NAO lauds vaccine rollout but flags staff-fatigue concerns

Public-spending watchdog says £8.3bn programme has been good value for money – and has come in under budget so far
Covid-19 vaccination centre

By Tevye Markson

25 Feb 2022

Staff burnout could hamper the continuing success of the Covid-19 vaccine rollout, the National Audit Office has warned.

The public=spending watchdog said the programme has been a success and good value for money, "meeting unprecedented targets, helping to save lives and reducing serious illness and hospitalisation", in a report released today.

But it cautioned that there are now risks to the programme’s continuing success, such as staff burnout because of “sustained pressure” on some,  and a lack of surplus capacity in the healthcare system.

The NAO called on the Department of Health and Social Care to address these issues given there are still around 3.7 million unvaccinated adults.

It urged DHSC to consider the best organisational structure for the programme, and how future costs and other resources may need to differ from the current emergency response.

DHSC told NAO at the end of 2021 it was too soon to set out a more sustainable, long-term approach to Covid-19 vaccination, but said it was planning to address this in 2022.

NAO head Gareth Davies said: “The vaccine programme has been successful in getting early access to what were brand new COVID-19 vaccines, securing supply of them, and administering them to a large proportion of the population at unprecedented speed.

“The programme must now redouble its efforts to reach those who are not yet vaccinated while also considering what a more sustainable model will involve as it moves out of its emergency phase.”

The vaccine rollout was the biggest and most complex vaccination programme in UK history, with 85 per cent of the adult population vaccinated in less than a year.

This was more than six times the number in the previous annual flu vaccination programme. And exceeded the NHS’s initial expectation that 75% of adults would take two doses.

Up to the end of October, the vaccine programme had cost £5.6bn, out of the total available funding of £8.3bn available until the end of March, including £2.9bn to purchase Covid-19 vaccines, and £2.2bn on deploying the vaccine.

As of October, the Vaccine Taskforce had put in place contracts or agreements with six suppliers for over 340 million doses of vaccines to be delivered to the UK by the end of 2022.

Securing the supply early and then maintaining this supply was crucial to the successful roll-out, NAO said.

It said the Taskforce and its partners worked with a clear strategy and took a proactive approach to dealing with potential barriers and managing uncertain outcomes.

An example of this was the Taskforce purchasing several different potential vaccines at an early stage, explicitly recognising that some might never be approved, and setting up a strategy to deal with potential surpluses, the NAO said.

 Vaccines minister Maggie Throup said: “Our phenomenal vaccination programme has saved countless lives and is helping us to live with Covid-19 without restrictions, making us the freest country in Europe.

“It’s great to see the NAO recognise the success of the programme – thank you to our brilliant NHS, GPs, community pharmacists, volunteers, civil servants and armed forces for your dedication which has helped turn the tide on Covid-19."

The NAO said the taskforce took proactive steps to make the vaccine accessible. GPs and community pharmacists have ended up administering many more doses than originally planned – 71% up to the end of October 2021 compared to a planned 56%.

Bodies involved in running the programme locally told the NAO "goodwill, flexibility, and dedication" had been required to set up and run vaccination sites at such pace and scale.

Equality efforts unsuccessful

However, concern remains over the uptake of Covid vaccinations among some ethnic minority groups, with just 48% of people of Chinese origin getting double-jabbed and 49% from Black Caribbean or Black Other backgrounds, despite national and local efforts to address inequalities.

There was also low uptake among younger groups (64% of those aged 18-24 and 68% of those aged 25-29 were vaccinated with two doses at the end of October 2021) and pregnant women (only 29% of women giving birth had received at least two doses of the vaccine).

Around 4.6 million doses of the Covid vaccine had gone to waste, as of October, around 45 of the total supply, the NAO said.

However, it said less this was less than expected. Almost half of the vaccines that went to waste were expiring AstraZeneca doses – 1.9 million – following the JCVI’s recommendation that people under 40 should not be offered this vaccine.

The NAO praised the role of new digital tools, including a new national data system set up to allow the NHS to identify, record and transmit vaccination data across the health and care system, as well as digital dashboards with detailed real-time analysis of uptake and supply.

The watchdog said they contributed towards the success of the vaccine deployment by making effective use of imperfect existing data.

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