Eleventh Report - The rollout of the COVID-19 vaccine programme in England

Select Committee

Public Accounts Committee HC 258 13 July 2022

Report Status Government responded

Conclusions & Recommendations 32 items (17 recs)

Source View on Parliament website

Government Response (AI assessment · 21 of 32 classified)

Accepted 12

Not Addressed 2

Rejected 7

Recommendations

10 results

2 Accepted

Comparatively low vaccination uptake persists in many vulnerable groups and, after the first booster campaign,...

Recommendation

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 Summary

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.

HM Treasury

View Details

3 Accepted

NHS England has started planning for a reduction in vaccine sites and staffing for the...

Recommendation

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 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 high 6 The rollout of the COVID-19 vaccine programme in England levels of vaccination uptake and ensuring that demands on healthcare staff are sustainable. In February 2022, NHS England set out requirements for local area planning for the vaccine programme through to March 2023. NHS England says it is encouraging each area to think about the best approach locally both in terms of the right mix of vaccination sites and the right staffing. Overall, it expects a reduction in the number of sites from the 2,900 active at that time. The NAO, the Royal College of Nursing and pharmacy representatives have all highlighted that future staffing is a major risk due to staff burnout and the lack of surplus capacity in the healthcare system more generally. Our own work looking at NHS backlogs and waiting times has highlighted the particular strains on GPs, who delivered around half of all COVID-19 vaccinations up to the end of May 2022. We note that NHS England has already taken some central action to support staff, including the maintenance of national contracts for volunteer responders. Recommendation: By the end of October 2022, NHS England should write to the Committee with the results of its assurance of local plans – particularly with regard to whether these provide an efficient and effective basis for the programme to achieve its aims, while safeguarding staff welfare and aligning with other demands on the NHS. It should also set out any further central actions it will take to address areas of deficiency in the plans. During 2022–23, NHS England working with others should develop clear, costed options for how the programme will ensure both value for money and accessibility in its future approach to COVID-19 vaccination, including who it expects Show less

Government Response Summary

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.

HM Treasury

View Details

4 Accepted

There is considerable learning from the COVID-19 vaccine programme that might apply elsewhere, both in...

Recommendation

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 Summary

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.

HM Treasury

View Details

6 Accepted

While vaccine wastage was well below assumptions in 2021, NHS England believes the level could...

Recommendation

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 Summary

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.

HM Treasury

View Details

7 Accepted

We were concerned that, in the week before the start of the new financial year,...

Recommendation

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 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 the 2021 Spending Review, the Department received £9.6 billion for all its key COVID-19 programmes throughout the three-year spending review period. But when we took evidence on 28 March, the Department still could not tell us how it would distribute funding among different programmes for 2022–23, including the vaccine programme. It also had not finalised the 2022–23 budget for UKHSA, which has key roles in COVID-19 vaccine storage and distribution, and monitors and analyses vaccine coverage and effectiveness. There are many 8 The rollout of the COVID-19 vaccine programme in England other parts of the vaccine programme, including GPs and pharmacies, external contractors, volunteer schemes, local authorities and temporary staff, that are central to successful delivery and also need timely confirmation of funding. Meanwhile, the Department for Business, Energy and Industrial Strategy was expected to continue funding efforts to boost domestic vaccine manufacturing capacity. Recommendation: Departments should always set out annual budgets and funding for their key bodies and programmes in good time, only using supplementary estimates to manage uncertainties as they arise later in the financial year. For the vaccine programme, the Department of Health and Social Care and the Department for Business, Energy and Industrial Strategy should, as part of the Treasury Minute response to this report, confirm the agreed funding for the main elements of the vaccine programme for 2022–23 and any subsequent financial years, alongside a clear statement of the aims and targets the programme needs to achieve with this funding. The rollout of the COVID-19 vaccine programme in England 9 1 Learning lessons and maximising uptake Show less

Government Response Summary

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.

HM Treasury

View Details

8 Accepted

We asked the Department how learning would be applied to future emergency response planning.

Recommendation

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 Summary

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.

HM Treasury

View Details

14 Accepted

We are most concerned about the comparatively low vaccination uptake that persists in many vulnerable...

Recommendation

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 Summary

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.

HM Treasury

View Details

15 Accepted

There has also been particularly low uptake of the vaccine among pregnant women.

Recommendation

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 Summary

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.

HM Treasury

View Details

17 Accepted

We asked the Department if communication campaigns had positively impacted vaccine hesitancy among any of...

Recommendation

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 Summary

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.

HM Treasury

View Details

23 Accepted

It is in this context that NHS England has started to plan for a reduction...

Recommendation

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 Summary

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.

HM Treasury

View Details

Conclusions (2) Observations and findings — click to expand

9 Conclusion Accepted

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 reach their own decisions about whether and to whom to …

Government Response Summary

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.

View Details

30 Conclusion Accepted

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, the Department received £9.6 billion for all its key COVID-19 …

Government Response Summary

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.

View Details