Could a GP-led mass vaccination hub in Victoria set a national template?

Anastasia Tsirtsakis

19/02/2021 5:45:59 PM

Grandstands around the country could be used to ramp up Australia’s COVID vaccine drive, following collaborative RACGP advocacy.

Empty grandstands
The proposed plan would see grandstands converted into vaccination clinics with patients spread out across 19 rows of seats.

GPs have proven themselves to be resourceful throughout the pandemic – from makeshift respiratory clinics to making their own personal protective equipment (PPE).
Now a football stadium turned GP-led mass COVID vaccination site is on the cards.
The proposed site is Whitten Oval, home to AFL club the Western Bulldogs, where up to 450 people could be vaccinated with the Oxford University/AstraZeneca candidate per hour once up and running.
Dr Anita Muñoz, Chair of RACGP Victoria and member of the RACGP’s COVID Working Group, told newsGP the innovative venture could be the latest example of successful advocacy conducted jointly by the state faculty and the Australian Medical Association’s (AMA) Victorian branch since the beginning of the year.
‘This is a great example of bona fide advocacy in action – and in a truly collaborative effort,’ she said.
‘We have put to the State Government consistently the notion that there are GPs who are willing and able to be mobilised as a surge workforce to assist with vaccinating Victorians, and what’s required is some flexibility in the models so that GPs can assist.’
If the proposed plan goes ahead, it would see three of the oval’s five stands converted into vaccination clinics with patients spread out across 19 rows of seats.
Twenty minutes will be allocated to each vaccination, allowing for up to 150 people to be vaccinated in each stand per hour, according to Dr Mukesh Haikerwal.  
The local GP, who set up Victoria’s first respiratory clinic and has been involved in the talks, says the set-up allows for patients to be safely socially distanced, and for thorough infection control.
‘That’s the idea – socially distanced, socially spaced, you’ve got infection control, you’ve got access to rows, and access to the pathway up to the stadium, and access to ambulance on standby,’ Dr Haikerwal told newsGP.
If the hub operates for six hours a day, up to 2700 people could be vaccinated per day, equating to almost 19,000 over seven days. There is also capacity to further ramp up efforts by converting a fourth stand and running evening sessions.
Dr Haikerwal said the Western Bulldogs are so far on board, with the Victorian Government now in talks with local councils Hobsons Bay, Maribyrnong and Wyndham.
Each municipality will run its own vaccination clinic in an allocated stand and deploy GPs and nurses from local practices.
‘The beauty of it is it’s actually community GP-led; so community GPs with the community councils,’ Dr Haikerwal said.
‘The idea is that the municipalities will enlist local doctors’ help and their practices’ help, [and] each municipality’s doctors would be a team with their practice staff looking after those people.’
While the funding model has yet to be finalised, Dr Steven Kaye, Deputy Chair of the RACGP Expert Committee – Practice Technology and Management (REC–PTM) and member of the RACGP’s COVID-19 Working Group, told newsGP the hub is a ‘terrific idea’.
‘I’ve been pushing for it right from the beginning,’ he said.
‘GPs have a moral leaning, and so we would be very keen to contribute to the vaccination. But the logistics of doing that in our own surgery it appears is very, very prohibiting from doing that effectively and economically in a viable fashion.
‘So having a having a mass vaccination centre where GPs can contribute to a day a week or a day a month, whatever the process is, would be ideal.’
Dr Muñoz agrees.
‘We are aware that smaller clinics may not be able to take part in the rollout, but that doesn’t mean that those individual clinicians can’t be mobilised,’ she said.
‘That’s the essential point we’ve been making from the beginning. It is a huge untapped resource and there are people willing to do hours or come out of clinic and go into another location to contribute their time.’
While new Australian Bureau of Statistics (ABS) data indicates almost three in four Australians are willing to get a COVID vaccine, GPs are anticipating some hesitancy around uptake.  

Dr Steven Kaye says having mass vaccination centres where GPs can contribute would be ideal.
Another anticipated benefit of the vaccine hub model, according to Dr Haikerwal, is that all education and consent will be done off site. He says initial stages of the rollout in a smaller number of general practice and respiratory clinic settings will be used to ‘iron out any snags along the way’ to prepare for mass rollout.
If all goes well with the Whitten Oval site, could it provide a template for the rest of the country?
Dr Muñoz certainly hopes so.
‘I aspire for it to be that way,’ she said.
‘Certainly, I know if we can demonstrate that this pilot site … works then absolutely you could do the same all over the state, and then I would expect that other states would immediately share the knowledge and build the capacity right across the country.
‘This indicates the power of general practice when it works together in a unified way.
‘It also signals the beginning, perhaps, of a new era in which there’s a greater understanding of what general practice is capable of, and therefore a greater interest and willingness to explore what general practice can do to solve public health problems.’
Dr Haikerwal feels the same way.
‘We just want to be ahead of the curve so when vaccines become available we have some way of dealing with demand and we’re not caught flat-footed,’ he said.
‘When you get beyond [phase 1a and 1b] the need becomes quite dramatically higher because populations increase dramatically.
‘So you need to get numbers through, and you don’t want people waiting months and months to get the vaccine. Then they’ve got to come back and get a second vaccine, so it’s not as straightforward as a flu vaccine clinic.
‘People in the west [of Melbourne] really suffered a lot in Australia through the first lockdown. To give some note to that in providing a rapid access service is quite a good signal that a, we care and b, we can do this.’
The Department of Health was contacted for comment.
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Dr Leanne Ruth Jones   20/02/2021 8:17:55 AM

As part of a practice that made as 1b application I thought we had to provide visual and auditory privacy - we did out influenza clinic in a hall last year to allow for social distancing etc but have not contemplated this for covid due to the privacy requirements also wont vaccine supply be an issue

Dr Jeanine Suzanne McMullan   20/02/2021 8:44:31 AM

This is bloody brilliant Mukesh! This is how my parents in the UK got vaccinated with Pfizer by their own GP, booked by their own clinic at their local swimming pool complex ( less stairs for oldies than AFL stadium). Laptop remote access to clinical notes and air upload. 5-10 GP clinic sized hubs- book and run a session. Volunteer first aid and guides. Paramedic station. It felt like polling day.
Enthusiasm and inclusion. Queensland- can we do this?

Dr Joanne Kerrie Samer   20/02/2021 11:12:31 AM

Fabulous idea! Interested to see how it could be scaled down to be more community focussed and remove the need for travelling too far from home. Maybe local football
clubhouses or community centres or the like??

Dr Julian Padraic Collins   20/02/2021 12:52:11 PM

This approach would be good. As other practices are finding the extent of actually being a GP clinic to be a vaccination centre is being judged from many angles. Logistics of space , financial rewards , and the increasing current workload of catching up with patients some who have not been seen face to face for more than 6 months. We are all for vaccinating out patients but the hub idea whose sole purpose is to vaccinate would be a better option moving into phase 2. We are deciding as a practice whether we as a group will confirm our initial interest as a vaccination clinic as the usual workload of GP consults has been busier this time than ever.

Dr Alan Graham MacKenzie   20/02/2021 4:50:13 PM

I have no issues with this other than the hypocrisy.
It is OK to vaccinate at the Footy Club ,but not at a general practice which has ceased to be accredited for various reasons.
Can a GP from an unaccredited practice ,or a retired GP contracted specifically for vaccination rollout do the footy club vaccines?

Dr Margaret Davison   20/02/2021 5:23:58 PM

I think this is a fabulous idea

Dr Paul Gerard Egan   20/02/2021 11:00:33 PM

This is a logical efficient and safe way to achieve rapid take up of vaccine. We used to do child immunisations like this on a smaller scale. Why not? Would be cost effective for the health bill and also our general economic recovery. Showgrounds. Exhibition building. Tennis centre?

Dr Tatiana Cimpoesu   21/02/2021 3:33:24 PM

such a great idea!

Dr Geoff Norman   23/02/2021 1:45:17 PM

Great idea. needs to go nationwide. Stadiums and Churches are great spaces these are where its got to happen.. They even used Salisbury Cathedral in England. So many practices are going to find it is all too hard. We're already busy . I anticipate a big difference from "EOI" numbers to those actually taking on the role in general practice.