GPs urged to be patient during initial stages of COVID vaccine rollout

Matt Woodley

8/03/2021 4:29:06 PM

RACGP President Dr Karen Price says the patient-driven pivot to fewer doses across more practices represents a ‘slower, better, safer’ model for phase 1b.

Doctor holding vial of AstraZeneca vaccine.
The COVID-19 vaccination drive will ramp up substantially once local manufacturer CSL begins releasing doses of the AstraZeneca vaccine. (Image: AAP)

The calls were made in the wake of some GPs questioning the financial viability of participating in the rollout, after a number of general practices received substantially fewer doses of the Oxford University/AstraZeneca vaccine than they were expecting.
Reports emerged over the weekend of some practices being allocated only 50 doses per week initially – despite requesting 200 per day – as a result of a strategic shift to spread the number of available doses across more clinics.
The patient-driven pivot was made in an effort to allow complex care patients – many of whom qualify for phase 1b of the rollout – to receive the vaccine from their usual GP.
RACGP President Dr Karen Price told newsGP while the Medicare Benefits Schedule (MBS) item numbers created to fund the rollout have been geared towards mass-vaccination, the initial phases will likely proceed at a slower pace before ramping up in the coming weeks.
‘Phase 1b has been complicated to start with, because these are mostly elderly patients who are still in the community, who have an established relationship with a GP and many of them are saying they want to be vaccinated by their usual GP,’ she said.
‘To try and get them into some other high volume process would be complicated and then we’ve got the younger adults with underlying medical conditions who are going to have to be triaged and verified by someone who knows them well, or they’re going to have to be substantiating their conditions to strangers.
‘There’s been a recognition that that’s a complex base and maybe phase 1b is going to be rolled out over a longer time period, and I think that’s where general practice will shine in terms of a slower, better, safer model.’
Dr Price said while she understood the anxiety of many GPs who have put plans in place to conduct mass vaccination drives from the beginning of the rollout, it is still very early in the process and suggested it could be a good opportunity to conduct smaller-scale pilot programs while doses remain limited.
‘Phase 2 may be where the mass vaccination really begins to pick up speed; you’ve got much younger cohorts, much less co-morbidity, perhaps much more digital literacy, and a much higher head of population,’ she said.
‘The Department of Health is trying to plan out the most complex vaccination rollout in Australian history, and trying to make sure that no one gets left behind and how to do that best.
‘I think there has been a little bit of a shift, and that’s probably because the patient voice has been fairly loud saying, “why can’t we just go to our usual GP?”
‘It’s actually a reflection of the goodwill that patients have with us. But it is a slight pivot, because I think a lot of doctors are gearing up for mass vaccination and going through 200 doses a day, so I can understand how that’s been a shock.’
Earlier, Federal Health Minister Hunt described the vaccine rollout as one of the greatest logistical challenges in Australia’s history, but said GPs could expect doses of the Oxford University/AstraZeneca vaccine to become more available once domestic production comes online and CSL starts distributing one million doses per week.
‘More than 1000 general practices will commence from the week of March 22, with a rapid scale-up over the following four weeks,’ he said. ‘This will ensure an efficient and equitable distribution of vaccines across the country.’
Dr Price also said that the upcoming greater availability of doses may ease concerns being felt by some GPs, but warned that general practice will need to stay adaptable as there will likely be other challenges ahead.
‘By mid-year, we’ll see that there are multiple ways that people will be able to access the COVID vaccination and that’ll be when CSL is really starting to pump out doses,’ she said.
‘But maybe later in the year we’ll even see Novavax as well, which will mean more complications, more pivots, more adaptions, and that’s the nature of a global pandemic, really.’
In the meantime, she reminded GPs that co-claiming is available, which may help make the initial stages of the rollout more financially viable.
‘I know GPs are tired and it’s been tough. That supply issue is critical and, of course, that unknown makes it very hard in a business planning sense,’ she said.
‘The Medicare item numbers are designed for a lean, high volume, mass vaccination process but if you want to do a slower stream, you can do co-claiming as long as it’s reasonable and you follow the 80/20 rule.
‘We’re not quite ready for mass vaccination yet, but I believe we will be so just hang in there.’
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Dr Matthys Kritzinger   9/03/2021 1:19:25 AM

What about General Practices who are unable to meet the stringent conditions as set out in the initial EOI , but who are quite willing and capable to vaccinate ( All docs and nurses currently doing the online training modules )their own cohort of patients and would like to participate in getting as many Australians vaccinated as possible? Will they be allowed to get some vaccines?

Dr Eleanor Kate Woolveridge   9/03/2021 8:53:01 AM

This is highly frustrating from a business sense but it does make sense from a patient care POV. Unsure why the feds didn’t just sell it it this way from the get-go. Inadequate consultation with GPs no doubt. Also cynic in me suspects they always wanted it this way but sold it differently to get GPs on board. Let’s hope those that were allocated 50 don’t now pull out at the last minute. Moving forward. It would be nice to know ASAP what our phase 2 allocations are with ample notice!!

Dr Arnold Dela Cruz   9/03/2021 9:58:17 AM

One can't do much as it is limited by what he /she is getting. Just have to contend oneself and yes make is slower, safer & better. Could be a good learning process especially when more vaccines will be made available soon , hopefully. It's just that what was told isn't exactly being what is being given and that's a bit disappointing.

Dr Peter JD Spafford   13/03/2021 10:25:53 PM

Dr Karen, the catch word is pivot and it appears you are pivoting around what the government wants. Phase 1 a,b ?c,d then phase 2 which it appears you are not sure what that is. Then what? Phase 3. OMG what is that going to be?