GPs need ‘complete predictability on supply’: Calls for better communication amid vaccine delays

Anastasia Tsirtsakis

30/03/2021 4:25:11 PM

Lagging deliveries have forced some GPs to be creative in securing vaccines for their patients.

A frustrated GP.
A number of practices have had to cancel their plans to vaccinate patients as they face significant delivery delays.

More than 540,000 coronavirus vaccines have been administered in Australia, of which GPs administered close to 120,000 just last week.
Federal health authorities remain optimistic the COVID-19 vaccination program remains on track, but the experiences of general practices across Australia tell a different story.
Dr Kat McLean, a GP and clinical lead at a respiratory clinic/immunisation centre on the Gold Coast, is among the GPs telling that story.
After their first week administering vaccinations, while navigating the floods, a second shipment of doses was due to arrive late last week. The clinic was contacted and informed they would be delayed until Saturday, but by 5.00 pm they had yet to arrive.
‘We had lots of problems actually getting through to Linfox, who were coordinating the delivery,’ Dr McLean told newsGP.
‘[Then] we received a message that their call centre was closed because it was after hours, and the recommendation at that point was that we would need to cancel our immunisations booked for Monday – we had 200 people that were booked in.
‘That late on Saturday … it was a very, very difficult position to be in.’
Dr McLean and her colleagues were not alone. She says a number of local GPs reported similar issues, as did several practices in the Tweed and Brisbane areas.
Dr Maria Boulton’s clinic is among them.
‘We expected them to arrive last Saturday, but are still waiting,’ the GP and practice owner told newsGP.
‘Some practices have had to cancel entire clinics because their vaccines didn’t arrive in time. This means staff are spending hours cancelling appointments – this takes time and resources.’
Faced with the prospect of having to reschedule 200 patients, Dr McLean says the clinic was thankfully able to draw on its close relationships with its Primary Health Network and hospital and health service.
‘To me it seemed bizarre that we didn’t have an after-hours response that was appropriate,’ she said. ‘That really could have ensured that we had some certainty about delivery on a Sunday to coordinate for that to happen at scale across all centres impacted.
‘I was able to have a conversation with our public health physician on Saturday, who was then able to successfully navigate the bureaucratic process to arrange transfer of vaccine from the hospital and health service to the respiratory clinic.’
While Dr McLean was able to find a solution, she says it is not a sustainable one. 
‘I certainly don’t think our hospital and health service can reach out and do similar on a large scale, and nor should they have to,’ she said. 
‘Whilst we all understand that sometimes there might be delays – and the flooding was certainly an example of a reasonable time that we might have some supply problems – the extent of the disruption took us by surprise.’
RACGP President Dr Karen Price told newsGP that her practice in Melbourne has not been immune from logistical issues. She was also on site in Queensland witnessing the impacts of the delays firsthand. 
‘What we ultimately need is complete predictability on supply,’ she said.
‘We know there’s that capacity to do it and we’re itching to do our bit, but if I was a practice owner, given what’s gone on, I’d be saying, “Well, I’m not making appointments till I’ve got the vaccine in”, because at the moment it’s too fraught and the cost to a practice of setting everything up, getting all these people waiting, is enormous.
‘You have to go around and tell 100 people, “Sorry, not today, because the vaccine didn’t arrive”. We saw that happen in the UK.
‘That’s one of the worst things a practice can do, not fulfill those expectations. Apart from the costs of it, I think that’s where some of the pain is coming from.’

Dr McLean says the impact of vaccine cancellations is further amplified in Queensland, as greater Brisbane faces a three-day snap lockdown amid a growing COVID outbreak.
‘We’ve certainly seen a significant increase in demand for immunisations with the local community transmission, and we’re concurrently also managing a significant surge in testing requirements that our GP respiratory clinics play a really key role in,’ she said.
‘We are absolutely working hard at the moment and trying to do everything within our powers.
‘For the GPs out there, having to phone 50 patients to reschedule their [immunisations] when we are under such immense pressure with what’s happening with the local community spread, it’s asking a huge amount in terms of the goodwill of GPs, and I can understand why GPs are really, really frustrated about this.’
Dr Boulton says practices need greater assurance.
‘It’s like trying to organise a concert when you are not sure whether the performers will be there or when they will arrive,’ she said.
‘It is important for GP clinics to have certainty over when their supplies will arrive so we can organise vaccination clinics, let patients know when they are on and organise the staff around them.’
Without this certainty, Dr McLean says the financial impact for clinics is sure to be ‘significant’.
‘Practice owners are having to roster staff and employ new staff to actually cater for this,’ she said
‘When you’re not able to deliver the immunisation, you have a team there that is still having to be paid for the time and no income that is coming in to cover any of those costs.’
Dr McLean would like to see clearer communication between the supply chain and clinics.
‘GPs are scrambling to keep things together, and certainly, when we’re doing it on the run without clear communication it is much more challenging and the cognitive load is significant,’ she said.
‘It would be really good to actually know that our supply was there in the fridge more than a day or two before we were starting to have to roll out the next lot of immunisations.
‘I take my hat off to those in the GP community and the immunisations that are being rolled out amid everything that is occurring, because it’s being done under really, really difficult circumstances from the logistics supply and communication perspective.’
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Dr Holly Deer   1/04/2021 6:27:28 AM

We have had exactly the same experience here at Crystal Brook, SA. We were told roll-out was due next week, with vaccines due to arrive today. Through no fault of our own, this has been delayed by a week so at this point 50 patients already have had to be rescheduled. Our lead practice nurse has spent days, not hours, working on this to ensure we've done everything right our end so we were ready at the time we were told we could start.
It is extremely frustrating now that has had to change already - we haven't even had the chance to start yet! We've taken this to our local federal MP to see if anything further can be done as the last thing we want to do is let down the patients booked in.

Dr Krzysztof Wojciech Szatsznajder   2/04/2021 2:11:48 PM

Very similar problem at our clinic in Patterson Lakes. We will not receive a delivery for a week starting 12/04. 100 patients booked will have to be notified this week. There is no word able to describe our feelings at the moment. We have contacted offices of Federal Health Minister, Victorian Health Minster, The Leader of the opposition's office, AMA, I have spoken to Neil Mitchell on air twice this week. Nobody has been able to offer any solution. We are made look incompetent in the eyes of our patients. We must find a solution otherwise someone will find a solution for us and take it away from us by creating a large, mass immunisation centres operated by unknown entities.
The system is only good when it supports the frontline operator. It this case we do not feel supported.
One more interesting observation - we have been informed that once you miss on your weekly delivery, you will not be able to receive the missing stock the following week - it is gone for ever. Why????