VACCINATION: Pharmacy is ready for new roles

Peter Horrock attributes the success of community pharmacy-led Covid vaccination services to the innovative and ‘can do’ approach seen across the sector…

Community pharmacists and their teams have successfully expanded the influenza vaccination programme and have supported the delivery of the Covid-19 vaccination rollout in a big way, reaching out to vulnerable patients and hard-to-reach communities.

The administration of vaccinations at community pharmacies has the potential to further increase vaccine uptake and make community pharmacies the hub for all vaccines. What other vaccination services could they consider in addition to providing the core NHS vaccinations?

Community pharmacy has well and truly established itself as a key provider of vaccination services, with 2021 being the most significant year to date. We see demand waning away as we exit the pandemic, it provides time to reflect on the journey pharmacy has taken to get to this point and what direction we may head in the future.

I have been actively involved in vaccination services for more than 10 years now, since the early days when locally commissioned PCT services were set up as pilots to support accessibility. At the time there was much hesitancy from colleagues, new regulatory hoops to jump through, yet a patient base that was willing to access a more convenient method of service provision.

Along with many others who forayed into the administration of vaccinations, travel vaccines and occupational vaccinations have offered a regular service offering throughout the year.

This has allowed our clinicians to remain competent while providing a diversified income away from usual NHS reimbursement.

In some areas we have seen general practice completely stop all private vaccinations choosing to refer patients to the community pharmacy for any such requests.

Over the last few years, I have been delighted with the uptake of vaccinations in each of our pharmacies, year on year we have seen a doubling of flu vaccinations provided and more and more NHS and private customers coming back each year.

However, the flu season often creates a sense of uncertainty, ‘have I ordered the correct vaccine’, ‘will my scheduled delivery arrive’, ‘will we face hostile behaviours from other providers’, and I can confidently say not one year has gone by without some form of disruption.

In fact, not only do I fear disruption I now expect it, with 2022-2023 already showing disruption due to some of the previous cohorts not being eligible later this year.

Vaccination services are now core business for all pharmacies within our group, with vaccination training being a key learning objective for our trainee pharmacists. Last year we even trained our students before they joined us, so they were ready to support our Covid vaccination programme.

The Covid vaccination programme has been a tremendous success for community pharmacy and something I feel immensely proud to have been involved in. We committed a significant amount of resource towards premises preparation and staff training and were fortunate to have three sites approved in January 2021 at the start of the community pharmacy vaccination programme.

For at least the first six months, the vaccination programme consumed a significant part of the working week, despite the additional staffing resource we had facilitated. Our early adoption of the programme gave us a unique position of being able to share our experiences with colleagues across the sector, providing advice and support to those joining.

Yet some of the most rewarding collaboration came from the work we were able to do with our PCN practices and CCG colleagues. We held a shared vision to vaccinate as many of our local population as possible resulting in joint clinics, outreach events, 24-hour clinics and the targeting of missing eligible cohorts. Our collaboration was recognised nationally and something we have adopted across several sites and replicated by others.

My colleagues that have supported the vaccination programme have been an invaluable resource in every location, especially the non-clinicians working under the legal framework of a National Protocol, this included technicians, dispensers and trainee pharmacists who all accessed the relevant training and worked under the supervision of our clinicians.

The National Protocol was a gamechanger enabling tasks to be undertaken by the most appropriate member of the team. This for me is a blueprint for the future and a fantastic way of challenging the norms and ensuring that pharmacists and their teams are utilised to the roles and responsibilities relevant to their skill set. It would be a great shame if following the pandemic that legal mechanisms that have given us this flexibility are removed and we lose the experience that has developed over the past year.

Overall, I attribute the success of pharmacy vaccination services to the innovative and ‘can do’ approach that we see across the sector, coupled with the demand from patients for a professional, efficient, and convenient service.

Community pharmacy has well and truly demonstrated its place in the provision of vaccination services both privately and on behalf of the NHS. We remain a ready and waiting workforce poised to increase capacity, as required, to all future vaccination programmes, including the planned introduction of children’s Covid vaccinations and future adult boosters.

As general practice and the wider NHS struggles with the post Covid backlog, we are ideally placed to offer both routine childhood immunisations and adult vaccines such as shingles and pneumococcal as an advanced service. But we must not stop there. There are several injectable medications that can be given safely in pharmacy.

The successes of the Covid-19 vaccination programme and pharmacies contribution will be held dearly by both patients and the NHS. We must now make sure that this platform we stand on is used to elevate the ability of the profession to adapt and take on new responsibilities.

(Peter Horrocks is clinical standards director and superintendent pharmacist at Knights Pharmacy.)