EXCLUSIVE: Many elderly or housebound people in England are not getting their first vaccination against the Covid virus because of failures by the system, an investigation by correspondent.world has revealed.

25 February 2021 By Paul Martin

This could have already led to hundreds of unnecessary infections and many deaths, experts at these charities claim.

Part of the problem is that many people have become unable to cope or housebound in the past year and have not been added to the official ‘housebound’ list, so they do not get a home visit to be vaccinated.  

England’s National Health Service [NHS England] says people are eligible to receive a vaccination at home if they are unable to leave their home at all, or require significant assistance due to illness, frailty, surgery, mental ill health or are nearing end of life. 

But it does not specify exactly how family doctors, known in the UK as General practitioners, or GPs, should identify these patients.

Jacob Lant, head of policy and public affairs at Healthwatch England, said the ‘definition’ of housebound should be broadened.  It should now include those who ‘feel housebound in the context of covid’.

The rollout of vaccines to people in their own homes appears to have been slow, according to the Health Services Journal [HSJ], in part due to the storages of the vaccine and the complexities of transporting them.  GPs have now been offered an extra ten pounds per home vaccination a sign that this rollout is not going well.

One charity, Age UK, the largest in Britain focused on the interests of the elderly, said the pandemic and its effects have actually caused far more people than usual to decline rapidly, or to become confused or nervous about going out. Most of these rapid declines have not yet been picked up by GPs and classified as ‘housebound’.

‘The last year or so has had an immensely profound impact.  The danger is that these people have slipped into these conditions over the last months and are flying under the radar.  They need to ask for help but do not as it’s so overwhelming, or just reluctant,’ Ruthe Esden, Head of Health at Age UK, told the Correspondent.World.  

‘They need to ask for help but do not as it’s so  overwhelming.  Many have simply lost self-confidence.

‘Or they feel they don’t want to be a bother to the doctors — they think they’re already very busy.’

These people would benefit if told that they could go to the local chemist-shop to be vaccinated, say pharmacists.  But, according to Woolwich Late Night Pharmacy’s Rajem Kandel, they are often being confused as either the local vaccinating pharmacy is not mentioned in communications to them, or they get apparently conflicting messages from the NHS and their local GP surgeries.

They need someone to visit them at home, or will need accessible transport or someone to go with them.

 ‘There’s the national booking system, and also local GP groups, and that’s a recipe for some confusion,’ Esden said.  ‘Some people really want the vaccine but they feel very anxious and they have lost confidence in going out of their front door… which they haven’t done for a long time.

‘A phonecall can make all the difference,’ according to Age UK’s Esden.  She says many of those who’ve not yet had a vaccine are usually not rejecting it outright — they just are confused or have genuine concerns, for example that the medicines they are already taking will clash with the vaccine dose.

The pharmacists we spoke to complained that they only have a very limited list of people they can contact — those who have already been coming in for repeat prescriptions of medicines.  ‘We have no idea which of the rest of our customers have or have not had a jab, and whether we can help them,’ Mr Kandel said.

Age UK rejects the idea that vaccination is being taken up by such a large proportion that the remainder in each category need not be vaccinated, said Esden.

‘We are talking about people in the highest-risk groups, so it’s not good enough to say we have done enough… getting them vaccinated could make the difference for the individual and for society .’

Research by Age UK due out in the next few weeks shows just why many people are being missed out — the rapid deterioration of people’s physical and mental health.  That’s produced  loss of confidence, confusion and physical setbacks, and, according to Age UK’s previous calculations, is affecting between a third and and fifth of people over seventy.

  • Nearly half feel less confident going to a hospital appointment and 2 in 5 feel less confident about going to the GP surgery
  • 2 in 3 (7.9million) or 64% feel less confident about taking public transport 
  • 1 in 3 respondents (4.2million) or 34% report feeling more anxious since the start of the pandemic
  • Over a quarter (3.2 million) or 26% can’t walk as far as they used to
  • 1 in 5 (2.4 million) or 20% are finding it harder to remember things
  • 1 in 5 (2.3 million) or 18% say they feel less steady on their feet
  • 2 in 5 (5.3 million) or 43% felt less confident about going to the shops
  •  1 in 4 (3.3million) or 26% felt less confident about spending time with family

Pharmacists say it should be made much easier for people to walk in to chemist-shops and get a jab.  Two hundred and sixty pharmacies in England are already set up to deliver over one thousand jabs a week — but are finding they’re up against too many hurdles to make use of their full capacity.

Subject: Woolwich Late Night Pharmacy

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Left : Senior Clinical Pharmacist Sobha Sharma.

Centre: Superintendent Pharmacist Jignesh Mehta.

Right: Covid vaccination clinic co-ordinator Kabita Kandel. 

Sobha and Rajen Kandel run three chemist-shops in London.

Their Woolwich Late Night Pharmacy is open till 10-30 p.m. and, if they had the customers, they say they would keep it running till one in the morning. 

‘The NHS imposes very strict guidelines – we can only jab people who have pre-booked, and we cannot vaccinate walk-ins, but other places [like GP hubs] are having walk-ins,’ Rajen Kandel told Correspondent.World.  

‘Why are there different rules and messages?

‘Some of our customers walk in and we tell them we cannot do it.  Our credibility is being questioned by our customers.

‘We have three vaccinators minimum a day. 

‘Some of our patients are getting texts or letters from different sources. They are confused.  They are thinking they must go somewhere else. Especially the elderly are very worried about where to go.  We are the nearest and most convenient.  The letters from GPs and NHS are clearly confusing people.

‘We had three thousand a week capacity, but were getting fifty a day though it’s going up now. We feel deep disappointment.  

‘Some days we have no stock at all and have zero vaccinations.  We are now getting around a hundred bookings per day, but we can handle many more.

‘The letters sent out by GPs never mention the pharmacies.

‘Some of our patients are getting texts or letters from different sources. They are confused.  They are thinking they must go somewhere else. Especially the elderly are very worried about where to go.  We are the nearest and most convenient.  The letters from GPs and NHS are clearly confusing people.

‘We kept all our pharmacies open all through pandemic.  We are at the forefront, but our work and the risk we have taken to keep it going has not been recognised well enough by the government.’

The Kandels have indeed paid a price for their vaccination service – both of them, and their children, caught Covid.  They think Mrs Kandel caught it first, from a person who came in for a jab even though she had symptoms.

‘Pharmacies are the ideal place for people to pop in and take a jab,’ Mr Kandel said. ‘Yet many high street pharmacies are at risk of closing down.  Pharmacists get paid 12 pounds fifty a vaccination, and overall since the pandemic our sector has had some advance money from Government —   350 million pounds.  But they’re loans, and we’ll have to pay it back.’

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