CLAIM:
“Vaccine rollout north of the Border is not reaching GPs quickly enough” – Ruth Davidson, FMQs, January 20
DOORSTEP ANSWER
Scotland has prioritised vaccinating care home residents and frontline medical staff (to protect services). Compared with England, Scotland has vaccinated a far higher proportion of care home residents and frontline staff. The Scottish approach is to be methodical, rather than seek headlines.
BACKGROUND
As of Monday January 18, Scotland had been “allocated” 717,000 doses of the two Covid-19 vaccines but just 265,000 individuals had been inoculated. This seeming discrepancy between doses allocated and actual vaccinations was criticised by opposition parties.
At FMQs on January 20, Davidson said: “We know how many doses of vaccine have so far been delivered to Scotland, we know how many GP practices have agreed to take part in the process.
"The only thing that’s missing is for too many practices across Scotland they have not yet actually received any supplies.”
The inference behind these criticisms is that the Scottish Government has failed to use its existing vaccine supplies fast enough, certainly compared with the situation in England.
READ MORE: Scotland's Covid-19 vaccine roll-out 'makes absolute sense', WHO doctor says
ALLOCATION AND VACCINATION PROCESS
The criticisms made by Davidson are based on a misunderstanding of the word “allocation”. Vaccine supplies move through a distribution pipeline from manufacturer to patient. The “allocation” is made by the UK Government and represents a notional total number of doses that Scotland will eventually receive. These are not allocated in one go but come in a sequence from the manufacturer.
Doses are then sent to a central distribution point to be processed: checked, sorted, packaged and dispatched to the place where the vaccine will be given. This is more than a logistical exercise as the Pfizer/BioNTech vaccine needs to be kept continuously at very low temperatures. As a result, processing can take several weeks.
As of January 21, some 70,000 doses were in transit to Scotland and circa 120,000 were undergoing processing. At that point 310,000 doses had actually been used on patients while another 175,000 were with delivery centres ready to be used.
At best then, it is only the 175,000 doses at patient delivery points awaiting use that are the subject of contention - not the implied 400,000 doses claimed by Davidson. Even here criticism is unwarranted as it fails – deliberately or not – to account for the way patient delivery occurs.
READ MORE: Scotland's Covid vaccine programme: Sturgeon rejects Tory lagging behind claim
Priority north of the Border has gone to vaccinating elderly care home residents. As there are more than 1000 residential care homes in Scotland, this is a more complex process than mass vaccination at specialised outpatient facilities relied on in England to boost numbers. Maintaining a buffer stock of vaccines in Scotland is therefore a function of covering a very large number of care homes and the central management of delicate materials.
To give an example, due to the high number of care homes in Edinburgh, it has taken longer to roll out vaccinations than in other areas. This was further complicated by strict national guidelines regarding vaccination in care homes with a current Covid-19 outbreak. This necessitated a new, agreed risk-assessment system to protect staff and residents.
ROLE OF GP FACILITIES
One specific aspect of criticism of the vaccination programme in Scotland concerns the role of GP surgeries. The British Medical Association in Scotland has claimed that some surgeries are ready to “mass vaccinate” but do not have enough supply.
On January 20, the FM reported that only three-quarters of GP surgeries have received a vaccine batch. This has led to calls for some of the local vaccine stock available in Scotland to be distributed to GP surgeries to boost vaccination of categories such as the over-80s.
READ MORE: Nicola Sturgeon says UK Government had 'hissy fit' over Covid jag figures
Again, the issue is prioritisation. Ad-hoc deliveries of vaccines to GP surgeries could boost immunisation in limited areas, to limited numbers. Then there would be gaps as supplies dried up quickly. The Scottish Government has chosen a more methodical course, seeking to fully inoculate care home residents and NHS staff, then move on in February to systematically vaccinate the over-80s and over-70s at GP surgeries.
According to deputy FM John Swinney: “… I can confidently say to you that the commitments we have given, that all over-80s for example will be vaccinated by the end of the first week in February, is a commitment that will be fulfilled.”
ENGLAND AND SCOTLAND COMPARED
As of January 21, Scotland had given a first dose of the vaccine to over 90% of care home residents. In the same time frame, in England only 63% of care home residents had been vaccinated, according to Health Secretary Matt Hancock.
Scotland has also chosen to prioritise vaccinating health care staff. As of January 21, more than 70% of NHS and care workers had received a first dose. But it was only on January 8 that NHS England wrote to trusts across within its jurisdiction with plans to vaccinate all frontline staff.
Given the impact of Covid on the numbers of frontline NHS staff available for work, the Scottish decision seems sensible - though it has obviously impacted on the speed of vaccination of other categories, e.g. the over-80s.
CONCLUSION
By January 20, the daily rate of increase in vaccinations in England had peaked and started to slow, as the English medical authorities tried to catch up on inoculating care home residents and frontline staff. Meanwhile north of the Border, the rate of vaccinations was speeding up considerably as attention moved to the wider population.
These variations are not the result of incompetence, but stem from differences in strategy and prioritisation. In England, vaccination policy has been dictated by making headlines, possibly to mask earlier political failings over a dysfunctional English track and trace scheme and alleged cronyism in the award of medical supply contracts.
In Scotland, the approach has been to think long-term. Time will judge as to which approach is more effective in dealing with the pandemic.
FACK CHECK RATING:
Sadly, the Baroness is playing politics with the roll-out.
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