YOU can tell it’s a nurse doing an injection because you barely feel it.
Not my words, but those of an NHS union representative. Is he right? Certainly nurses carry out the lion’s share of vaccinations in healthcare settings including annual flu boosters so we should expect a high degree of proficiency.
His wider point was that health service staff are best placed to jag arms with Covid vaccines.
In February, Unison wrote to the then health secretary Jeane Freeman Scottish Cabinet Secretary for Health today to request that she instruct health boards only to use independent contractors as a last resort rather than offering them work ahead of their own NHS and bank staff.
Whether you agree with the union’s assertion about nurses or not, dentists and other non-NHS staff including optometrists have played a massive role in the Covid vaccination effort, which was this week hailed the most successful in the history of the health service by Matt Hancock.
READ MORE: World leaders urge UK to share Covid vaccinations with poorer nations to ease variants threat
More than three quarters of the UK population have now received a first dose of a vaccine, with almost half as fully protected as they allow and it is hoped the rapid acceleration could help cushion the blow of an anticipated third wave of the virus.
While the roll-out has been an undoubted success, the staffing of Scotland’s volunteer taskforce has been a blot on the landscape.
In January, the Scottish Government said national terms and conditions had been negotiated to enable independent contractors including GPs, dentists, pharmacists and optometrists to participate in vaccinations delivery, on a sessional basis, on behalf of health boards.
Sounds simple, straightforward and fair but in reality has been anything but.
The lucrative £66 per hour shift rate was intended to compensate contractors for the loss of staff but was misinterpreted by staff.
This led to locum pharmacists being taken off the top rate and paid £15, bringing them into line with nurses. Pharmacists say this led to hundreds abandoning the system and are claiming it has resulted in hundreds of shifts being left unfilled in major cities like Glasgow and Edinburgh.
Dentists and optometrists - whom pharmacists say are less qualified to deliver vaccines - are still entitled to claim the top rate.
There have been lurid claims (from pharmacists) about dentists boasting about lavish purchases including flashy cars and paying off mortgages. The latter seems unlikely but the situation has understandably created a lot of bad feeling in an other-wise positive environment.
Under the new agreement, individual pharmacies were still able to claim the higher rate but could decide how much they paid employees but this is now said to have ended.
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Health boards say pharmacists are still entitled to continue to work under the same conditions as nurses but few are said to have returned.
In England, payment varies between NHS trusts but Paul Day, of the Pharmacists Defence Association believes, overall, it is a fairer system and has voiced support for nurses being paid more.
He said: “England don’t have either the scandal of in what nurses versus dentists are getting paid working alongside each other doing the same thing, or the scandal of dentists and optometrists being able to do what pharmacists have been stopped from doing.
“So I guess in that sense yes it seems to be considered fairer.
“On that second point though, that is a wider issue for Scotland as it stems from the close relationship the Scottish Government have with pharmacy employers and their representative body, Community Pharmacy Scotland.”
The government is said to have made it easier for bank nurses to obtain extra work following claims private sector staff were hoovering up shifts.
At one point, pharmacists were also being accused of rigging the shift booking system, when they were entitled to the higher rate of pay.
Pharmacists claim the loss of their input has led to Scotland having a slightly slower vaccination rate than England - more second doses have been delivered south of the border. Around 200 were registered to provide jags in Glasgow.
The Pharmacist Voice tweeted pictures of queues outside The Hydro writing: “Would these queues exist if pharmacists were still vaccinating? Nope! Six pharmacists doing 10 hours at 8 vaccines an hour is nearly 500 extra vaccinations a day.” Few have complained about having to queue for a potentially life-saving vaccine though.
Both, NHS Lothian and NHS Greater Glasgow and Clyde have said consistently that they have enough vaccinators to deliver the programme despite issuing regular and often short-notice alerts, appealing for more bank workers.
NHS Lothian announced earlier this week that the army will return to plug gaps in shifts are issuing a text warning of ‘critical’ shortages at Edinburgh’s main centres.
There is nothing usual in this, it has been done in other countries including Italy to accelerate the roll-out in vulnerable groups but pharmacists claim it is evidence bigger health boards are struggling.
It is not yet clear how vaccinations will be delivered in the longer term and by whom.
READ MORE: Covid patients given 'unecessary' drugs posing resistance threat
There has been a suggestion only those over 50 will require boosters, which would mean a vastly reduced workforce is required.
Meanwhile, the pharmacists show no signs of giving up their fight.
They say they are not motivated by greed and have suggested that a flat rate of £30 for all vaccinators would address the inequities.
“At what point or how bad does it need to get before SNP hold their hands up and realise maybe we do need to bring back qualified people to the programme,” said one.
“It’s my main issue with the NHS is that they will never backtrack on their errors, They are never wrong.”
The vaccination programme has been a major success but a fairer payment system that acknowledge the equal effort of everyone involved should perhaps be considered going forward.
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