THE goal of immunising 400,000 Scots a week against Covid could be derailed unless more is done to cut “ridiculous bureaucratic hold ups” that are leading some would-be vaccinators to quit, clinicians have warned.
Health Secretary Jeane Freeman set out the vaccination target and timetable last week, saying that Scotland would need an estimated 3,400 vaccinators once delivery is ramped up to include the under 60s and second doses from the end of February.
Some 5,500 healthcare professionals have already registered their interest, including dentists, pharmacists, optometrists and retired clinicians, nurses, and midwives.
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However, one leading dentist said he has already given up on the process amid a barrage of paperwork and training modules ranging in everything from radicalisation prevention and fire safety to IT security and equality and diversity awareness.
David McColl, a Glasgow-based dentist and chair of the British Dental Association’s Scottish Dental Practice Committee (SDPC), said: “It’s a fiasco.
“We are really, really keen to get involved in the vaccination process but they’ve made it so clunky.
“You’re looking at doing 15 hours of modules and that’s before you even begin the application process. Frankly I started it and gave up because I don’t really have the time to do that.
“You’re talking about me, with 33 years in dentistry, having to do equality and diversity training.
“The Government really need to get focused here. What are they trying to do – are they trying to make people jump through bureaucratic hoops, or are they trying to vaccinate the population?”
Mr McColl said dentists in England are now being allowed to self-certify to speed up the process.
He pointed out that dentists are already trained to give injections and carry out cardio-pulmonary resuscitation (CPR) if a patient suffers an allergic reaction.
“We go through annual resuscitation training,” said Mr McColl.
“Part of that is if someone had an anaphylactic shock we would be injecting them intra-muscularly with adrenaline, which is what we keep in our emergency drugs kit.
“So we’re already trained for intra-muscular injections – we do it on an annual basis.”
Mr McColl said he had heard of “lots” of colleagues in dentistry signing up to, but then abandoning, the vaccinator programme.
“People like me who really want to help out are just fed up with it,” he said. “They go through this process and they just put their head in their hands and think ‘what is going on here’? It’s just nonsense.
“I can’t tell you how disappointed we are, both with our board and with the Government, over this. I really don’t know what’s going on.”
In a statement, NHS Greater Glasgow and Clyde said it had received 188 “expressions of interest” from registered dental professionals.
Of these, 81 have completed necessary recruitment checks and have either completed – or are in the process of completing – their training.
It added: “We are working as quickly as possible to bring more on stream and join our teams working on the vaccine roll-out.”
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At a briefing for journalists this week, Dr Nicola Steedman, Scotland’s deputy chief medical officer, said the Government was looking at whether “unnecessary hurdles” could be removed, especially for people with clinical experience, but stressed that the training in place was what had always been required for vaccinators.
“We don’t take vaccination lightly,” said Dr Steedman. “People have to be confident and competent.”
The situation is mirrored across the UK with Prime Minister Boris Johnson blasting it as “absurd” and insisting that Health Secretary Matt Hancock was taking “steps to get rid of that pointless bureaucracy” in England.
Dr Andrew Buist, chair of the British Medical Association’s Scottish GP Committee, said he had flagged the issue with Scotland’s CMO, Dr Gregor Smith.
He said: “We must do everything we possibly can to make sure there are no ridiculous bureaucratic hold ups.
“At the moment, workforce is not the rate-limiting step [in the vaccine rollout]– but it might become a rate-limiting step in February, when the supply of vaccine picks up.
“You need to capture people’s enthusiasm. If they’re presented with a lot of forms to fill out people will cool.”
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Anne Thomson is among those who joined the vaccinator scheme, having retired from the NHS in December 2019.
The specialist MS nurse, from Prestwick in Ayrshire, had already found herself bogged down in paperwork seeking everything from her O Level results to her immunisation history since first volunteering to return to the frontline last March, when the pandemic took off.
At the end of last year, she was invited to apply to become a vaccinator and, following a telephone interview, found herself at an induction day run by NHS Ayrshire and Arran.
Ms Thomson said: “We had a guy from moving and handling telling us we weren’t to carry anything more than 16kg and if we did we were to hold it close to our chest – you couldn’t make it up.
“There was a guy from violence and aggression who came to talk to us about how to recognise anger and de-escalate it.
“There were nine of us in the room – six of us were nurses, one was a retired consultant anaesthetist – and then this woman told us all about how she was a foster carer and how difficult that was managing it all with Covid.
“I’m thinking ‘when do we learn anything about the vaccine?’.
“I went along thinking ‘they’re going to tell us all about the vaccination, they’re going to give us an update on anaphylaxis’, but no – there was nothing.
“We had to watch an 11-minute video of a Resusci-Annie dummy being resuscitated in a hospital setting: ‘pull the buzzer, dial 2222, call your friend to bring the crash trolley’.
“I’m thinking, if I’m in a church hall in Prestwick I won’t have a buzzer and I won’t have a friend with a crash trolley. We’ll be dialling 999 like the rest of the public, so why are you making us sit through this?
“Honestly, I thought the guy who was the consultant anaesthetist was going to explode.”
Following the induction, Ms Thomson and the other attendees were signed up to LearnPro – the online education system for the NHS – and given a list of modules to complete.
These included child protection, IT security, display screen agendas, fire safety, moving and handling of patients, management of aggression, child protection, childhood immunisation, and how to talk to parents about the vaccine – even though the vaccine is not yet licensed for under-16s.
Ms Thomson said some of the modules, such as infection control and a video demonstrating how to prepare the Pfizer vaccine, were logical, but one on ‘promoting the effectiveness of immunisation practice’ gave way to a further 12 modules covering topics such as immuno-globulins [antibodies], antigens, B cells, and T cells.
“It just tips you over the edge. All I want to do is go and give people an injection in the arm,” said Ms Thomson.
“It’s not as if I worked in admin – I left a very clinical role. We were doing IVs, giving MS patients chemotherapy and monoclonal antibodies.
“It should be different for people coming from clinical jobs.”
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The Scottish Government says just under 5,500 individual vaccinators have registered, not including all participating GPs.
In addition to local health board training, over 4,000 people have taken part in national training to administer the Pfizer vaccine and 4,700 on the Oxford vaccine.
It is unclear how many of these individuals have completed the training.
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Asked if they would simplify the process for those with clinical experience, a spokeswoman said: “We are currently looking at both the NHS returner portal and GMC and NMC emergency registers, and we are grateful offers of volunteer support as we work to rollout the biggest vaccination programme Scotland has seen.
“We are also working with the voluntary and community sector to set up a centralised volunteer coordination hub for deployment at mass vaccination centres.
“Linked in with existing volunteer frameworks and local resilience partnerships, the hub will be designed to make good use of the locally offered support.
“Health boards continue to recruit and redeploy staff and we are also actively recruiting from NHS Scotland’s accelerated recruitment portal, and drawing from the wider clinical workforce, including dentists, GPs, and pharmacists.”