The rollout of the COVID-19 vaccination programme in England

In the light of the expanded and accelerated booster programme, NHSE&I should take additional steps to manage the vaccine workforce and its welfare sustainably, and to examine how the programme can minimise its potential adverse impact on other health and public health services, bearing in mind it is the same workforce which delivers all these services. It should also ensure it gives front-line providers the necessary lead-in time to prepare for programme changes.

NHSE&I and UKHSA, working with local and national partners, should seek new ways to increase uptake for groups where rates are lower than for the rest of the population, and should also evaluate what has worked well to date and could be replicated in future in other vaccination and similar public health programmes.

The Taskforce, NHSE&I and UKHSA, working with local partners, should set out a clear strategy for managing surpluses and wastage in 2022 and review the overall expected wastage, ensuring they learn lessons from the write-offs required for AstraZeneca.

Taking into account its ongoing procurements, the Taskforce should set out a clear strategy for how it will maintain flexibility to respond to the continuing uncertainties of the pandemic, including the emergence of new variants, and changes in demand. This should include consideration of the mix of vaccines in its portfolio, timing of deliveries and the relative cost and efficacy of different vaccines.

DHSC and BEIS, working with the Taskforce, NHSE&I and UKHSA, should capture wider lessons from the programme, and identify what adaptations and innovations they should retain for other health and public health programmes and future responses to emergencies. By the same token they should take steps to identify and address acknowledged weaknesses, such as the accuracy and availability of care sector data and the identification of unpaid carers.

DHSC and BEIS, working with the Taskforce, NHSE&I and UKHSA, should set out a clear plan to identify and reach a sustainable future model for COVID-19 vaccination, clearly setting out responsibilities at national and local level, based on a considered review of the costs, structures, staffing and delivery models used so far. In advance of any formal plan, they should seek early opportunities to consolidate COVID-19 vaccine activities within existing structures.