Community pharmacies have played an ever-growing role over the course of the COVID vaccination programme. We are now fast reaching a tipping point, when pharmacies will overtake GPs and administer the majority of COVID vaccines. The story was exclusively covered by the Mirror:
- To date, community pharmacies have provided almost a quarter (24%) of all COVID vaccinations in England.
- Over a third of pharmacy COVID vaccinations were administered in the country’s 20% most deprived communities.
- So far in 2023, community pharmacies have provided 2m+ COVID vaccines in England – nearly half (46%) of all Covid vaccinations administered this year.
In 2020, the COVID vaccination programme was originally designed to be delivered primarily in hospitals and mass vaccination centres. Community pharmacies were not considered to be a major part of the programme – with only a handful being able to engage. Community pharmacies provide greater access especially for people living in deprived neighbourhoods1 who often have fewer hospitals, GPs, and dentists. Therefore, they were called on to plug gaps in national provision with the NHS controlling which pharmacies could provide vaccines based on local need. In 2021, over a third of COVID vaccinations administered by community pharmacy were provided in the 20% most deprived communities.
Thankfully, this autumn, we have seen a new approach by NHS England, with any pharmacy being able to provide COVID vaccines.
Unfortunately, a lack of funding, combined with unnecessary NHS bureaucracy, has created obstacles to pharmacies wishing to engage with the programme this autumn. Every pharmacy in England is suffering from a funding shortfall of at least £67,000 each year2. The NHS have also made a significant reduction to the standard rate they will pay for COVID vaccinations to be administered, making the programme almost impossible to deliver without loss to the pharmacy.
NHS England now need to make several practical changes to make the programme simpler for patients and pharmacies, as well as improving the decision-making process that underpins the programme. In particular, the CCA wants to see a reduction and greater standardisation of bureaucracy so pharmacies can come online quicker. Additionally, the supply of COVID vaccines must be moved to existing logistical routes, allowing pharmacies to order and manage COVID vaccine stock much in the same way as all other medicines are supplied for the NHS. These changes will also set the stage for further expansion of community pharmacy vaccination programmes.
Malcolm Harrison, Chief Executive of the CCA said:
“Community pharmacy is the anchor of the COVID vaccination programme. However, the true benefits of community pharmacy will not be realised without change.
This year alone, community pharmacy has provided nearly half of all COVID vaccines and stands ready to help turbo-charge the rollout during this winter period. Unfortunately, core funding remains a major issue. Moreover, pharmacies nationwide face a ‘postcode lottery’ of bureaucracy which is stifling their involvement in the vaccination programme.
Although, we experienced a lot of toing and froing concerning this year’s vaccination programmes, which consequently placed the sector in a precarious state – our members will continue to strive and deliver for patients and the public.
Prevention is always better than cure. It is now in the hands of the NHS to address the remaining barriers, so community pharmacy can ensure that patients continue to receive the vaccinations they need.”
Shadow Minister for Primary Care and Prevention, Preet Kaur Gill MP said:
“Community pharmacists play a key role in vaccinating the public and taking the pressure off overstretched GPs.
It is high time for us to realise the potential of community pharmacies. They have so much more to offer our NHS, but the Conservative government is holding them back.
Labour will ensure community pharmacists are working to the top of their license. We will put community pharmacies at the heart of our reforms to build a Neighbourhood Health Service, so people can easily get the help they need on their doorstep.”
NOTES TO THE EDITOR
The CCA’s full recommendations to improve patient access and reduce the costs of delivery are as follows:
- National Booking System (NBS) – At present the main route for patients to access pharmacy COVID vaccinations is through the NBS. The NBS needs to be integrated with existing pharmacy IT solutions. This would mean that patients could access COVID through the NBS or via pharmacy managed pathways, and internal company systems (such as calendars) would be automatically updated. This would also allow appointment options to be reviewed and updated from existing pharmacy systems.
- Assurance processes – Community pharmacies already deliver many different NHS services, including administering other vaccinations. The design of the COVID vaccine programme means many more checks are required, often managed by local NHS teams. The detailed requirements of these checks can be very different, depending on the pharmacy’s location, creating a ‘postcode lottery of bureaucracy’. The lack of standardisation and additional bureaucracy doesn’t help the NHS, pharmacies, or patients.
- Vaccine supply – Current vaccine supply is managed by the NHS. Whilst there have been continual improvements in the process, vaccine supply remains uncertain and cumbersome. The supply of COVID vaccines needs to be moved to existing logistical routes, allowing pharmacies to order COVID vaccines and manage levels of stock holding in the same way as all other medicines supplied for the NHS.
- Funding – In August 2023, without warning, NHS England announced they would reduce the standard vaccination fee for COVID vaccines. The reason offered was that the vaccines can be administered at the same time as flu vaccines. However, we know that patients do not always want to receive both vaccines at the same time. Given that co-administration is not always possible it is important there is sufficient resource to provide the necessary high-quality care for patients. The high levels of inflation mean that it costs more than ever to vaccinate patients, not less.
1 – Todd et al. The positive pharmacy care law: an area-level analysis of the relationship between community pharmacy distribution, urbanity and social deprivation in England, BMJ Open, 2014, 4:e005764. doi: 10.1136/bmjopen-2014-005764
2 – CCA, Funding gap in England equates to more than £67,000 per pharmacy, January 2023
CONTACT THE PRESS OFFICE
Nancy Ahoua, Communications Officer at the CCA – [email protected]