How is the NHS going to deliver a million vaccinations a day? The simple answer is that it won’t, certainly not every day. Despite Boris Johnson’s promise that “everyone eligible aged 18 and over in England will have the chance to get their booster before the New Year”, the health service is not committing itself to giving all adults a third jab this month.
Instead it is promising to offer everyone a chance to book by the end of the year. In practice, the expectation is that millions of these appointments will be for vaccinations in January. Many younger people are not expected to come forward until next month, so the booster programme is not expected to be completed until February.
The NHS believes it can reach five million doses a week, a million more than the record, but it has not made a written commitment.
To achieve that number health bosses will be able to delay essentially all care that is not life-threatening. GPs will be cancelling routine appointments and hospitals will be cancelling surgery and outpatient clinics so that doctors can be redeployed to vaccine centres.
Yesterday Emily Lawson, head of NHS England’s inoculation programme, told vaccine administrators that they should consider all non-urgent care open to delay to focus on jabs. Vaccination centres were told to start extending opening hours from today, with appeals going out for volunteers and paid staff. GPs are expected to be given further financial incentives.
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Walk-in units are seen as the quickest route to mass vaccination, so there will be a big expansion of pop-up sites in shopping centres, parks and other convenient places. Dozens will be added to the existing 3,000 today, with many more planned for the coming weeks.
All this is difficult for Sajid Javid, who has spent his first six months as health secretary insisting on the importance of routine care. He has ordered the NHS to deal with the mounting backlog and told GPs to get back to face-to-face appointments.
He acknowledged today that this will have to take a back seat. Hospitals will be allowed to postpone hip replacements to prioritise vaccinations and “the face-to-face appointment that is the most important with any GP is while you’re getting jabbed”, he said.
Understandably, Javid argues that the arrival of Omicron has changed the picture, but some NHS bosses could not resist a dig today. Matthew Taylor, head of the NHS Confederation, told the BBC: “It’s only a few weeks since politicians were indulging in attacking members of the primary care team for the fact that they weren’t always able to offer face-to-face appointments. It’s really important that the government is clear with the public about the consequences this [vaccine drive] is going to have for the rest of what the health service can offer.”
For all that the booster programme got off to a leisurely start, turning the national health service into a national vaccination service is clearly only sustainable for a few weeks. To have turbo-charged boosters earlier would have meant people waiting longer in pain, a trade-off that seems reasonable in the face of an Omicron emergency, but seemed less palatable a month ago.
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With boosters taking two weeks to kick in and Omicron infections doubling every two or three days, there are big questions about whether it is too late for vaccination to do more than soften the peak of the wave. The judgment in Whitehall is that it is better to cancel routine care for vaccines than cancel operations for a Covid surge in January. The fear is that the NHS may end up doing both.
