William Ridsdill Smith is a GP at the Woolpit Health Centre, Bury St Edmunds, Suffolk.
Rebecca West is a Project Officer, Healthwatch Brighton and Hove.
Ben Cobbold is Practice Manager at the Woolpit Health Centre.
Richard West is a GP at the Woolpit Health Centre.
Editorial note: The BJGP cannot give formal advice regarding the running of vaccination clinics. These should always be run in accord with both national and local guidelines. However we are happy to publish this bright idea, where the authors describe their drive through ‘flu vaccination clinic, a model which they now intend to use for the Oxford AZ Covid vaccine. Please note this model is clearly not suitable for the Pfizer vaccine, where the MHRA recommend a 15 minute wait post-vaccination.
Woolpit Health Centre is a semi-rural practice in Suffolk with 14000 patients, with 6500 patients 18 and over eligible for a flu vaccine. This article reports on a mass vaccination drive-through ‘flu clinic at a local business park.1 We administered 2814 vaccines over 7 hours. The attendance rate was over 99.5% and 70% patients were over 65.
We are making plans to repeat the clinic with the Oxford Astra-Zeneca Covid-19 vaccination which does not need a 15 minute observation time.2 We will share the site with neighbouring practices.
Method of drive-through ‘flu clinic.
We invited all patients via direct mail to book an appointment, with 202 slots every 30 minutes. Volunteers and practice staff directed patients to three covered bays. Each bay had a team of four clinicians who gained consent, recorded the vaccine batch on the patient invitation slip, and administered the vaccine. We started injecting 15 minutes before the advertised start time and finished 10 minutes early. 100 cars arrived before 9am. We had 282 cars an hour, with an average wait of 25 minutes. Each injection took an average of 53 seconds. We did not have any immediate adverse reactions and the recovery waiting bays were not used. Two cars broke down and needed assistance, and one knocked a traffic cone.
Learning points
Patient satisfaction was high and patients felt safe, with a stream of positive comments on social media, including one from our local MP and health minister. Very frail patients who had previously requested home visits attended. Some patients were unhappy they were unable to walk or cycle through; a designated bay in future would solve this. One commented on the fumes generated by cars queuing. Queuing traffic could be reduced by more specific appointment times. The expense (£6000) of covered bays was justified as it did rain frequently. Staff time was no more than previous walk in clinics. The key to success was meticulous planning by our practice manager and support from the local community and patient participation group.
Patient satisfaction was high and patients felt safe, with a stream of positive comments.
Tweaks for the covid-19 drive through clinic:
This model would be suitable for the Oxford Astra Zeneca vaccine. We will be inviting eligible patients by direct mail with designated appointment times at minute intervals, and ask patients who cannot attend to contact the practice. We will have a ratio of two pre screeners for every vaccinator. The pre screeners will check the patients have completed the screening questions on their invite and will gain consent. The vaccinator will collect the paper invite and record time, site of vaccination, name of vaccinator and vaccine code. We have been offered the use of two warm office rooms for drawing up vaccines and entering vaccine data onto the Pinnacle system. We will have more bays available for those patients who wish to wait after their vaccine. The key to success is meticulous planning by our practice manager and support from the local community and patient participation group.
References
- Delivering Mass Vaccinations During COVID-19: A Logistical Guide for General Practice. Dr Simon Stockley S, King K, Leach J, Fleming J. Version 2.0 – 30 July 2020 https://elearning.rcgp.org.uk/pluginfile.php/149506/mod_page/content/75/Mass%20Vaccination%20at%20a%20time%20of%20COVID%20V2.0.pdf accessed 8/1/20
- No requirement to observe patients for 15 minutes after Oxford/AstraZeneca Covid vaccination, Sofia Lind. Pulse Today 07/01/21 https://www.pulsetoday.co.uk/news/clinical-areas/allergy/no-requirement-to-observe-patients-for-15-minutes-after-oxfordastrazeneca-covid-vaccination/ Accessed 8/1/21
Featured photos from Dr William Ridsdill Smith
