NHS staff now come after care homes for vaccine

[UnlimitedUnspecific]

The government have just changed their plans - now care homes will get the vaccine before the NHS, which in reality means instead of the NHS at this point since there are only 800,000 vaccines and 1.2 million people in care homes.

I am furious. The PPE provided to doctors and nurses doesn't properly protect them from the HUGE viral load of a patient ill enough to be hospitalised. Only yesterday the government admitted that the rate of Covid-19 infections caught INSIDE hospitals was far too high, and yet doctors and nurses will have to wait, what I expect will be weeks or months for a vaccination. In the meantime, their health and lives and those of their families, and those of other patients in hospital, other staff in hospital, people whose work takes them into hospital or transport workers serving hospitals - all at high risk.

(posted this on another thread already, but it will be lost in the comments)

Care homes can be shielded, NHS staff have a plastic pinny and a paper mask.

Another problem with the logistics of sending vaccinated GPs into care homes to vaccinate the elderly is that it will take weeks for the GPs to be protected by the vaccine - there are 2 doses.
So it will be weeks before anyone gets the vaccines sitting in storage.

GPs already go into homes, not sure what the difference is. Many homes have nurses or other people qualified to do injections so I don't see why they can't do it. Other homes have regular visits from nurses who work in the community, they could do it. At a home where I have an elderly relative they have their own private GP, he does a clinic every week he could do it. Homes sometimes work collaboratively, e.g. I used to run HR for a group of homes, some had nurses some didn't, so they could be shared, if I had spare places on a course I'd offer them to other local homes, they did the same so nursing resources could also be shared.

Where there's a will there's a way.

The announcement should never have been made yesterday that NHS would be first. How cruel to give something then take it away when it means so much to so many.

I think this is the big issue. Care homes were told they would be first then that changed, now changed back. So many people upset. The residents in the care home I go to were very upset yesterday, they know how vulnerable they are, they know why they were a priority and we have been lucky, no cases no deaths, imagine being 80 seeing friends dying of this disease and then there is the vaccine and you are top of the list and then that is changed.

It has soured the whole thing, everyone had such a boost that it was coming.

The only thing my DIL has said is that she could have the jab and be safe but she could still take it home to her family as they aren't sure it will stop transmission.

Care homes were always priority 1. There was only a change discussed because of logistics.

Surely if the most likely groups to get CV are vaccinated first, that means fewer hospital admissions and therefore a safer working environment for clinical staff?

That's always been the aim of lockdown, and the reason behind the vax prioritisation (only changing because of the storage issues of the first approved vax - which presumably have been sorted).

Front line staff are doing an amazing job, don't get me wrong, but surely you'd like to see fewer infected patients?

I wonder if it is due to the high efficacy of the Pfizer vaccine compared to the AZ Oxford one and whether the AZ Oxford once works in the elderly. They may specifically want the Pfizer one for the elderly if they have heard the AZ Oxford one may not work effectively in the elderly. The government betted heavily on the AZ Oxford vaccine when ordering this one compared to Pfizer, which I believe they have ordered much less of (and now been given only 800,000 doses, plus no hope of getting it here by road after 1 Jan).

I thought it is care home staff first as logistically they cannot get the vaccine to the residents yet. I would hope that front line staff would also remain to priority but then again, 50 % of my team have had Covid and we are assuming the rest of us who were in close office proximity to those asymptomatic carriers must have had some strong T cell responses going on so lots of NHS workers will have antibodies already. Maybe any staff in a vulnerable category should t remain a priority such as older black males and the high BMI staff. I cannot get too upset about this but there is definitely some strange ethical thinking going on that would protect a 90 plus year old with advanced dementia over a front line a&e / Covid ward/ paramedic worker who will without doubt be in daily contact with Covid.

Spikeyball that is really splitting hairs. If you are told you are the priority and then told some other group is getting it before you then you quite rightly don't see you are a priority.

How have the logistics changed since yesterday?

I agree with you OP and I think other key workers should be ahead of care homes. As they would say on a plane, it's securing your own oxygen mask before helping others.

Front line staff are doing an amazing job, don't get me wrong, but surely you'd like to see fewer infected patients
Unfortunately, many of those in hospital are not the elderly in care home. Hospitals are full of those 45 years older and above. Each hospital has hundreds of patients on Covid-19 wards - these are not ICU wards, but for patients who need hospital care.
Those numbers will not go down by vaccinating care homes.

@KenDodd

I agree with you OP and I think other key workers should be ahead of care homes. As they would say on a plane, it's securing your own oxygen mask before helping others.

Very good analogy

I cannot get too upset about this but there is definitely some strange ethical thinking going on that would protect a 90 plus year old with advanced dementia over a front line a&e / Covid ward/ paramedic worker who will without doubt be in daily contact with Covid.

I've worked with teenagers in care homes. The ignorance about care homes is staggering.

I agree with you OP and I think other key workers should be ahead of care homes. As they would say on a plane, it's securing your own oxygen mask before helping others. Who is going to help the care home residents if their carers haven't even got an oxygen mask?

@ancientgran

I agree with you OP and I think other key workers should be ahead of care homes. As they would say on a plane, it's securing your own oxygen mask before helping others. Who is going to help the care home residents if their carers haven't even got an oxygen mask?

I do agree that care home staff should be first in line also. They can access hospital vaccinations much more easily, or the previously plans to run vaccinations from large stadiums etc would also be suitable for care home staff.

Isn't there an issue of consent for care home residents or can the officer in charge give a blanket approval for residents who do not have capacity, or is it their relatives who have the final say.Plus are those with capacity able to refuse.
Another minefield, NHS staff will be able to be vaccinated if they turn up for jab as they are able to give consent at that time.
When I had flu jab had to sign a paper to say I knew what the jab was and what it was for I presume it will be the same for coronavirus

This is about who is at greater risk. That is undoubtedly care homes.

What I mean by that comment which may be misinterpreted is that many elderly people I have spoken to feel it is pointless just keeping them all endlessly Alice to what ends. Those in their 70's and early 80's who are still fairly independent like my parents would most definitely preferred to carry on seeing family and getting out and about to bring kept safe and confined to home. They would have accepted the risk and possible outcome. We have this obsession with keeping everyone alive as long as possible but that is not the choice of many people, especially when their quality of life has diminished. My father is furious that his generation are being kept alive at such a massive cost to the new generation coming up. He was actually in tears telling my teenage daughter about it. Difficult decisions though and glad I am not making them.

"Spikeyball that is really splitting hairs. If you are told you are the priority and then told some other group is getting it before you then you quite rightly don't see you are a priority."

Care homes have always been priority 1 group. All the government guidance says this. Nothing has changed.

Isn't there an issue of consent for care home residents or can the officer in charge give a blanket approval for residents who do not have capacity, or is it their relatives who have the final say.Plus are those with capacity able to refuse I've already given consent for my elderly relative to have it in her care home, I have LPA for health and care. If someone in a home has capacity they can make a decision like anyone else with capacity. I assume if you don't have capacity and don't have someone with a LPA for you then someone has the responsibility to make the decision just like they would if you needed medical attention for another condition.

Care homes have always been priority 1 group. All the government guidance says this. Nothing has changed. Except they were told yesterday they weren't getting it first. Not sure how you interpret priority but I can tell you our residents thought it mean they were first.

I'm a practice nurse. GP's themselves won't be going into care homes vaccinating anyone, that would be the nurses' job. Except we've been told we won't be doing it. My clinics are full of other things already for weeks. I don't know who will, the district nursing service is in crisis already.
The sad thing is that by the time the elderly care home cohort are all vaccinated and other groups are started on, a significant percentage of the former will have already died of other things.

"or is it their relatives who have the final say."

Relatives don't have any say legally unless they have lasting power of attorney for medical matters and even then that doesn't mean final say.

ancientgran, I am certainly not ignorant about care homes and I am sure you will agree that the vast majority of care home residents are aged 80 plus. That is why this should not be a blanket decision for any one group. Not all NHS workers are coming into contact with Covid daily. In fact some have been working from home and still are. Yes, we need to prioritise but carefully, without blanket decisions. FWIW I am sometimes frontline and am also overweight and asthmatic but do not consider myself to be a top priority and am happy to wait in line. My teenage daughter has been unable to work in her carehome job since returning to college and I think she should be a priority as highly likely to be an asymptomatic carrier and would be devastated if she thought she may have given it to one of their residents.

Not all NHS workers are coming into contact with Covid daily. In fact some have been working from home and still are

The plan yesterday was for frontline staff to be vaccinated first. Frontline staff in hospitals do come into contact with Covid daily.

My DH comes into contact with hundreds on every shift. He wear a plastic pinny and a paper mask not dissimilar to the ones worn by the public.

He is mostly certainly not safe and neither are his family.

I had hoped the vaccination roll out would run much smoother than all the other things that have gone wrong this year (testing, PPE etc.)
Sadly, it's all another mess up. My NHS trust were told to prioritise NHS staff as we couldn't transport vaccine to care homes. There was also indication the Oxford Vaccine would be approved within days to which this vaccine would be better used in care homes. We had been setting everything up ready for this, and now, at the very last moment, officials have changed this guidance and said the first batch need to split up and taken to care homes. However, there are still uncertainties surrounding the safety of this given the temperatures and times it can be moved, but we have been told to push ahead. There are also concerns that hundreds of doses vaccines will now go to waste by splitting these vaccines up and moving them around from care home to care home especially as when we get to care homes we don't know know if residents will be willing to have the vaccine or not. We are not checking ahead. We just arranging a day and time to turn up basically. I understand care homes have always been top of the list but they shouldn't keep changing their guidance they are sending to us.

@Char2015

I had hoped the vaccination roll out would run much smoother than all the other things that have gone wrong this year (testing, PPE etc.) Sadly, it's all another mess up. My NHS trust were told to prioritise NHS staff as we couldn't transport vaccine to care homes. There was also indication the Oxford Vaccine would be approved within days to which this vaccine would be better used in care homes. We had been setting everything up ready for this, and now, at the very last moment, officials have changed this guidance and said the first batch need to split up and taken to care homes. However, there are still uncertainties surrounding the safety of this given the temperatures and times it can be moved, but we have been told to push ahead. There are also concerns that hundreds of doses vaccines will now go to waste by splitting these vaccines up and moving them around from care home to care home especially as when we get to care homes we don't know know if residents will be willing to have the vaccine or not. We are not checking ahead. We just arranging a day and time to turn up basically. I understand care homes have always been top of the list but they shouldn't keep changing their guidance they are sending to us.

That is very interesting, thank you for posting.

Total shambles (how to snatch defeat from the jaws of victory, as usual by this government).
Very upsetting that this new plan will likely lead to wasting of some of those precious vaccines.