St George's prepares alumni to face the challenges of Covid-19 vaccine rollout

Published: 24 February 2021

Throughout the country, teams have worked tirelessly to prepare their clinics for the rollout of the Covid-19 vaccine, meeting ambitious targets in order to vaccinate the most vulnerable patients as quickly as possible. Two of our alumni, Physician Associates (PAs) Raj Gill and Nasra Yusuf, from Swiss Cottage Surgery GP clinic, have worked in a team which has given over 8,000 Covid-19 vaccinations since they began vaccinating patients two months ago. They spoke to us about how they prepared for the rollout, and what has contributed to the team’s success.

Swiss Cottage Surgery is one of nine practices in the Central Camden Primary Care Network (PCN) working closely together to provide integrated services. Their shared vaccination hub, Bloomsbury Surgery, was the first mass Covid-19 vaccination hub in north-central London when it opened its doors in December. The efforts of the team working at the hub were shared in a New York Times article last month.

Prepared for situations outside your comfort zone

 Physician Associate  and recent graduate, Nasra, speaks about how her time at St George’s has helped prepare her for the current situation as a relatively new Physician Associate, saying: “Over the last year, I have needed to get to grips with working remotely in a fairly new role. Having a very supportive team has helped, and this way of working is new to everyone, so it’s something we’ve all gone through together.”

She adds, “St George’s definitely helped prepare me for the outside world. I was placed in situations outside of my comfort zone, when I had to adapt my skills. We were also trained in how to deal with patients with infectious diseases, which gave me an understanding of how to handle these patients and use PPE.

“I was placed in Swiss Cottage Surgery for my GP placement, which helped me get to know the team before I joined. I’d been in my role for six months when the pandemic hit, so my experience at St George’s, and the skills I developed there, really helped me to adjust.”

“You are also adjusting day-to-day depending on what you are doing – you might be dealing with patients face-to-face, or you might be needed to give out vaccines, and the needs of your patients will vary. It can also be challenging dealing with patients over the phone rather than face-to-face. It’s quite a different way of working, but I do enjoy having this variety in my role.”

“At the beginning, we didn’t know what we were dealing with, but we’ve supported each other through everything, and it’s the good nature of the staff which has helped everything run so smoothly. Patients even comment on what a positive experience it is to visit us for their vaccine.”

- Raj Gill, Physician Associate -

Adapting to new developments

Raj, who is a Physicial Associate Partner at Swiss Cottage Surgery, explan how the team is responding to a constantly-developing situation: “We were given five days’ notice that they would be giving out the vaccine, so we needed to mobilise our workforce very quickly.

“We often find out what our next steps will be by listening to the news. This can be difficult, as we need to be very quick to respond to changes on that day, depending on what the latest announcement is. Adapting to new developments as we go can make it more of a challenge to handle communication with patients and manage expectations.”

Central Camden PCN covers a diverse population and Raj explains the varied responses to the vaccine: “Response to the vaccine has been very positive in communities where engagement with, and therefore trust in, their local GP is high. But in other areas, where patients are not as used to visiting a doctor, or they feel disenfranchised from their practices, there can be a greater reluctance to take the vaccine.

“We have found that attendance of patients aged 80 and above to vaccinations has been very good. This might be because members of this age group generally access their information via the news, or the radio.

“Sometimes, those who have access to information from a wide spectrum of sources can show more mistrust, because they’re exposed to misinformation – for example, on social media – and we have had to address these patients’ concerns and work harder to convince them that the vaccine is safe.

He added that another challenge is when patients fail to turn up for their vaccine. “We have a narrow window of time – 6 hours from when the vial is opened – to find another patient to vaccinate, so that the vaccine is not wasted. Some places are struggling with this, but we’re very lucky that we’ve not had a single dose wasted on our own site.”

A coordinated response

Raj explains that not long before the approval of the vaccine, the nine practices within the Central Camden PCN had already set up a coordinated flu programme, with bespoke portacabins for delivering the vaccine.

He says, “This is one of the reasons we were chosen as one of the first sites to administer the vaccine – because we were already set up to vaccinate people while having the correct measures in place to manage current restrictions. Our experience of handling the flu vaccines in this way (as well as the work we’d already undertaken in the first lockdown to put in place automated messaging to patients) meant that we were almost ready to go when we were asked to give the Covid-19 vaccine.”

There were, however, other factors to consider, such as how to store and handle the vaccine safely, marshalling patients to allow safe social distancing, and building in time to observe the vaccine patients for the required 15 minutes after vaccination.

Teamwork

Nasra and Raj comment that having such a large team has helped make the process more seamless. There are 11 PAs in the team, as well as a few volunteers. This has helped the clinic to be flexible with appointments and shifts, as well as managing to give around 45 vaccines an hour between the team. Raj adds, “We have a multidisciplinary team, and this has been a whole team effort, involving not just Physician Associates but also other staff including Pharmacists, Care Coordinators and Project Managers.”  

“At the beginning, we didn’t know what we were dealing with, but we’ve supported each other through everything, and it’s the good nature of the staff which has helped everything run so smoothly. Patients even comment on what a positive experience it is to visit us for their vaccine.”

Speaking about being at the forefront of the vaccine rollout, Raj says, “I feel a big responsibility to make this work. This isn’t just for our own patients - it has a much wider impact on society. It’s going to move the country forward and allow us to ease restrictions.”

Raj adds, “St George’s really pushes you to be the future leaders in Healthcare. I’ve taken that ethos into the workplace, when I started somewhere people didn’t know what a Physician Associate was, and I have had to help build an understanding of that role.”

“All of our PAs are also from St George’s, and we have students from the University, and they all come in with that can-do attitude. I really feel that St George’s instills in you a desire to take on new challenges and encourages you to think that there’s nothing you can’t achieve.”