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Pharmacy technicians in North Wales have started administering flu vaccines as part of a pilot to manage increased demand, the local health board has said.
The vaccines are administered by pharmacy technicians and a preregistration pharmacy student, under patient specific directions (PSDs), as part of a community pharmacy enhanced service in two Fferyllwyr Llyn pharmacies on the Llyn peninsula in North West Wales.
PSDs are written instructions signed by a prescriber for medicines to be supplied or administered to a named patient after the prescriber has assessed the patient individually.
In a statement to The Pharmaceutical Journal, a spokesperson for the Betsi Cadwaladr University Health Board (BCUHB) said the PSDs were being operated by the pharmacies’ independent prescribing pharmacists.
The pilot follows changes to UK-wide legislation in October 2020, which now allow a broader workforce to deliver flu vaccines.
Under the new legislation, protocols can be drawn up in each of the four UK nations to determine which healthcare staff would become newly qualified to administer vaccines and include “requirements for the supervision of an additional experienced vaccinator” if needed.
Board meeting papers from the BCUHB, published on 12 November 2020, said primary care in the North Wales area “is experiencing a significant increase in demand for the annual influenza immunisation” programme.
The papers said the health board supported “community pharmacies with additional vaccine from contingency stock”, with added supplies “available via the Welsh Government with the main focus being to ensure all those people in an existing priority group are vaccinated”.
As of the third week of the programme, the meeting papers said 59.2% of patients (99,000) aged 65 years and over had received a flu vaccination, compared with 40% (68,000) at the same point in 2019.
“A greater collaborative approach has been developed to ensure more care home staff and domiciliary workers are vaccinated via community pharmacies which is also progressing well, with over 1,000 care home staff having already been vaccinated,” the papers explained. “Furthermore, a pilot patient specific direction to support flu vaccination by pharmacy technicians has recently been commissioned.”
Steffan John, superintendent pharmacist at Fferyllwyr Llyn pharmacies, said he “would estimate that about 50% of our flu vaccines this year have been administered under a PSD”, adding that the pilot has “worked really well for us”.
“With the increase [in] demand and the need to pre-book as many vaccinations as possible this year due to COVID, we were keen to look at a new way of working,” he said.
John explained that patients complete a pre-screening questionnaire, which the pharmacist reviews. Then, where appropriate, the patient would be put on the PSD.
“Technicians and preregistration pharmacists would then book the appointment and administer the vaccine on the day, with only the administration record required to be completed by them.”
He added that the pilot has enabled the pharmacies to offer more appointments, and “allow the pharmacist to concentrate on walk-in requests for flu vaccines where appropriate, but also deliver the independent pharmacist prescriber-led acute conditions service”, which he said has seen an increase in demand, “as getting a GP appointment during the pandemic has been challenging”.
The BCUHB spokesperson said the pilot would “run until the demand for flu [vaccines] has subsided — likely to be in the new year”.
“We will be exploring the scheme with the pharmacy teams after that to determine whether there were any issues around providing the service, with a view to potentially expanding it in future years,” they said.
A spokesperson for the Welsh government said: “While this is not part of our plan to widen the vaccinating workforce for the flu vaccine, we are committed to increasing the number and use of pharmacists independent prescribers in community pharmacy and expanding the role of pharmacy technicians across Wales.
“How pharmacist prescribers use the legal mechanisms available to them to supply and administer medicines is a matter for individual pharmacists. This is an example of how our plans to make independent prescribing widely available in community pharmacies can more effectively use the range of skill within pharmacy teams.”
When asked whether similar plans were expected to be rolled out in Scotland, the Scottish government said its “flu vaccination and COVID-19 vaccine programme board is considering how COVID-19 vaccines will be deployed, including logistics such as who will deliver vaccinations and how they will be stored”.
“All NHS boards stand ready to assist with the delivery of vaccination to the local population as part of the national plan.”
