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Standard immunisation services will struggle to cope with the twin challenges of winter flu and Covid-19, according to guidance for nurses on setting up new mass vaccination programmes.
This is why is it vital that robust plans are put in place to ensure many more people can access the flu jab and to prepare for a much hoped-for coronavirus vaccine, stressed the guide published by the Royal College of Nursing.
“This guidance should help nursing and all health care staff prepare as best they can”
According to the RCN, nurses will have a critical role in devising and implementing the large-scale immunisation programmes required to protect the public this winter.
The college said staff may be required to offer vaccinations in unusual venues such as car parks and leisure centres as well as providing flu jabs to the vulnerable at home or in care homes.
The document comes just days after the publication of official guidance setting out the steps the NHS must take as it enters phase three of the pandemic, which stressed the need to expand flu vaccination and tackle a backlog in the delivery of childhood immunisations.
The RCN guide reiterates the vital importance of keeping routine immunisation going – despite the challenges presented by Covid-19 – to avoid increases in preventable diseases and deaths.
Nursing staff involved in the delivery of immunisation will need to work in new and innovative ways, according to the guidance, which covers key topics including record keeping, risk assessment and staff training.
This will include looking at ways to provide vaccination outside normal venues like GP surgeries to minimise the number of people going in and out of health settings.
“As a result of the Covid-19 pandemic there has been considerable discussion about offering vaccination in novel settings such as healthcare centre car parks, other open spaces or temporary structures such as gazebos to reduce the time people are in the surgery,” said the guidance.
“Alongside this there is a recognition for a need to offer large-scale vaccination services particularly to support the influenza vaccination programme for 2020/21 and in preparation for Covid-19 vaccines as they become available,” it added.
It went on to stress that the “usual” vaccination premises and staff “are unlikely to be able to cope with this increased need for capacity alone”.
The guidance highlights the need for large-scale vaccination plans to be developed locally with input from a wide range of nursing and other professionals in primary care, community services, school nursing, pharmacy and acute services.
“The local population needs, infrastructure availability, service capacity and demand all need careful consideration,” it stated.
While testing for Covid-19 has been carried out in outdoor venues, this may not be appropriate for mass immunisation, especially given the vagaries of the British weather.
Instead, nursing involved in immunisation may need to look at taking over large indoor venues such as leisure centres and places of worship.
“Vaccination in temporary open-air venues and structures can pose potential risk, such as difficulties in maintaining vaccine cold chain, waste management or following infection prevention and control procedures,” said the guidance.
“Buildings such as sports and leisure centres, community centres and religious venues may offer the potential to facilitate a mass throughput of people,” it added.
Providing the logistics are thought through and a local risk assessment carried out these types of spaces “can be a valuable option”, it stated.
The guidance also emphasises the need to ensure services are accessible to everyone with plenty of flexibility.
The RCN said the aim of the guide was to give some practical advice to all nursing staff involved in immunisation services in “these new and challenging circumstances”.
Helen Donovan, RCN professional lead for public health, said nursing staff were the “backbone of immunisation services”.
“This guidance should help nursing and all health care staff prepare as best they can and make sure they are able to work effectively with local authorities and other parts of the health and care system to ensure this extremely important vaccine programme runs smoothly,” she said
“We will continue to represent the voice of nursing to public health agencies across the UK and ensure that nurses have everything they need to do their part and beat the flu this winter,” she added.