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Vaccination

Government consults on allowing pharmacy technicians to administer COVID-19 and flu vaccines

The government has also proposed expanding the scope of patient group directions to allow pharmacists to administer unlicensed vaccines, including a COVID-19 vaccine.

Open access article

The Royal Pharmaceutical Society has made this article free to access in order to help healthcare professionals stay informed about an issue of national importance.

To learn more about coronavirus, please visit: https://www.rpharms.com/resources/pharmacy-guides/wuhan-novel-coronavirus

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The proposals said that an expanded workforce was required to deliver the expanded flu vaccination programme and the COVID-19 vaccine once it becomes available

Pharmacy technicians could become eligible to safely administer a COVID-19 or influenza vaccine under new government proposals.

The proposals, which are part of a wider consultation document around changes to the human medicine regulations (HMR) to support the roll-out of COVID-19 vaccinations, said that an expanded workforce was required to ensure that the COVID-19 vaccine could be “safely deployed widely” as soon as it becomes available, as well as to ensure that the recently announced expanded flu vaccination programme could be delivered.

In the document, published on 28 August 2020, the government proposed three amendments to the HMRs, including expanding the scope of patient group directions (PGDs) to allow pharmacists to administer any medicine, including COVID-19 vaccines, the supply of which has been temporarily authorised under regulation 174 of the HMRs.

Currently, a PGD cannot be used to administer anything that does not have a full marketing authorisation, but this change would enable healthcare professionals who already deliver vaccinations under PGDs to continue to do so for unlicensed vaccines.

“A new type of national protocol” has also been proposed to allow registered healthcare professionals who do not normally vaccinate, and people who are not registered healthcare professionals, to safely administer a licensed or temporarily authorised COVID-19 or influenza vaccine.

Pharmacy technicians — who are registered with the General Pharmaceutical Council — are not currently able to vaccinate under PGDs. When asked by The Pharmaceutical Journal to confirm that pharmacy technicians were included in the proposals, the Department of Health and Social Care said no options are off the table in terms of which healthcare workers would be eligible.

The protocol, the government has said, would be written similarly to a PGD and would “provide the flexibility” to define the training and competence requirements of vaccinators and the clinical consideration they must follow.

Finally, the government has suggested expanding the workforce legally allowed to administer vaccines to health and care workers under NHS and local authority occupational health schemes, so that additional healthcare professionals — including pharmacists, midwives, paramedics, and physiotherapists — will be able to administer vaccines alongside nurses.

The consultation will run for three weeks with the measures expected to come into force by October 2020.

Graham Stretch, clinical director of Brentworth Primary Care Network, said that it was important to do “something fast” to expand the available workforce to deliver flu vaccinations this year and help mitigate a second wave of COVID-19, and that he would “support that in general for all staff”.

However, he added that for a long time he had believed pharmacy technicians should also be able to access PGDs to improve patients’ access to medicines.

“A lot of pharmacists feel a little bit threatened as they see it as being a key role, but the practical aspects of administering a vaccine is a procedural thing that anyone can be trained to do. We’re allowing our personal wish to keep our roles to cloud our judgement a bit — we need to be much more pragmatic,” he said.

“Case-by-case PGDs need to be approved properly, so you would need to be careful [the PGD] didn’t require a certain clinical level of skill, but there are things that technicians could definitely be doing — and flu vaccines is absolutely one of them.”

New flu service specification published

On 28 August 2020, NHS England published an updated service specification for the ‘Community pharmacy seasonal influenza vaccination advanced service’ and patient group directions, which will come into effect on 1 September 2020. The latest version of the specification will mean:

  • Contractors no longer need to obtain written consent from each patient prior to vaccination, although they must record that verbal consent was obtained;
  • Contractors no longer need to notify regional teams prior to undertaking vaccinations off-site;
  • Pharmacists no longer need to notify a patient’s GP in advance of vaccinating them in their home or care home;
  • Pharmacists are now able to vaccinate off-site within professional standards. This includes being able to vaccinate care home staff within the care home;
  • Pharmacists are now able to vaccinate patients in any appropriate space within the pharmacy. However, a consultation room is still required so that the patient can still have their vaccination in the consultation room if they request it;
  • Patient cohorts have been updated to reflect the content of the 2020/2021 annual flu letter

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2020.20208311

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