Vaccination is now a frontpage story in every newspaper

11 December 2020

It’s a sobering thought, but I suspect that the most useful things that I did during my career probably resulted in nothing happening.

Good preventive care saved patients from heart attacks and strokes, and when I was RCGP Chair, we prevented numerous pointless government initiatives.

But there was no glamour, no kudos, no story. It was all rather boring, offering nothing but real benefits.

Vaccination is much the same, part of the package of care that makes a genuine lifesaving difference, but is entirely unglamorous, unnoticed and unremarked - at least it was until December 2020. Vaccination is now a frontpage story in every newspaper.

Back in 1956, aged 7, I was photographed for the Birmingham Post for a campaign encouraging the uptake of polio vaccine.

David Haslam - polio

At the time, poliomyelitis was a major health problem, until immunisation almost completely wiped it out.

COVID-19 is an even greater challenge, and whilst vaccination may not be as glamorous as the drama of Intensive Care, I certainly know which I’d rather receive.

GPs should be proud to be key players in this work.

Post written by

Professor David Haslam

Professor Sir David Haslam began his career as a GP in Cambridgeshire and was Chair of the RCGP from 2001-2004 and College President from 2006-2009.

Other roles in an illustrious career have included BMA President and Chair of the National Institute for Health and Care Excellence from 2013-2019.

He was knighted in June 2018 for his services to NHS leadership.

Latest updates from College Chair Martin Marshall

COVID-19 vaccine update

Up until late last Friday it was thought that the delivery of the Pfizer/BioNTech vaccine would be in hospital hubs and mass vaccination centres. As with everything else this year, that quickly and substantially changed with NHS England’s letter to practices asking them to play a much larger role, and much sooner than anticipated.

It's going to be a massive logistical challenge but there’s been a huge amount of interest from practices keen to be involved - thank you. It’s remarkable given how busy you already are with the flu vaccination programme and our everyday business-as-usual. NHSE have identified 280 sites that are now preparing to deliver the vaccine starting Tuesday next week.

The College is here to support you in this and we have established a vaccine response group, which I’ll Chair. The aim is to ensure you have access to the most up to date information and resources necessary to pull off what will be a Herculanean effort. Keep an eye on emails from the College as well as updates to our website and COVID-19 resource hub.

Ahead of Tuesday, we're asking members whose practices are involved in the COVID-19 vaccination programme to share photos - via social media platforms - of your experiences as your clinics prepare for and deliver the vaccine, using the hashtags #GPisOpen and #GPcovidjab. See this message from Mohan Sekeram, a GP trainer in South London.

It’s so important that the COVID vaccination programme is rightly seen as an NHS-wide effort - not just for professional morale, but for public confidence as we know GPs and our teams are amongst the most trusted in the NHS.

The focus may have been on hospitals delivering the vaccine so far, but ultimately it is highly likely that a large proportion of jabs will be delivered in general practice.

Unsurprisingly, I’ve spoken a lot on this topic in the media this week. Listen back to me on Radio 4’s PM programme, BBC News Channel and LBC.

NHS England has produced a series of documents to support PCN designated sites.

MHRA warning

One key development with the vaccine this week is that the MHRA has put out a warning that patients who have a history of significant allergic reactions should not receive the Pfizer/BioNTech vaccine. This follows two NHS workers who had an 'anaphylactoid' reaction after receiving the vaccine - both have severe allergies and carry adrenaline pens with them, and both are recovering well.

This may cause some concern for patients but as with any new vaccine we are going to keep learning about it, and it is not unusual for a small number of patients to have an adverse reaction to a vaccination. This is something vaccination sites will be prepared for.

What this does mean is that patients are now required to wait at the vaccination site for 15 minutes after their jab. This is a necessary safeguard but we know it’s going to cause yet another logistical challenge for some practices. We’re raising the issue with NHSE and will share any guidance or advice we receive as to how to overcome it.

We don’t want this to deter people from coming forward to have a vaccine, if invited, and College officers have ensured they are reiterating this message in any media appearances. Vice Chair Michael Mulholland spoke on LBC on Wednesday.

General practice is open

I met with Jo Churchill, Minister for Primary Care, on Tuesday to discuss the forthcoming vaccination programme and how we can best work with government to reiterate the message that general practice is open.

We know it is. Indeed, we’re carrying out more consultations than this time last year, as well as delivering the expanded flu vaccination programme - and NHS figures show that more than half of general practice consultations are being delivered face to face.

Unfortunately, this message isn’t getting through to everyone with some patients feeling that they don’t have access to their GPs - and the media are capitalising on this. Feedback we’ve received from our Patient and Carer Partnership Group is that some messaging from practices is either unclear or out-of-date.

It’s important that the notices on practices’ front doors, telephone message systems and websites are all up-to-date and in line with current government guidance: that GP services are available, as they have been throughout the pandemic, but they are being delivered differently to usual - and that if face to face consultations are needed, they will be facilitated.

We’ve also heard about a concerning scam whereby patients are being contacted and offered the COVID-19 vaccine for a significant charge. A message on your practice website, telephone system and/or front door reminding patients that the vaccine is currently only available via the NHS for free could very well save many patients money and stress.

Sodium Valproate guidance

Updated guidance on the prescription of valproate for patients during childbearing years has been published this week.

The guidance has been produced to inform all healthcare professionals of best practice around the use and prescribing of valproate and to support them in navigating situations that could arise as a result of prescribing valproate to women during childbearing years, given the significant risk of birth defects and developmental disorders that can occur if it is taken during pregnancy.

First published last year, the updated guidance reflects minor changes made by the MHRA and changes to GMC decision-making guidelines, as well as input from all contributing organisations, to give healthcare professionals updated practical information and guidance on prescribing valproate to women with bipolar disorder or epilepsy, the only licensed indications for its use.

It has been authored by Judy Shakespeare on behalf of the College and Sanjay M Sisodiya on behalf of the Association of British Neurologists and Royal College of Physicians, and endorsed by 19 other medical organisations. Thank you to all involved.

Access the guidance.

Webinar on post-COVID syndrome

One of our recent member surveys found that 67% of respondents were looking after patients with symptoms from COVID-19 lasting longer than 12 weeks, many of whom were never admitted to hospital with COVID-19 or even tested. 81% told us you needed more clinical guidance to help manage this condition.

Last Tuesday, Vice Chair Michael Mulholland chaired a webinar on the management of the long-term effects of COVID-19, alongside Gail Allsopp, the College’s clinical lead on post-COVID syndrome, Carolyn Chew-Graham, chair of the Scientific Foundation Board, and Oxford University’s Trish Greenhalgh.

It also features a representative from the ZOE COVID app team from King’s College London, discussing patients’ perspectives on their symptoms and the support they felt they needed.

You can catch it on the COVID-19 resource hub.

The RCGP is currently working with NICE and SIGN to develop guidelines for healthcare professionals on post-COVID syndrome. We have also produced some top tips for GPs for managing the long-term effects of COVID (894 KB PDF).

RCGP member portal improvements

We’re making improvements to our member portal, which means your account will be unavailable from 16:00 on Friday 18 December until 16:00 on Sunday 20 December. Between these times only, it will not be possible to book a place on RCGP webinars and events.

You can still access eLearning and the trainee portfolio during this time.

If you attempt to log into your member account during this time, you may see an error stating "Your username and password is incorrect". Please do not attempt to reset your username or password.

Apologies in advance for any inconvenience caused and thank you for your patience.

Post written by

Professor Martin Marshall, Chair of RCGP Council

Professor Martin Marshall is Chair of the Royal College of General Practitioners and a GP in Newham, East London. He is also Professor of Healthcare Improvement at UCL in the Department of Primary Care and Population Health. Previously he was Programme Director for Population Health and Primary Care at UCLPartners (2014-2019), Director of Research & Development at the Health Foundation (2007-2012), Deputy Chief Medical Officer for England and Director General in the Department of Health (2006-2007), Professor of General Practice at the University of Manchester (2000-2006) and a Harkness Fellow in Healthcare Policy. 

He is a Fellow of the Royal College of Physicians of London and of the Faculty of Public Health Medicine and was a non-executive director of the Care Quality Commission until 2012. He has advised governments in Singapore, Egypt, Canada and New Zealand, has over 230 publications in the field of quality improvement and health service redesign and his primary academic interest is in maximising the impact of research on practice. In 2005 he was awarded a CBE in the Queen’s Birthday Honours for Services to Health Care. 

A co-founder and driving force of the Rethinking Medicine movement, Martin has a passionate commitment to the values of the NHS, patient care and ensuring the GP voice is central in a time of great change. When he’s not working, he likes being outside, preferably on a mountain or a coastal path with his wife Sue and their puppy. 

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