Roll out of the COVID:19 vaccine programme

Public Accounts Committee Closed Inquiry
Opened: 26 Jan 2022 Closed: 8 Nov 2022 Parliament page
This inquiry follows on from our February 2021 report on the development and rollout of the first vaccines in the UK The Committee will question senior officials at DHSC, NHS England and the UK Health Security Agency on how well placed the government is to meet its full objectives for … Read more
17 Recommendations
15 Conclusions
1 Report
1 Oral session
2 Letters
1 Event
Activity timeline 6 events
8 Nov
2022
Report published
8 Nov
2022
Correspondence
13 Jul
2022
Report published
12 May
2022
Correspondence
28 Mar
2022
Oral evidence
28 Mar
2022
Formal meeting (oral evidence session) · Room 8, Palace of Westminster
Oral evidence sessions 1 session
28 Mar 2022
View on parliament.uk
Roll out of the COVID:19 vaccine programme
Amanda Pritchard · NHS England Dame Dr Emily Lawson · NHS England and NHS Improvement Dr Jenny Harries OBE · UK Health Security Agency Madelaine McTernan · Department for Business, Energy and Industrial Strategy Shona Dunn · Home Office
Title HC No. Published Items Response
Eleventh Report - The rollout of the COVID-19 vaccine programme … HC 258 13 Jul 2022 32 Responded
Recommendations & Conclusions
32 results
2 Recommendation Accepted
Eleventh Report - The rollout of t…
Comparatively low vaccination uptake persists in many vulnerable groups and, after the first booster campaign,...
Comparatively low vaccination uptake persists in many vulnerable groups and, after the first booster campaign, has even dropped further for some. Overall uptake of COVID-vaccination has been high, reaching 90% of adults by the end of May 2022 (based on … Read more
Government Response
NHS England, supported by UKHSA, will evaluate approaches to vaccine delivery and work with local systems to continue evaluating different approaches to vaccine delivery, especially for communities where uptake and confidence may be lower. NHS England intends to continue offering vaccinations through a range of flexible delivery models, supported by culturally tailored and targeted campaigns.
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3 Recommendation Accepted
Eleventh Report - The rollout of t…
NHS England has started planning for a reduction in vaccine sites and staffing for the...
NHS England has started planning for a reduction in vaccine sites and staffing for the rest of 2022 in anticipation of lower overall demand, but it is not yet clear how its strategy will strike the right balance between maintaining … Read more
Government Response
The government agrees with the Committee’s recommendation and states that NHSE wrote to the Committee on 31 October 2022 to provide an update on the outcome of assurance of local plans.
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4 Recommendation Accepted
Eleventh Report - The rollout of t…
There is considerable learning from the COVID-19 vaccine programme that might apply elsewhere, both in...
There is considerable learning from the COVID-19 vaccine programme that might apply elsewhere, both in the health sector, such as screening programmes and routine vaccinations, and across wider government. In our March 2022 report on government preparedness for the pandemic, … Read more
Government Response
The government agreed to identify successes and lessons from the COVID-19 vaccine programme and communicate to the Committee the main improvements it will make as a result in other health programmes and wider government.
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5 Recommendation Rejected
Eleventh Report - The rollout of t…
After starting with a portfolio of seven candidates, the UK’s vaccine supply for 2022 and...
After starting with a portfolio of seven candidates, the UK’s vaccine supply for 2022 and 2023 now relies primarily on just two, yet many of the risks that the ‘portfolio’ approach was intended to mitigate remain. The UK’s portfolio strategy … Read more
Government Response
The government disagrees with the recommendation to review the future procurement strategy for COVID-19 vaccines, stating that the current strategy is kept under constant review with expert advice. They cite agreements with developers that give access to updated vaccines and bivalent vaccines having received regulatory approval.
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6 Recommendation Accepted
Eleventh Report - The rollout of t…
While vaccine wastage was well below assumptions in 2021, NHS England believes the level could...
While vaccine wastage was well below assumptions in 2021, NHS England believes the level could increase in 2022, which would be regrettable. Up to the end of October 2021, the NAO estimated COVID-19 vaccine wastage levels for England of under … Read more
Government Response
The government agreed to update the Committee on levels of wastage, number of doses donated internationally, and doses still to be supplied by the end of 2022; figures for wastage and donations as of July 2022 are provided; details of future supply are commercially sensitive and will be shared in confidence in a letter.
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7 Recommendation Accepted
Eleventh Report - The rollout of t…
We were concerned that, in the week before the start of the new financial year,...
We were concerned that, in the week before the start of the new financial year, the Department had not finalised the allocation of its £9.6 billion Spending Review settlement for COVID-19 response activities, creating uncertainty for the vaccine programme. In … Read more
Government Response
The government agrees with the recommendation and has set aside a minimum of around £2 billion of funding in the 2022-23 financial year for vaccine procurement and deployment against COVID-19. They plan to deliver a spring booster, roll out vaccinations to 5-11 year olds, and deploy an autumn booster, while maintaining the capability to expand or accelerate the programme.
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1 Conclusion
Eleventh Report - The rollout of t…
On the basis of a report by the Comptroller and Auditor General, we took evidence...
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (the Department), the Department for Business, Energy and Industrial Strategy (BEIS), NHS England and NHS Improvement (NHS … Read more
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8 Recommendation Accepted
Eleventh Report - The rollout of t…
We asked the Department how learning would be applied to future emergency response planning.
We asked the Department how learning would be applied to future emergency response planning. The Taskforce noted that a success factor had been the closer working relationships with vaccine manufacturers, which were critical to the speedy supply and deployment of … Read more
Government Response
The Department will carry out a systematic exercise to identify successes and other lessons from the programme and, within six months of this report, communicate to the Committee the main improvements it will make as a result in other health programmes, as well as any wider applications to emergency response planning or other government programmes, with target implementation in Spring 2023.
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9 Conclusion Accepted
Eleventh Report - The rollout of t…
Overall the evidence session indicated that officials were keen to learn lessons and saw clear...
Overall the evidence session indicated that officials were keen to learn lessons and saw clear potential benefits from doing so. However, it seemed likely to us that different organisations could be left to learn their own lessons and then to … Read more
Government Response
The government agrees that there are lessons to be learned from the COVID-19 vaccine roll-out, and NHSE is leading development of an integrated immunisations strategy, and the department will write to the Committee setting out the main improvements being made as a result of this work.
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10 Recommendation Rejected
Eleventh Report - The rollout of t…
The vaccine programme still has some issues to address.
The vaccine programme still has some issues to address. In England, 2.98 million adults were still unvaccinated at the end of May 2022. Analysis by UKHSA has confirmed that full and booster vaccination reduces the risk of someone falling seriously … Read more
Government Response
The government disagrees with the recommendation to set a challenge to reduce the number of unvaccinated adults to 2.5 million and achieve 80% booster uptake, arguing it is moving away from target-based approaches.
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11 Recommendation Rejected
Eleventh Report - The rollout of t…
We asked officials about their strategy with regard to the unvaccinated.
We asked officials about their strategy with regard to the unvaccinated. UKHSA and NHS England told us that the basic public health message remained clear—that everyone was encouraged to get vaccinated—and that they continued to work with local government, local … Read more
Government Response
The government disagrees with the Committee's recommendation to reduce the number of unvaccinated adults to 2.5 million, stating that it will continue to focus on reaching out to the unvaccinated but will move away from setting targets.
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12 Recommendation Rejected
Eleventh Report - The rollout of t…
NHS England said it had built on approaches recommended by the Scientific Advisory Group for...
NHS England said it had built on approaches recommended by the Scientific Advisory Group for Emergencies and the World Health Organisation to achieve the excellent uptake to date.27 But it acknowledged that the country was no longer in a state … Read more
Government Response
The government disagrees with the Committee's recommendation to reduce the number of unvaccinated adults to 2.5 million, stating that it will continue to focus on reaching out to the unvaccinated but will move away from setting targets.
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13 Conclusion Not Addressed
Eleventh Report - The rollout of t…
However, effective targeting is now essential because those who are not fully vaccinated are concentrated...
However, effective targeting is now essential because those who are not fully vaccinated are concentrated in particular social groups. According to NHS England, many unvaccinated people are young city-dwellers, with just five cities accounting for a quarter of the total … Read more
Government Response
The government disagreed with the committee's recommendation to reduce the overall number of unvaccinated adults to 2.5 million and achieve an 80% uptake for first boosters among adults within four months. They stated they continue to focus on reaching out to the unvaccinated and not fully vaccinated and are using walk-in and mobile vaccination clinics to enable easy access.
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14 Recommendation Accepted
Eleventh Report - The rollout of t…
We are most concerned about the comparatively low vaccination uptake that persists in many vulnerable...
We are most concerned about the comparatively low vaccination uptake that persists in many vulnerable groups and, after the first booster campaign, has actually widened in some. For example, compared to people of White British origin, people of Black, Black … Read more
Government Response
The government agreed to evaluate approaches for increasing vaccine uptake in vulnerable groups and support local areas in deploying the most effective approaches, including fresh approaches to tackle low uptake in some ethnic groups.
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15 Recommendation Accepted
Eleventh Report - The rollout of t…
There has also been particularly low uptake of the vaccine among pregnant women.
There has also been particularly low uptake of the vaccine among pregnant women. As of February 2022, analysis by UKHSA showed that only 58% had received 2 doses.34 The Royal College of Nursing told us that lessons needed to be … Read more
Government Response
The government agrees to evaluate which approaches are most effective for increasing vaccine uptake in vulnerable groups, communicate findings to local areas, and provide support for deploying the most effective approaches, including fresh approaches to tackling low uptake in some ethnic groups.
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16 Conclusion Not Addressed
Eleventh Report - The rollout of t…
Additionally, Mencap raised concerns with us about specific difficulties in identifying and prioritising people with...
Additionally, Mencap raised concerns with us about specific difficulties in identifying and prioritising people with severe and profound learning disabilities.38 It said there was a need for more accessible communications for this group and to tackle needle phobia, which had … Read more
Government Response
The government agrees with the Committee’s recommendation that NHS England and UKHSA should urgently evaluate which approaches are most effective for increasing vaccine uptake, communicate again with local areas about what works, and provide support to them to deploy the most effective approaches, but focuses its response on the recommendation regarding vulnerable groups generally and does not address Mencap's specific concerns about those with severe and profound learning disabilities.
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17 Recommendation Accepted
Eleventh Report - The rollout of t…
We asked the Department if communication campaigns had positively impacted vaccine hesitancy among any of...
We asked the Department if communication campaigns had positively impacted vaccine hesitancy among any of these groups. The Department told us that there had been a positive shift in general but conceded that there remained more to do.40 NHS England … Read more
Government Response
NHS England and UKHSA will evaluate which approaches are most effective for increasing uptake, communicate again with local areas about what works, and provide support to them to deploy the most effective approaches, supported by the UK Health Security Agency (UKHSA) vaccination evaluation framework, with target implementation in Spring 2023.
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18 Conclusion
Eleventh Report - The rollout of t…
As part of an earlier inquiry in January 2021, the Taskforce told us how its...
As part of an earlier inquiry in January 2021, the Taskforce told us how its portfolio strategy aimed to “optimise the chances of success” in securing access to vaccines at a time of huge uncertainty about whether effective vaccines were … Read more
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19 Recommendation Rejected
Eleventh Report - The rollout of t…
Since then, out of the original portfolio of seven candidates, six have been approved for...
Since then, out of the original portfolio of seven candidates, six have been approved for use in the UK to date.44 But with six vaccines to choose from, it is noteworthy that only three—AstraZeneca, Pfizer and Moderna—have actually been deployed … Read more
Government Response
The government disagrees with the recommendation to review the future procurement strategy for COVID-19 vaccines, stating that the current strategy is kept under constant review with expert advice. They cite agreements with developers that give access to updated vaccines and bivalent vaccines having received regulatory approval.
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20 Recommendation Rejected
Eleventh Report - The rollout of t…
In our assessment, many of the risks that the portfolio approach was intended to mitigate...
In our assessment, many of the risks that the portfolio approach was intended to mitigate remain. Most notable among these is the risk that future variants of the virus may respond better to one vaccine than another, perhaps a vaccine … Read more
Government Response
The government disagrees with the recommendation, stating that the portfolio approach was the right strategy in the early stages of the pandemic, and the vaccine procurement strategy is kept under constant review.
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21 Recommendation Rejected
Eleventh Report - The rollout of t…
The Taskforce also told us that the COVID-19 vaccine market was still developing and that...
The Taskforce also told us that the COVID-19 vaccine market was still developing and that it considered many different factors when deciding which vaccines to procure, including the evolution of the virus and improved learning about different types of vaccines … Read more
Government Response
The government disagrees with the recommendation to review the future procurement strategy for COVID-19 vaccines, arguing that the current portfolio approach is constantly reviewed with clinical and commercial expertise.
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22 Conclusion
Eleventh Report - The rollout of t…
The next stage for the rollout of the COVID-19 vaccination programme is to vaccinate 5-...
The next stage for the rollout of the COVID-19 vaccination programme is to vaccinate 5- to 11-year-olds. NHS England told us it recognised that this would probably be a slower and more challenging rollout given the adaptations necessary to accommodate … Read more
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23 Recommendation Accepted
Eleventh Report - The rollout of t…
It is in this context that NHS England has started to plan for a reduction...
It is in this context that NHS England has started to plan for a reduction in vaccine sites and staffing in 2022. Its strategy responds to the likely drop in the overall scale of the vaccination effort, but it is … Read more
Government Response
NHS England will review and assure local COVID-19 vaccination plans throughout the summer and autumn of 2022 against optimal delivery, and wrote to the Committee on 31 October 2022 to provide an update to the Committee on the outcome of assurance of local plans.
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24 Conclusion
Eleventh Report - The rollout of t…
We also heard from NHS England that it was moving to a position where the...
We also heard from NHS England that it was moving to a position where the NHS and wider public sector estate should be used for vaccination sites wherever possible, in preference to renting private sector sites. Nevertheless, officials confirmed that … Read more
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25 Conclusion
Eleventh Report - The rollout of t…
The NAO report highlighted that future staffing was a major risk for the programme as...
The NAO report highlighted that future staffing was a major risk for the programme as a whole, due to staff burnout and the lack of surplus capacity in the healthcare system more generally.60 This was echoed by evidence provided to … Read more
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26 Conclusion
Eleventh Report - The rollout of t…
COVID-19 vaccine wastage was considerably below assumptions in 2021.
COVID-19 vaccine wastage was considerably below assumptions in 2021. We heard from NHS England and the Taskforce that this was due to system-wide efforts throughout the vaccination supply, distribution and deployment chain to ensure as much vaccine as possible was … Read more
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27 Conclusion
Eleventh Report - The rollout of t…
At our evidence session NHS England told us it was expecting wastage levels to increase...
At our evidence session NHS England told us it was expecting wastage levels to increase in 2022, because of the anticipated fall in overall demand.67 This is because, as demand reduces, it becomes harder to guarantee that all doses in … Read more
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28 Conclusion
Eleventh Report - The rollout of t…
Opportunities to reduce wastage should also be part of NHS considerations about which vaccination sites...
Opportunities to reduce wastage should also be part of NHS considerations about which vaccination sites will remain open in future. A nationwide pharmacy chain, Boots UK, told us that it would support a future model in which particular vaccination sites … Read more
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29 Conclusion
Eleventh Report - The rollout of t…
The Taskforce told us that predicting demand for 2022 remained difficult.
The Taskforce told us that predicting demand for 2022 remained difficult. It said it had consciously taken a cautious approach to procurement, based on the presumption that having too much vaccine would be better than having too little.71 There were … Read more
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30 Conclusion Accepted
Eleventh Report - The rollout of t…
The week before the start of the new financial year, the Department had still not...
The week before the start of the new financial year, the Department had still not finalised the allocation of its £9.6 billion Spending Review settlement for COVID-19 response activities, creating uncertainty for the vaccine programme. In the 2021 Spending Review, … Read more
Government Response
The government agrees with the Committee’s recommendation and has currently set aside a minimum of around £2 billion of funding in the 2022-23 financial year for vaccine procurement and deployment against COVID-19.
HM Treasury
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31 Conclusion
Eleventh Report - The rollout of t…
There are many other parts of the vaccine programme, including GPs and pharmacies, external contractors,...
There are many other parts of the vaccine programme, including GPs and pharmacies, external contractors, volunteer schemes, local authorities and temporary staff, that are central to the delivery of the programme and that need timely confirmation about what funding will … Read more
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32 Conclusion
Eleventh Report - The rollout of t…
Finally, we note that in setting up the vaccine programme the Department provided indemnities to...
Finally, we note that in setting up the vaccine programme the Department provided indemnities to vaccine manufacturers, which gave cover for future claims against producers for any adverse effects of their vaccines. These indemnities may add to the costs of … Read more
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Government Response AI assessment · 21 of 17 classified
Accepted 12
Not Addressed 2
Rejected 7
Total 17 recs + 15 conclusions
Correspondence 2 letters
8 Nov 2022 Correspondence from Amanda Pritchard, Chief Executive, NHS England, re House of Commons Committee of Public Accounts Eleventh Report of Sessions 2022- 2023: The rollout of the COVID-19 vaccine programme in England, dated 31 October 2022
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12 May 2022 Correspondence from Amanda Pritchard, Chief Executive, NHS, re Follow up to the Public Accounts Committee oral evidence session on COVID-19 vaccines – 28 March 2022, dated 22 April 2022
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