Many different members of the workforce may wish to be involved in the delivery of the COVID-19 vaccination programme.
What we know so far is that a registered healthcare professional will need to carry out the clinical assessment and consent. A suitably trained non-registered member of staff will be able to administer the vaccine itself under clinical supervision.
General practice and PCN staff
Members of staff already qualified to provide vaccinations are likely to be the main part of the workforce administering the COVID-19 vaccine in general practice.
Most of the programme should be delivered by staff other than GPs, who will be most useful in overseeing and providing routine care to other patients as needed.
As the administration of the vaccine will be under an enhanced service directed by NHSEI, it will be optional for practices to sign up.
Staff will be covered by the CNSGP (clinical negligence scheme for general practice) as it is NHS commissioned work.
The Government has introduced new national protocols to allow non-clinicians to administer the currently available vaccines.
The Government aims to recruit and train many thousands of volunteers to administer the vaccine and help it meet its mass immunisation targets.
Volunteers who meet the criteria in the protocols for 'required characteristics of persons' for administering the vaccine will be indemnified under CNSGP (clinical negligence scheme for general practice).
Exceptions to this are where:
- volunteers are deployed through the arrangements established centrally by NHSE/I with St John Ambulance
- volunteers will be indemnified under existing policies
- volunteers in non-clinical roles, who will be will be covered under a practice’s own third-party liability insurance.
The volunteer has to:
- be between the age of 18 and 69
- have at least two or more A-levels or equivalent
- be at low risk of COVID-19
- be prepared to undergo a reference check.
The law was recently amended to allow registered healthcare professionals who do not normally vaccinate to safely administer a licensed or temporarily authorised COVID-19 or flu vaccine. This includes:
- student doctors and nurses
- doctors and nurses working outside the NHS
- people who are not registered healthcare professionals.
Paid roles for non-NHS staff
NHS Professionals – the flexible workforce provider for the NHS – are leading on recruiting and training people for the new vaccinator roles. This will be across the different COVID-19 vaccination services that will be set up over the coming months.
Practices may also wish to approach your local medical schools about the possibility of medical students assisting in the programme. When doing so there are a number of areas that you will need to consider.
The BMA medical students committee has issued guidance on medical students volunteering for COVID-19 services.
Medical students should be appropriately remunerated for the work that they carry out. Terms should include relevant risk assessments and safety guarantees. They should be arranged in the same way that any existing healthcare assistant roles or other agenda for change roles are currently offered to medical students during the pandemic.
Any roles should be available to students on an opt-in basis and avoid any adverse impact on their education. Students should not take on any vaccine-related role if they are already on placement or have other ongoing educational priorities.
We advise that students should be issued with honorary contracts in order to formalise, describe and clarify their relationship with the vaccinating practice and define accountability and governance.
Under such a contract they would then be operating as employees and would be indemnified under the practice’s CNSGP indemnity.
Roles offered to medical students should be appropriate to their level of clinical experience and remain within their clinical competence.
It is recommended that the most appropriate role for medical students would be vaccinators under the professional direction of registered health care professionals such as nurses and/or doctors.
This will allow for direct supervision and ensure that a registered healthcare professional is immediately available for queries or assistance, if required.
- Medical students should only act under the supervision of a qualified health professional.
- Practices should ensure that all staff working in the vaccination programme have undertaken relevant risk assessment.
- Practices will need to ensure that medical students have the necessary skills and training to administer vaccines in general. This includes the general immunisation training available on e-learning for health and face-to-face administration training, where relevant, as well as training in anaphylaxis.
- As with all staff assisting with the programme, they will also be required to undertake online COVID-19 specific training modules available on the e-learning for health website. GP practices will be expected to oversee and keep a record of this.
Doctors in training in general practice should not be diverted away from educational activities to staff vaccination centres as this could degrade their educational experience.
However, they may wish to volunteer to provide extra sessions at vaccination centres. Any such sessions must be entirely voluntary and should be contracted as extra hours which, by definition, would then be within scope of CNSGP.
Sessional doctors may wish to offer their services to vaccination hubs. All sessional doctors engaged by the vaccinating practice will be covered by CNSGP for this NHS service.
In England, retired staff can register to re-join the NHS and its COVID-19 vaccination team for mass vaccination centres. There are different routes to join depending on your circumstances.
You do not have to make a new application if:
- are a retired clinician who answered the call to come back to help the NHS earlier this year and
- have completed pre-employment checks through NHS England and NHS Improvement’s Bringing Back Staff programme.
You will be contacted by the NHS England team directly or you can contact your local practice or PCN to get involved.
- are a retired clinician interested in returning to the NHS but have not previously returned to NHS work since retirement, or
- returned to support the NHS by any route other than NHS England and NHS Improvement’s Bringing Back Staff programme
visit the NHS Professionals website where you can make an application and undergo the necessary pre-employment checks.
The Government has announced that doctors who offer their support in delivering the programme in primary care will be exempt from the requirement to be included on the England medical performers list.
The regulations remove previous barriers and mean that any GMC registered doctor will be able to administer the vaccine and ancillary vaccine services.
In the UK, the Chartered Institute of Environmental Health has established a register of people willing to volunteer to support services in the UK during the pandemic. This includes people with public health and administrative skills currently working in the private and business sectors.
Everyone working on the programme will be given the training needed to ensure they can safely and effectively carry out their responsibilities. Those who have applied for vaccinator roles will be provided with comprehensive vaccination training.
Public Health England offers guidance on immunisation training during the pandemic to support providers for whom immunisation is going to be an on-going routine professional responsibility.