Betsi Cadwaladr outline challenges as it is revealed only eight pharmacies have been commissioned to deliver vaccine

Community Pharmacy Wales say there is 713 community pharmacies in Wales and Betsi Cadwaladr University Health Board (BCUHB) has commissioned only eight pharmacies out of 152 to deliver the vaccine.

The body believes they can make a ‘major contribution’ to the roll-out and have published figures showing their success in delivering the highest number of flu vaccines in Wales in a community pharmacy setting.

They say the accomplishment demonstrates community pharmacist capacity to deliver Covid-19 vaccines.

A spokesperson from Community Pharmacy Wales said: “The number of community pharmacies actually commissioned to deliver a Covid vaccination service in Wales remains disappointingly low, despite reassurances from Welsh Government we would and should be integral to rolling out the programme.

“With the completion of the first nine out of 10 vaccine cohorts now in sight, the community pharmacy network is feeling increasingly frustrated and underused.

“We delivered 12 per cent of all flu vaccines in Wales over the last six months, demonstrating we have the skills and the appetite to be more fully involved.”

BCUHB has administered more than 400,000 first doses of the Covid vaccine. A number reached over the weekend.

Dr Chris Stockport, executive director of Primary Care and Community Services

This figure shows a huge number of vulnerable groups have been vaccinated thanks to the combined efforts of a large amount of people.

Responding to the plea for community pharmacies to be more involved in the roll-out, Dr Chris Stockport, executive director of Primary Care and Community Services, said the health board is ‘happy’ to involve any partners but a number of challenges are in place preventing more community pharmacies being used.

“We’re happy to involve any of our partners who want to support the vaccine rollout, and we’re lucky to have a passionate, enthusiastic network of community pharmacies operating throughout North Wales, ready to play their part,” he said.

“North Wales has led the way in testing how pharmacies can practically contribute to the roll-out, and we’ve learned from our pilot schemes that there are factors beyond our control to reach a place where we can commission more colleagues in Primary Care to deliver the vaccine.

“The biggest challenge we face in widening out the number of vaccination centres is vaccine supply. As is the case for everyone else across Wales and the rest of the UK, what we can achieve is still limited to the number of vaccines available to us.

"The capacity we’ve already got in place through our MVCs, LVCs, hospitals and GP practices could be doing even more vaccines if they were available to us, so to date we haven’t been able to roll out more locations as there hasn’t been additional vaccine supply available to use them.

“There are also a number of logistical challenges when introducing more locations where people can receive their vaccines. Unlike the annual flu vaccination campaign, the Covid-19 vaccinations available to us have challenging storage requirements, with a limited shelf-life, and come in multi-dose vials.

“All of this means that we need to book clusters of appointment together, planning appointment carefully to make sure that we use every last dose. It also means we can’t run the campaign like our flu jabs, where essentially anyone eligible can turn up and get their jab on the spot because the vaccines are in single-dose syringes and have more flexible storage requirements.

"A similar approach with the Covid-19 vaccine would present a real risk of wasted vaccines, which we absolutely cannot do.”

Dr Stockport said that organising where patients go and then arranging appointments is also a "huge operational challenge" for the programme.

“The more vaccination sites we involve, the greater this becomes,” he added.

“Every new site we open up means more administration time, and we are very grateful to our GP colleagues for the work that their administration teams have put in to identify and book their patients in to be vaccinated at the practice.

"Community pharmacies work differently to GP practices and don’t have registered patients, or teams of administrators, so the process of identifying eligible patients and arranging appointments has been an extra challenge where we have involved them in the programme.

"We are currently working hard to overcome these challenges around allocation and booking of patients into vaccination appointments, including working with Welsh Government and other parts of the NHS to explore the use of technology to support bookings, in anticipation of vaccine supplies growing sufficiently to allow us to increase the number of places offering vaccinations as the programme moves forward.

"We’re really grateful to the role everyone is playing in continuing to reduce the risk of spreading Covid-19 and making the vaccine rollout programme a success."

BCUHB is working through everyone in the area, based on the UK-wide priority order and as fast as the vaccine supply allows, and is on course to vaccinate all of priority groups one to nine before the middle of April.

Dr Stockport added: "Going forward, the challenge of vaccinating group 10, which is essentially everybody else, will be different to that of the higher risk groups prioritised across Wales so far.

"This younger age group presents a range of different challenges for us to manage, not least moving from vaccinating smaller groups of people to one huge group of patients. There’s also the added complication of lock-down measures lifting, and people returning to work, all of which impacts on how we reduce rates of people missing appointments or being unavailable to get their vaccination in the first place.

"To help meet this challenge, over the coming months I expect we will see a shift in how vaccines are delivered, with our Mass Vaccination Centres, Local Vaccination Centres, GPs and other primary care providers all playing a different role to what we’ve seen before."