'It shows what we're capable of': the NHS's vaccine triumph

A huge effort has helped the UK provide 14m first doses of Covid vaccines in about two months

In St Albans, GPs took over a former nightclub to provide Covid vaccinations every 20 seconds; in Carnforth, Lancashire, delivering jabs was helped by volunteers from the local Rotary Club; in parts of Surrey and West Sussex a GP federation converted a bus to give inoculations to those proving hard to reach.

The extraordinary effort – the UK has provided 14m first-dose jabs in a little over two months – has become a national mission, with cathedrals, mosques and temples becoming vaccination sites to reach communities around the land. And, after a year of coronavirus failure, it has been a striking success.

A target set by Boris Johnson in December to offer a jab to all 15 million in the first four priority groups by 15 February is on the verge of being met. The effort has been remarkably consistent around the country.

Wales was the first to declare on Friday morning that it had reached the goal, although the first minister, Mark Drakeford, said he was “anxious to avoid the narrative that it is somehow a competition between UK nations”. Scotland, which reported that 98% of over-80s living in the community had already had a jab, is expected to follow suit alongside England and Northern Ireland this weekend.

The achievement has been in large part down to the NHS, threatened this week with another reorganisation in England, and in particular, the ingenuity of its primary care network that was left to develop local programmes.

Eight GP practices in St Albans came together when the call came from NHS England to start actively preparing to deliver immunisations. Mike Walton, a local doctor, recalled “a scramble for premises” at the end of November until they found out that the owner of the local Batchwood Hall nightclub had gone into administration and they could take on the site. New sites were necessary to avoid clogging up already under-pressure GP premises as the infection numbers began to take off.

Health workers administer Covid-19 vaccines at a drive through centre at Batchwood Hall in St Albans.
Health workers administer Covid-19 vaccines at a drive through centre at Batchwood Hall in St Albans. Photograph: Daniel Leal-Olivas/AFP/Getty Images

“We did our first jabs on Tuesday 15 December; that morning we had no lights, no running water, no central heating. It was only with the help of the council that we got the lights on at 1pm, a couple of hours before we started work,” Walton said.

It was the moment the country had been waiting for for months and GPs had to work fast. Critically, GP practices were asked to band together by NHS England, using primary care networks, to get the scale needed to provide vaccinations locally, not least because the Pfizer vaccine initially came in batches of 976 and had to be transported at a temperature of -80C.

A group of vaccination super-centres were also opened in January with great fanfare, in places such as the Ashton Gate football ground in Bristol, operating to some extent in competition. They, too, invited people to appointments, in parallel with the primary care networks, often to the irritation of local doctors.

Members of the public have by and large chosen GP-led networks, which have provided around 75% all initial vaccinations so far. Meanwhile, some patients were reporting that the large sites, at places like the ExCeL centre in London, were almost completely empty of patients when they visited for a jab this week.

Dr Nikki Kanani, the medical director of primary care for NHS England, cited the experience that GPs have in delivering annual flu jabs – about 15m in the year before the pandemic. “Putting a GP at the heart of this was an NHS decision – it was exactly the right thing to do,” she said.

Although vaccine take-up has been high – 96% among 75 to 79-year-olds, for instance – pockets of harder-to-reach groups remain, including BAME communities. In parts of Surrey and West Sussex, the Alliance for Better Care, a federation of 44 practices, teamed up with a local transport company to create a mobile vaccination unit on a bus.

A paramedic with a patient in a coach being used as a mobile vaccination centre near Inverness, Scotland.
A paramedic with a patient in a coach being used as a mobile vaccination centre near Inverness, Scotland. Photograph: Andrew Milligan/PA

It has been delivering 100 to 150 vaccinations a day for the past fortnight, driving to locations such as a Hindu temple and a housing estate where practice data showed take-up was poor, in an effort to reach people reluctant to travel, or who have other reasons for hesitancy.

It was a tried and tested model, delivered to a plan put together by the NHS England chief executive, Sir Simon Stevens, and his team over the summer. Contrast that to the repeated disasters of last year, where new services created by ministers outside the existing health system, such as test and trace, or the contact-tracing app, ran into repeated problems.

Vaccine supply problems complicated the situation early on, such as deliveries arriving at the last minute, unexpectedly, or not on the days or amounts expected. A GP remembers being told at 9.30pm on Christmas Eve that the vaccine would come “the day after Boxing Day, just enough notice for us to get into our care homes”. Others said appointments frequently had to be rescheduled at short notice.

It was a repeated complaint that many GP-led vaccination centres could only open a couple of days week, but the reality was that supplies from Pfizer and AstraZeneca were limited. Ministers were convinced that the vaccines taskforce, whose job it was to buy the lifesaving drugs, had secured enough from Pfizer and AstraZeneca to hit the 15m target. They were proven right.

Around the NHS, there is considerable pride in what has been achieved, at a time when case numbers have been high and hospitals have clogged with record numbers of patients. Although there is a reluctance to say it publicly, at a time when the government is proposing a shake-up to concentrate power in the hands of the health secretary, the speed of vaccination is seen as a vindication.

“It’s no surprise that two of the countries who have done the best on vaccination so far are Israel and the UK,” said Beccy Baird, a senior fellow at the King’s Fund thinktank. “These are countries with some of the strongest primary care systems. In England, large numbers of people are registered with a GP; they know their communities.”

Katherine Saunders, the chief executive of the Alliance for Better Care, said in her area in Surrey and Sussex they had been able to vaccinate up to 6,200 people on one day across seven sites. “We’ve not even been going at full whack yet. But already this is incredible, such a source of hope for people. It shows what the NHS is capable of.”


Dan Sabbagh

The GuardianTramp

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