Pharmacist Ashley Cohen shares his experience of setting up and running Covid vaccination services, and advises his peers that the pay-off for what will inevitably a tough slog to start with will be well worth it

I’ve talked before about the frustration and anger at having to work through a pandemic with limited funding and lack of perceived leadership at the centre to support community pharmacy at large.  

But I’d also like to share some of the more positive aspects of pharmacy, and how our sector has shown a can-do attitude to support one of the biggest vaccination programmes ever.  

Over the last couple of months, I have had the opportunity of setting up two separate vaccination sites, managed and run by a multi-disciplinary team including some of our pharmacy staff. With the recent news about community pharmacy being asked to play an important role in the Covid booster programme, it seems timely to share my experiences on the preparations and key steps leading to going live and running vaccination clinics. 

Last week, NHSE called on pharmacies to submit expressions of interest by 28 July to be a part of the third phase of the Covid vaccination programme to administer booster jabs. Pharmacies provide a service that can vaccinate 100 per week, 350 per week or 1,000 per week. I would encourage all of you to take some time out of your busy schedule to read the NHSE/I materials available before deciding if this programme is for you. 

To help you decide and give you some additional information as to what to expect through the national programme, I’ve compiled a list of my top 10 points. They are based on my experience in setting up the vaccination clinics and running them alongside the day-to-day operational challenges of owning several pharmacies during a pandemic. 

  1. Do not be under any illusion - running a Covid vaccination clinic is nothing like your winter flu campaign! 
  1. The work involved in setting up the service is immense. You need to make sure you have a good support team working with you if you are about to embark on this booster programme. As you go through the selection process and get prepared to go live, the work required, emails back and forth, webinars you need to attend, and such like, will be a full-time job. 
  1. You need to think about this as a separate business – you’ll need admin support to help with the set-up, training relevant staff, and recruiting a pool of qualified vaccinators and other support staff to manage each day you are vaccinating. Do not expect your current pharmacy teams to do this in between putting the orders away and dispensing prescriptions! 
  1. There is lots of support to help you get set up on the system from the regional teams, but you will be inundated with emails, training webinars on the national booking system, how to use Pinnacle, understanding the Q-Flow portal, understanding the flow of vaccines and supplementary inventory and consumables that each site will need. 
  1. Even though there is good help available from several sources locally, regionally and nationally, my experience from starting the process is that you don’t know the right questions to ask from the outset. The language used was alien to me, and it took a few weeks to feel comfortable in understanding what it was that we were doing! 
  1. Those pharmacies with limited space may still struggle to safely deliver this programme even with the smaller volumes. So, it is important you assess the internal space and outside space available to you. You may need to look at empty adjoining buildings or car park space that can be used. 
  1. The best advice I can give to anyone who is interested in providing the service is to go and shadow a few other sites so you can see what’s involved before you start. We spent many hours at several different sites looking at different delivery models and speaking with the clinical supervisors, shadowing the data inputting teams using Pinnacle, and talking to site managers about the booking systems and marshalling requirements. This will enable you to learn from other site set-ups so you can learn from the mistakes others before you made. 
  1. Ask yourself what impact this new service will have on your current team. Do they have capacity to help and support the programme, or will you need to source additional staff externally? 
  1. Think hard about how you will manage your own pressures during September through to December. Consider how you might work this alongside your flu vaccination programme, and other operational challenges you might have over the autumn and winter months. 
  1. Think about the impact on cash flow. Although we are paid £12.58 for each vaccine we administer, it’s paid in the same way as prescriptions reimbursements so it can be up to three months from when the vaccination was administered. Be aware you might not receive any income from the service for five months from when you start working on it. The time you’ll have to put in up front does not get reimbursed, so you need to think carefully about current branch capacity, cash availability with your current bank and if you have the time to work on it leading up to vaccinating. 

My advice might have put a few of you off getting involved. But, running Covid vaccinations has been one of the most rewarding projects I have worked on in my 25-year pharmacy experience. Here’s why. 

Community pharmacy has been crying out for additional clinical services for several years, so this is a chance to showcase our clinical and communication skills and prove to NHSE/I that we are a flexible workforce that has the ability and capacity to support these programmes. 

It’s new funding outside of the five-year contractual framework, so why would you not want to be involved? 

Having been the clinical supervisor in our pharmacy-led sites, I have forged much better relationships with our neighbouring general practices. Our clinics are run in the adjoining practice’s buildings (purely due to size and patient flow), and we work with a pool of doctors, nurses, HCAs, pharmacists and pharmacy technicians, demonstrating the value we add in managing these clinics.  

I genuinely believe we are making a difference locally in our hard-to-reach communities, with patients who cannot access the larger vaccination sites. It’s good for our patients to see pharmacy teams working alongside other professionals in this campaign, so it raises our profile further with our local communities.  

The vaccination programme is so greatly appreciated by the public, and I had forgotten what it was like to hear the words “Thank you” so many times during a working day, even if on occasion, patients had waited 30 minutes to receive the vaccine. 

As the clinical supervisor running a vaccination day, I am leading the service so having GPs, nurses, and other professionals coming to me for advice and support is really rewarding professionally. 

It is great experience for some of our pharmacy teams to be involved in something so different from their day-to-day activities. Our pre-registration pharmacists, ACTs and pharmacy technicians alongside all our regular pharmacy managers and locum pharmacists have been trained to be vaccinators and to help with the reconstitution and dilution of the Pfizer vaccines. It is an incredible and highly rewarding experience for everyone. We have received some fantastic feedback from our pharmacy teams about how they appreciate being involved and it has helped internally with staff morale. 

It’s so easy to give many reasons why you don’t want to get involved with this service, but I would encourage every contractor to take 30 minutes out and read the information available.

Yes, its hard work and challenging, but rewarding both professionally and financially.