Regional health leaders were frustrated by a lack of local control during the Covid vaccine rollout, a new report into the UK’s response to the pandemic has found.
Module 4 of the independent UK Covid-19 Inquiry heard evidence that regional-based health commissioners and local providers characterised the vaccine programme as ‘top-down’ due to strong central government oversight and ‘leadership over implementation’ maintained by NHS England.
However, the inquiry also heard that the model of central control was effective in ensuring fast and coordinated vaccine delivery in the early days of the pandemic.
And by the spring of 2021 this central control has loosened to enable more flexibility and more tailored strategies to be put in place, the report said.
It added: ‘Regional health leaders characterised the vaccination programme as ‘top-down’, due to strong central oversight.
‘They reported frustration over a lack of local control over issues such as appointment booking and supply management.
‘Local health providers reported that they did not initially feel able to tailor delivery to the needs of their local community (e.g. through vaccine allocation and choice of delivery venues) in order to address local inequalities such as lower vaccine uptake among people from some ethnic minority groups.’
The report, which was published on Thursday and is the fourth from the inquiry, evaluated the development and deployment of vaccines and therapeutics in the UK during the Covid-19 pandemic.
It said that the NHS in England was able to plan for delivery through ‘tried and tested routes’ already in place for routine vaccine programmes which meant it could quickly scale up deployment.
‘For example, GP practices were experienced in fulfilling NHS England contracts for vaccination in routine immunisation programmes such as flu vaccination,’ it added.
During the pandemic, NHS England also worked with directors of public health to identify which communities in a particular area had lower uptake and were likely to need additional help to access vaccines.
Despite these efforts, vaccine uptake was lower in some communities – such as areas of higher deprivation and in some ethnic minority communities – and ‘more must be done to improve uptake’ in the event of another pandemic, the report said.
It added that the rapid spread of false and misleading information online had fuelled vaccine hesitancy globally, and a lack of confidence in authority was also a ‘significant factor’ in the UK.
Overall, the report said approximately 132 million Covid vaccinations were given across the four nations in 2021, making it the largest vaccination programme in UK history.
By July 2021, 86.8% of the adult population in England, 89% in Scotland, 90.1% in Wales, and 81.6% in Northern Ireland had received at least one vaccination dose.
The Inquiry report praised the ‘extraordinary efforts’ of people across the UK who delivered the vaccine rollout and described it as a ‘great achievement’, especially given that healthcare workers were at the highest risk of infection during the pandemic.
It also suggested five measures to ensure the UK is better placed to develop and deliver vaccines in any future pandemic, which include:
- Establishing a pharmaceutical expert advisory panel;
- Producing targeted vaccination strategies and communications to increase vaccine uptake and reduce inequalities;
- Improving monitoring and evaluation of vaccine uptake and delivery to understand the most effective ways of increasing vaccine uptake;
- Facilitating regulatory bodies’ access to healthcare records;
- Reforming the Vaccine Damage Payment Scheme.
Baroness Hallett, chair of the UK Covid Inquiry, said: ‘We cannot know when, but there will be another pandemic. My recommendations, taken as a whole, should mean that the UK is better prepared for that pandemic.
‘I urge governments across the UK to work individually and collectively to implement these recommendations, in full and in a timely manner.’
