Calls to return the delivery of essential vaccination services to GP practices have been issued following increasing concerns the current programme is “not fit for purpose”.
Highland GPs are calling for a u-turn on the new vaccine delivery system – which saw the responsibility of vaccination services shift from local practices to the Health Board
The Vaccination Transformation Programme (VTP) saw responsibility for vaccines transferred to health boards, with Highland GP practices delivering the last vaccines to children in February 2023.
Recent data shows a drop in the uptake of vaccines across the region and Dr Ross Jaffrey, a Beauly GP and cluster quality lead for seven practices across the surrounding area, has written in a new report that the current model “is failing to provide effective vaccination uptake for children and eligible flu groups”.
His report states that MMR uptake in Highland for children aged six has dropped to 85 per cent from above 91 per cent before September 2022 – falling to 71 per cent (compared to 85 per cent pre-VTP) in the most deprived areas.
“We are now open to historical long forgotten childhood illness”, Dr Jaffrey said.
Beauly GP Dr Ross Jaffrey. Picture: Callum Mackay..
“There are currently record numbers of cases of whooping cough in the Highlands, where last year saw Scotland’s first infant pertussis (whooping cough) death since 2014. “
The report also highlights how uptake figures for the flu vaccine in “at risk groups” are down almost 50 per cent from 2022/23 in Scotland (from almost 57 per cent in 2022 to just over 33 per cent in 2024).
In the Highlands, the overall uptake has fallen from 64 per cent in 2022 to 53 per cent in 2024.
A drop in uptake among healthcare workers is also mentioned, dropping to less than 30 per cent in 2024.
Dr Jaffrey said that he faced a three-month wait trying to book his own vaccine slot in early October.
“Cancelled clinics, and little flexibility to change appointments makes access a challenge,” he said.
“Even the most motivated are finding this new process difficult,“ he said.
NHS Highland Healthcare workers flu vaccine uptake. Graph by: Dr Ross Jaffrey.
Costs of the VTP model have also been reported as much higher (in excess of £6 million) than the previous system, when GPs provided the service for £1.5m.
Inverness and Nairn MSP Fergus Ewing backed the report, saying essential vaccination services “should be restored to Highland GPs without further delay”.
He said: “Dr Jaffrey’s report is the latest of very serious warnings to the local health board and the Scottish Government health minister.
“I have met the health minister, raised the matter at First Minister’s Questions, repeatedly written to them warning of this since 2022.
Inverness and Nairn MSP Fergus Ewing (SNP).
“I have even asked the Lord Advocate to intervene to act now, rather than wait for another fatality to occur. I did so following the death of an infant through pertussis.
“The inactivity is beyond irrational. It shows that there is a total failure to heed the repeated warnings from local Health Practitioners, the eyes and ears of public health in Scotland. It amounts to a kind of stasis – a total failure to take the actions clearly necessary to protect public health.”
He concluded saying he will raise the issue at Holyrood during a debate on Rural Health this Thursday.
Former Nairn GP Alastair Noble said the new delivery system has been a “total disaster”.
He said: “This goes back to the Inverness Courier’s SNP leadership hustings in March 2023 when I asked the candidates (former First Minister and then health secretary) Humza Yousaf; Kate Forbes and Ash Regan if they wanted to be the First Minister that oversees the reintroduction of infectious diseases like Polio and Meningitis to infants in the Highlands?
Alastair Noble, Chair of Nairn West Community Council. Picture: James Mackenzie
“This issue was raised then, and here we are still trying to get it sorted out.
“We have to prioritise general practices and integrated social care teams. What we need is an integrated system – one that surrounds and helps those patients and parents most in need of support.
“This 2018 contract has been an absolute disaster for Highland infants, patients and GP Practices. It has to be changed.
“In Nairn, we have the skills, expertise and facilities. We have to prioritise General Practices and integrated social care teams. What we need is an integrated system – one that surrounds and helps those patients and parents most in need of support.”
A spokesperson for NHS Highland said: “Rates of vaccination have been falling both locally and nationally and we have been working with Public Health Scotland and Scottish Government to improve our local performance.
“The most recent local uptake figures for infant vaccinations have shown some improvements and our level of influenza and Covid vaccinations are similar to national rates.
“We have been encouraging uptake of winter vaccination and would ask those eligible who have not yet taken up the offer to come to a vaccination clinic. Drop-in clinic availability is on the NHS Highland website.
“We recognise that it has been difficult to implement this change efficiently and effectively across the large geography of NHS Highland. We have therefore been working closely with colleagues in general practice to develop options for the delivery of vaccination from practices where that would be most appropriate. We have submitted a proposal for this at a national level and we are awaiting a response.”