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PCNs opt to honour existing Covid vaccine appointments despite Government announcement


By Awil Mohamoud
Reporter
5 January 2021

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Some practices and PCNs have said they will honour existing second dose appointments for the Pfizer vaccine, despite the Government’s recent decision to delay the interval between doses.  

The Government announced last week (31 Dec) that healthcare professionals should give the second dose at 10-12 weeks after the first, rather than at the three-week interval, to help vaccinate more people sooner – a decision that would involve cancelling thousands of appointments. 

In a statement (31 December), the chief medical officers acknowledged that the short notice of this change – which has been heavily criticised – would be ‘operationally very difficult’ and would ‘distress patients’, but said it was necessary ‘to follow public health principles and act at speed’. 

However, some vaccination sites have rejected this advice and announced that they will continue with appointments as planned, before adopting the interval change for the next phase of clinics. 

On Twitter, Dr Simon Hodes, a GP in Watford, said it was ‘ethically and practically the correct decision’ for his PCN to honour its three-week follow up vaccine appointments, and warned that a 12-week gap may result in lower patient uptake.

Responding online to Dr Hodes, Nikita Kanani, NHS England medical director for primary care, said: ‘Just to clarify Simon, many practice teams have spent the weekend rebooking in line [with] the updated guidance’.

NHS England also announced a support package last week – including £1,000 per first wave site to cover administration costs – to help practices respond to the change.

‘Logistically impossible’

A number of practices also issued urgent updates to patients on Facebook following the Government announcement. 

On 1 January, Bridport Medical Centre in Dorset said in a post: ‘Logistically, at such a late stage, it would be impossible to rearrange the appointments for the 975 patients booked on 6 January.

‘Our Jurassic Coast clinical directors, together with Dorset CCG have agreed that this clinic should go ahead, as planned.’

Meanwhile, Herne Bay PCN, in Kent, released a video message and a post on the social media site, which said it ‘fully supports’ the new guidance, but due to ‘significant time constraints’ has decided to honour all second dose vaccination appointments on 5, 6 and 7 January. 

It added: ‘We agree with the longer interval between dosing moving forward, but we simply do not have the time or staff to cancel nearly 1000 appointments and then rebook 1000 more before Monday evening.’

Miriam Medical Centre in Wirral, also issued a statement that said the practice would not be cancelling scheduled appointments for the second booster dose from this week and requested that patients attend as scheduled. 

Another PCN – Horsham Central PCN in West Sussex – said it has already vaccinated 1,900 over 80s with the first dose of the Pfizer vaccine and would not be cancelling existing appointments.

It added: ‘As a PCN, we are going to continue with the second dose to patients already booked in for this, and will adjust the timeframe for the second dose in the next wave of patients.

‘This has been a clinical decision by the Covid-19 vaccination clinical supervisor, supported by the BMA, after careful evaluation of risks and benefits.’

‘Grossly unfair’

This comes after the BMA released a statement yesterday (4 January) stating that they would support any vaccination sites that opted to honour existing second dose appointments for patients. 

The BMA described the decision to ask GPs to rebook appointments for ‘tens of thousands of elderly and vulnerable patients’ was ‘grossly unfair’ and would cause ‘huge logistical problems’. 

The Institute for General Practice Management (IGPM), the newly formed representative body for practice managers, also warned that rebooking the existing appointments would be ‘logistically dangerous’.  

Meanwhile, the RCGP, in a statement on 31 December, said: ‘NHS England’s guidance does allow for some clinical discretion for practices to go ahead with second vaccinations where necessary – and if a practice uses this, it is important it is respected’.

NHS England and the Department of Health and Social Care have been approached for comment.

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