "biggest impact" as jags start to be offered to younger age groups.

Speaking during her daily coronavirus briefing, she said: "We are also looking at piloting 24/7 arrangements so that people, particularly when we get into the wider groups of the population, have choices about the time that they turn up for vaccines."

She added: "I certainly think if that kind of thing is going to add to what we are able to do, it is likely to have the biggest impact as you get down into the younger, or relatively younger age groups than it would necessarily in the over 80 or over 90 age groups."

A Scottish Government spokeswoman said the role of GPs varied between regions, but by March, the vaccination rollout will be entirely organised by health boards.

She added that there may also be variations in how GPs - if they are vaccinating patients other than the over-80s group - are sending out invites.

Source: Public Health Scotland weekly report, January 20

She said: “In most areas of Scotland, these GP groups have opted to send out their own invitations, because they know this older cohort of their patients and the clinically extremely vulnerable, and they may write or phone them to arrange this. This is a local decision.

"A smaller group of GPs opted to deliver the vaccine but not to deal with the scheduling. These GP clinics have been placed on the Service Now scheduling tool and letters have been generated on their behalf.

“From March onward and the population aged 64 and under, the model will be a health board and mass vaccination centre-led model, 100% with the national scheduling tool and invitation letters.

"We will still make available options for those who can’t or don’t want to go online, and the national booking line is available 8am-8pm seven days a week for people who prefer to speak to a call handler.”