Exclusive: how a high-performing surgery vaccinates 1,500 patients in a day

Mendip Vale Medical Group is an almost 60,000 list-size practice with six sites across Bristol and North Somerset. Since December the surgery has been one of the leading surgeries in the UK for vaccine delivery. Our Director James Truswell talks to Executive Manager David Clark on how his team have tackled the vaccine roll-out so far.

How is the vaccine roll-out going at Mendip Vale?

The roll-out is going really well; patients have been great and are really happy to receive the vaccine. We’re doing the last part of cohort six which will be finished by next Sunday, the category containing 18-65-year-old’s with underlying health conditions. This is the biggest cohort yet.

How have you co-ordinated the roll-out?

We’ve had one of our larger buildings at Langford designated as a wave one site for the vaccinations. It’s been effective because we’ve been able to use the whole ground floor. The building lends itself to doing mass-vaccinations as there are five entrances and exits, so it flows and there’s no crossover of patients.

We’re fortunate that because we’ve gone through recent mergers it means using Langford for vaccinations doesn’t disrupt our routine services – because our other sites are able to absorb additional general practice work. We’ve also been vaccinating regularly on Saturdays and Sundays to reduce the impact on our normal clinics.

How many patients are you vaccinating on a weekly basis?

Since we started in mid-December we’ve delivered up to 3 clinics in a week, however this is dependent on supply of vaccine, so on average we are running around 2 clinics per week currently.

We’re giving over 1,500 vaccinations to patients in a seven-hour session. Initially when we were purely using the Pfizer vaccine the highest number we could vaccinate in a day was around 975 which then increased to 1,170 as we were able to draw more doses. Now when we use the Oxford Astra-Zeneca vaccine, partly because the patient observation period is more relaxed and the storage of the vaccine is more flexible, we will deliver more than 1,500 vaccinations in a clinic.

To achieve 1,500 vaccinations within a day the vaccine team comprises of two GPs who are providing the clinical supervision, four vaccinators which can be a Nurse, Advanced Practitioner or a HCA, eight admin staff taking details and a further three meeters and greeters at the door to point people in the right direction.

We also have a car parking team provided by North Somerset Council who make a massive difference. When you’re vaccinating over 200 people every hour car parking does become a factor to consider and the team make it flow very well.

Mendip Vale Medical Practice in Langford where healthcare staff are vaccinating up to 1,500 patients within a 7 hour session

Is there anything that reduces the number of patients you can vaccinate?

If we had an unlimited amount of vaccine supply our practice could achieve 14,000 vaccinations per week. This means that in just over one month we could’ve delivered the first dose of the vaccine to our entire eligible patient cohort of nearly 60,000. But naturally the supply isn’t yet there. Not every surgery would be able to achieve this of course but we’re fortunate with our set-up, size and building provision that this would be achievable for us. We’re experienced in delivering high vaccine numbers, our record for a flu clinic is 2,544 in a 7 hour session but it’s easier to achieve this with a flu clinic because there’s no observation period and we can sometimes do part of the clinic outside.

What has the uptake of the vaccine been at Mendip Vale?

In the over 80s the uptake has been 99% and it’s 98.7% in over 75s. The next cohorts are still being finalised but it’s definitely in the high 90s in terms of percentage.

What have the biggest challenges been?

Previously, the biggest challenge was using the Pfizer vaccine with only 3 ½ days to use the entire canister of 975+ vaccines; of which we received limited notice of the delivery so it meant calling in patients at very short notice.

Currently the supply of the vaccine is the biggest challenge and we are still getting short notice with deliveries; sometime just 24 hours, but patients have been marvellous at coming in. And with the Oxford Astra Zeneca vaccine we don’t have the 3 ½ day deadline to use the vaccine.

When do you predict the UK will have everyone who wants a vaccine vaccinated with 2 doses?

I think by the end of August should be achievable, possibly even sooner depending on supply.

How has primary care adapted to the vaccine roll-out?

I think GPs have really stepped up the plate and made huge in-roads into the campaign. If you compare primary care to some of the mass vaccination centres; one of which recently only vaccinated 82 people in an entire day; then general practice has done exceptionally well. PCNs have all pulled together so the only thing that could derail us is the supply issue. But there’s going to be a third and fourth type of vaccine coming through, which should mitigate the chances of that.