This article was updated on 20 December to provide further details about payments to practices and information about changes to fit notes.
What is the target?
The government wants to offer every eligible adult over the age of 18 a booster jab by the end of December. Eligible adults are those who had their second dose at least three months ago.
Estimates suggest that the NHS across the UK will need to vaccinate over 1m people a day between now and the end of the month to hit this target.
Why has the deadline changed?
The new deadline has been set because of concerns about a rapid increase in COVID-19 cases, mainly driven by the Omicron variant. On Monday 13 December health secretary Sajid Javid told parliament that Omicron is spreading faster than any other variant of coronavirus and warned that the UK faced a sharp rise in deaths and hospitalisations among infected patients.
Data suggests that two doses of the vaccine do not provide much protection against infection with the Omicron variant (although less is known about how well they protect against serious illness). However, receiving a booster jab has been shown to significantly increase protection, hence the push to roll out boosters as rapidly as possible.
What does this mean for practices?
NHS England has asked all NHS and local government organisations to 'prepare to redeploy their
administrative and clinical staff to support delivery of the vaccination programme between now and the new year'.
All GP practices – including those who have not signed up to the vaccination enhanced service – are being asked to 'clinically prioritise' services to free up staff to help support the vaccination drive. Practices will be expected to continue 'urgent or emergency care and other critical services such as cancer' but pause routine or non-urgent care.
They have also been asked by NHS England to 'redeploy' staff to vaccination sites. Practices will be expected to share their staff availability and a point of contact at the practice with their local lead employer for the vaccination programme.
Further guidance on workload prioritisation is expected shortly from the BMA and RCGP and an operational note from NHS England.
CQC inspections will be suspended for the next three weeks unless the regulator has serious concerns about a provider.
What does this mean for PCN vaccination sites?
Anyone aged over 18 who had their second dose at least three month ago is now able to book their booster.
PCN sites have been asked to ensure those most at risk are prioritised, which includes care home residents and staff, those who are housebound and the severely immunosuppressed. NHS England wants GP and community pharmacy teams to complete vaccination of care home and housebound patients by the end of this week.
Vaccination sites have also been asked to ensure they are still making first and second dose jabs available to those who want them. Integrated care systems and CCGs are being encouraged to continue to provide mobile and pop up clinics.
PCN sites need to provide details of any additional vaccines they need this week. From Tuesday the number of vaccines delivered will be doubled.
NHS England has said the main priority to achieve the target is to increase capacity. Sites have been asked to open at least 12 hours a day, seven days a week and ensure they are using the national protocols as these allow unregistered staff to administer vaccines.
Additional staff will be available and lead employers should be 'pushing' these staff out to vaccination sites. Military personnel will be working with lead employers to provide logistical support. Fire, police, local authority and other public sector organisations have also been asked to identify and release any personnel that could help with the vaccination drive.
What about the 15-minute observation period?
The need for 15 minutes' observation after the Pfizer and Moderna vaccines has been temporarily suspended for patients with no history of allergic reactions following a recommendation from the UK CMOs. The Green Book has been updated to reflect this change.
The Green Book adds: 'Vaccinated individuals should be informed about how to access immediate healthcare advice in the event of displaying any symptoms. In some settings, for example domiciliary
vaccination, this may require a responsible adult to be present for at least 15 minutes after vaccination.'
It also contains a table showing how patients with a history of allergy should be managed.
Will there be extra money to support this?
NHS England has requested additional funding from the Treasury to support the vaccine drive.
Practices taking part in the vaccination programme will be paid £15 per jab administered on weekdays and Saturdays from 1 December 2021 to 31 January 2022, which will increase to £20 per jab administered on Sundays or Bank Holidays. An update to practices on 17 December said that practices will be paid £20 per jab delivered from 25 December to 3 January.
They will also be paid £30 for every third dose and booster vaccination of housebound patients t until 31 December, which will also be backdated for those already carried out.
What else do practices need to know?
NHS England has said it expects ICSs to finalise plans for the COVID-19 Medicine Delivery Units that will make new treatments available in the community for those most at risk from COVID-19. GPs and practices will be expected to help patients access these treatments by referring people to the units if they have not already been identified. There is guidance on this here.
From 17 December until 26 January 2022 the Department for Work and Pensions is changing the rules around fit notes. Self-certification to access statutory sick pay will be extended from 7 to 28 days and there will be no requirement for a fit note to access other benefits. NHS England said this should significantly reduce the number of fit note requests practices receive. Guidance on this is here.
The guidance for NHS staff who are identified as a close contact of a case of COVID-19 has also been updated so there is no longer a requirement to isolate if they are in contact with a case of Omicron.
Second doses for 12- to 15-year-olds will also be getting underway over the Christmas period. These can happen at least 12 weeks after the first dose. Young people are not required to have the vaccine at the same place they had their first dose, so PCN sites may be involved in providing these jabs as well as boosters. The national booking system opened to young people to book these jabs on 20 December.