The Covid-19 Vaccine programme
There is a fast-moving effort to ready the NHS to vaccinate much of the UK’s population. If the vaccine is safe and its effectiveness holds up, huge numbers of lives will be saved. A successful programme will mean we can spend fewer days under restrictions. Along with huge economic benefits, it’ll mean respite for the NHS’ heroic staff and a chance to see friends and family.
Any marginal improvements the system can achieve in terms of throughput and uptake for the vaccine will bring huge gains, so we must make it as effective as possible. Throughput matters for vaccinating the groups offered the vaccine as quickly as possible. The faster this happens, the more people can be protected and restrictions can start to ease. Just one week in lockdown with the virus costs the country around £3.7bn in economic activity. Uptake matters for similar reasons, but the Royal Society estimates we need to eventually hit as much as 80% uptake from those offered the vaccine to provide sufficient protection.
We know better NHS software can help on both uptake and throughput. But we think there’s room for improvement in what’s publicly known about the programme right now.
Primary care’s role
The specification for primary care’s role in vaccination was published last night. It seems to sit alongside a national programme delivered by other providers, about which we know little. What we do know is that PCNs have until next Tuesday (17th November) to agree to deliver the service. Things are moving very quickly.
We wanted to help PCNs and practices consider whether they can be part of this by sharing our thinking about where software can help and the role accuRx can play for them. We also wanted to explain the issues holding us and the system back from driving uptake and delivering as quickly as possible.
We’ve been thinking for a few weeks about how to help the NHS rise to this latest challenge, as we did in the first wave of Covid-19. Our platform provides a comprehensive messaging service for primary care to interact with patients, carrying nearly 2m messages per week. In the spring, we helped the NHS go from 3% of practices offering remote consultations to 99% — nearly all using our software. Our remote monitoring system helped primary care to remotely triage 300,000 Covid-19 patients. That scale is a very important part of where we think we can help during the vaccination programme.
Why the flu approach isn’t enough
The flu vaccination infrastructure and approach will be insufficient and less effective for Covid-19 than it could be. There are a set of issues we know already exist:
- There’s too much booking friction, which lowers uptake and increases practice workload
- Covid-19 vaccines require a second shot delivered in a short window four weeks later, and recall is a major burden on many staff in primary care
- Practices need to pool their capacity to deliver Covid-19 vaccines across the PCN.
- There’s no realtime data feed of who’s been invited, who’s booked, and who’s vaccinated, hindering targeted reminders, national logistical planning and supply chains.
Where software can help
We are confident that there are a number of things we could build to support the Covid-19 effort. We’ve published a live document that we’ve kept updated over the last few weeks as we’ve shared with national leaders and people working across primary care. Do take a look and please share your feedback with us for the next iteration.
Where we think our platform can help
We think our platform can support many steps in the process:
💌 Contacting patients with personalised communications directly from their trusted GP, improving uptake alongside national messaging
📱 Allowing instant booking of both doses without having to make a phonecall
✍ Informing patients for consent purposes, increasing throughput by saving precious GP time
🚨 Automating reminders for booking and the appointments for both doses, maximising uptake of the full course of vaccination
🤒 Setting up post-vaccination monitoring by ensuring safety data flows in, and making sure GPs can support patients with any side effects
📊 Providing real-time national data to inform public health campaigns, supply chain decisions and lockdown decisions
Why every day and every person matters
With technology like ours, the system can vaccinate more people more quickly and reduce the impact on its ability to continue delivering other services. We think this because:
- Nurses and doctors are the most trusted set of professionals in the country.
- Communications to patients from a clinician they are likely to know will drive uptake.
- Text messaging communication improves uptake of vaccinations over sending letters, which is the only mode of contact promised centrally in the Enhanced Service (ES) FAQ, and we can make it simple for practices to tailor the standardised messaging to the patients they know.
- This vaccine will be treated with understandable caution by some and will also be subject to outright misinformation. In October, YouGov reported 35% of people said they wouldn’t take it or did not know if they would take it. Combating this through tailored communications and enabling staff to answer questions will be key.
- Recalling patients to have their second jab and an easy process to book/reschedule their second shot will be essential. We see the impact of automated reminders on patient medical questionnaires sent using accuRx, a 50% baseline response rate (compared to <10% by phone or post), jumps to 70% after automated reminders.
We want to build these vaccine features. We can do it quickly, as we did with remote Covid-19 monitoring and video consults. We can help make practice and PCN internal processes as smooth as possible to administer effectively, and maximise both uptake and recall. We can also integrate practice systems with the national systems for call/recall that are promised but as yet unspecified.
What we need to be able to help
What worked so well during Covid-19’s first wave was a national framework for Video Consults, which meant practices could pick the software they needed and the centre would pay for their usage. Primary care is being asked to move very quickly once again but there seems to be no equivalent national funding stream for the technology the frontline needs to maximise vaccine uptake and throughput. We think there should be.
Whilst we have experience scaling usable software across all of general practice, and contacting over a third of the population, we know we can’t have all the answers and the best knowledge on this resides in the experts working every day in primary care. Please let us know your ideas, thoughts and feedback about what we’ve shared here. Most importantly, let us know how we can help if your practice was to take part in the ES. You can share your feedback here.