Doctors in Scotland will not be able to deliver a “massive” new programme of potentially life-saving vaccinations without help from other health specialists, the head of Scotland’s GPs has warned.
Alan McDevitt, chairman of the British Medical Association’s Scottish GPs committee, said school nurses, health visitors and district nurses were crucial to ensuring all those eligible for the new vaccines – including youngsters and the elderly – received them.
Dr McDevitt warned that GPs were already “stretched the limit” and said health boards would have to make additional nurses available to ensure the vaccine programme was carried out.
The Glasgow-based GP told The Scotsman that doctors had “no choice” but to agree to administer the vaccines, because they could prevent serious illnesses or even death. The jabs will help tackle rotavirus in young children, flu in the under-18s and shingles in the elderly.
There are no specific figures on how many people will be entitled to the new vaccines, but it is estimated up to 275,000 in Scotland will be eligible in the first year, based on recent census figures.
There has also been a change to the way the meningitis C vaccine is given. From next month, children aged 12 or 13 will be given a booster, and the dose previously given when a baby is four months old will be dropped. The vaccine will continue to be given at other ages.
Last night, patient groups called on health board officials and the Scottish Government to make additional funding available to pay for support to carry out the vaccine programmes.
Dr McDevitt told The Scotsman: “GPs are already struggling. Now, we have told GPs they have even more work to do delivering these vaccines. The bottom line is these vaccines could save lives and have to be carried out. But we will need every bit of support we can get from health boards to make sure this happens.”
At the end of last month, the Scottish Government announced all babies would be given a vaccine to protect against rotavirus, which causes diarrhoea and vomiting. Plans were also announced to roll out the winter flu vaccination campaign to children aged two to 17, and introduce a shingles vaccine for people aged 70 to 79.
Dr McDevitt said he envisaged schools would play an important part in delivering some of the vaccinations, but much work would still fall to GPs and their staff, particularly with the under-fives and older people.
“The funding we are getting for it is just enough. It is not over-generous,” he said. “Quite a lot of practices will find this a major challenge, trying to fit in with their other workload.”
Dr McDevitt said it was important the health community pulled together to help deliver big projects, even with the majority of funding for the vaccines going to general practice.
“We can’t be expected to take it all on board,” he said. “We are trying to do it in the most cost-effective way we can, but that involves assistance from as many people who are available to help.
“This means school nurses taking on some of the work, as well as district nurses and health visitors who have the skills. The trouble is, there are not enough of these posts, either.
“That is why we are calling on every health board to help us with these vaccines and make sure they do not withdraw support, in the form of these additional health workers, otherwise we will struggle to deliver this programme.”
Under their current contract, GPs get a set rate of £7.67 for each vaccine delivered, to pay for staff to give the jabs, the storage of vaccines and other costs.
Dr McDevitt said the rate had only risen “slightly” in the last decade and that the rise was “not in line with inflation”. He said the rate was now just 3p more this year than last, which was the first increase in several years.
General practice was already “maxed out” with its growing workload, he added.
He warned that the workloads, plus a continuing dispute with the government over GP pay and pensions, was beginning to put many medical students off choosing general practice.
He said: “We are starting to see a recruitment crisis. For example, there are currently 15 posts for GPs in the Highlands that have not been filled. The more GP workloads increase, the less attractive the role will be. This is obviously very worrying.”
However, despite these issues, Dr McDevitt said the BMA welcomed the drive to expand the flu vaccination campaign to children, saying: “By vaccinating children it will benefit the whole community.”
Margaret Watt, chairwoman of campaign group the Scotland Patient Association, said: “It is the same old story – not enough staff to carry out what is needed.
“Surely to goodness politicians and health board bosses should be able see the benefits to both health and finances, in the long term, of making sure there are enough people to give people these vaccines.
“One initiative we’d be in favour of is health boards keeping lists of retired nurses with the skills and experience to help out … It is such a waste they are not called on at time like this.”
A Scottish Government spokeswoman said: “Scotland’s successful immunisation programme brings great public health benefits.
“We have been working closely with health boards and GPs to ensure that these programmes can all be delivered safely and effectively.”
A spokeswoman for NHS Highlands said of the GP vacancies in the region: “Parts of remote and rural communities are facing significant challenges to recruit and retain GPs, hospital doctors and other professionals. There is a growing consensus of the need to explore new models of service delivery.”
Timetable for changes in the interests of better health
From September, people aged 70 and 79 in Scotland will be vaccinated against shingles.
In years two, three, four and five onwards more of the 70-79 age group will be offered the vaccine until, ultimately, only people aged 70 need to be targeted.
The programme is expected to cost around £2.8 million in its first year – and save the same amount in fewer hospital stays, doctors appointments and prescriptions All babies in Scotland born on or after 1 May this year will be offered vaccination against rotavirus. Last November, the Scottish Government announced babies in Scotland will be vaccinated against a vomiting and diarrhoea bug from September. It said the programme would cost about £2.5m per year. Currently, around 1,200 babies have to go to hospital every year. It is thought the vaccine could result in 70 per cent fewer rotavirus-related hospital stays.
From autumn, there will be a phased rollout of the new childhood flu programme – the extension of the seasonal flu programme to all children aged two to 17 years. The programme will be phased over the next two to four years. Younger children will be vaccinated against first, with older ages to follow.
It is likely school nurses will have to help with this programme when school-aged children are to be immunised, the BMA has said.
From June, there will also be changes to the current schedule for administering the Meningitis C vaccine.