GP practices have been invited to order additional Covid vaccine stock so they can begin vaccinating care home residents.
Practices can order a full pack of 975 doses or packs of 75 ready to take ‘straight into care homes’, NHS England said.
NHS England has now confirmed that the care home Covid vaccines rollout will go ahead ‘over the next few days’, starting with ‘larger’ homes.
An email bulletin sent to practices yesterday said: ‘Our priority is to now vaccinate our care home residents and staff, and continue to vaccinate over 80s and health care workers.
‘The rollout will begin during the week commencing 21 December through wave 1, 2 and 3 sites, followed shortly by local vaccination sites in later waves. Please order additional vaccine in order to vaccinate your care homes.’
Practices should request their delivery via an online form by 9.30am on Monday 21 December but should not book patients into clinics until they receive email confirmation of their order from NHS England.
It said: ‘You can order a full pack (975 doses) and pack down yourself, or order packs of 75 doses to take straight into your care homes.
‘If we do not hear from you, we will assume that you do not want to receive a vaccine resupply delivery. We will let you know about any further vaccine resupply opportunities as they arise.’
It recommended the team include two vaccinators (one lead and one support), a nurse or pharmacist vaccine manager to lead vaccine reconstitution and cold chain management, a paramedic or nurse post-vaccine observer and a team administrator.
The document added: ‘The roving vaccination team should be adjusted as required to account for the different level of support care home staff can offer (e.g. advance planning for consent), the configuration of the care home, and the number of residents.
‘With this set-up, as a guide a single vaccinator may achieve 30 vaccinations per half-day (i.e. 2 vaccinators: 60; 4 vaccinators: 120).’
It also confirmed that all members of the vaccination team should take a PCR/ LFT test prior to visiting care homes and that PCNs should ensure general staff testing is in place.
It said: ‘Any PCN staff testing positive should be excluded from visiting care homes, and a risk assessment should be completed to assess what other staff may have come in contact and require self-isolating.
‘If PCN staff cannot reasonably demonstrate no contact with Covid-19 positive colleagues, they must be excluded from care home visit. Care homes should also be encouraged to implement regular testing of care home staff and residents prior to vaccination teams visiting.’
NHS England also said that PCN clinicians should ‘review’ residents’ medical records for allergies, whether they are ‘medically fit’ and any other exclusions.
‘PCNs may need to allocate a number of staff for clinical review across GP practices within the PCN grouping to ensure all residents’ patient records can be accessed’, it added.
The document also said:
- PCNs should begin ‘joint planning’ with care homes ‘as soon as possible’;
- Vaccinators will need to consult residents’ relatives to confirm consenting decisions;
- PCNs should plan to vaccinate the highest-risk care home or PCN staff on site with any vaccine left ‘after all efforts’ to vaccinate planned residents and staff;
- Freezers provided to PCNs should be ‘active’ for 24 hours before use and then gel packs cooled for 24 hours, while vaccines should ‘under no circumstances’ be put in the freezer;
- After freezing, gel packs should be monitored in the cool box for 90 minutes to stabilise the temperature at 2-8C before vials can be transferred into the box.
It added that for 75-dose packs – for which a vaccine transport container ‘may not be required’ – can be used for large care homes while five-dose vials extracted from 975-dose packs can be used for smaller and medium-sized care homes.
An earlier version of the NHS England standard operating procedures said GP teams delivering Covid vaccinations should visit care homes a ‘minimum’ of four times and that ‘regular’ follow up visits ‘may be required’.