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Don’t repeat the mistakes of Test and Trace by outsourcing the Covid-19 vaccine programme

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The news that Britain has become the first country in the world to approve the Pfizer/BioNTech coronavirus vaccine has understandably met with jubilation. After an incredibly difficult year, this is our shot at getting things back to normal.

One of the reasons there is so much riding on the vaccine is because our Test and Trace system has failed to allow even a partial return to normality.  

But this was not inevitable.  

Other countries, from South Korea to Germany, have used test and trace systems to supress virus transmission and allow them to safely reopen parts of their economies.  

The failure to replicate this in England arose because our test and trace system was simply not fit for purpose. Outsourcing Test and Trace to private contractors has caused huge problems, as has its centralised design, which too often by-passed public health experts.  

We cannot afford the same mistake to be made with the delivery of the vaccine. 

That’s why the TUC are today calling on the government to learn the lessons from Test and Trace’s failure by following five steps to ensure effective take up and delivery of the vaccine:  

1. Empower local public health teams to take the lead 

Local public health teams have consistently proven more effective at outreach than the centralised Test and Trace system – with contact rates of over 90% compared to 60% for services run by Serco. But they have been forced to make do with small and piecemeal amounts of money in comparison to the billions handed to Serco. 

Local directors of public health must be given a central role in co-ordinating the vaccination programme and not be marginalised like under Test and Trace. 

With the vaccine likely to require significant outreach work at community level, local public health teams must be given the funding they need to run large-scale vaccination programmes. 

2. Improve supply chains 

The NHS’s fragmented and privatised supply chains massively slowed down the supply of PPE to frontline staff during the first wave of the crisis.  

They also led to billions of pounds being spent on contracts with companies that had no experience of producing PPE, weren’t required to go through a competitive process, and regularly failed to deliver. It is therefore concerning that the government is intending to exempt vaccination transfer from the need for a wholesale dealer’s license, and thereby risk opening up vaccine supply chains to profiteering. 

To avoid a repeat of the delays and profiteering that beset PPE supply and distribution, ministers should favour using public fleets to transport vaccines wherever possible. 

3. Trained healthcare staff should administer the vaccine 

The effectiveness of Test and Trace has been hugely undermined by private companies drafting in non-healthcare staff with minimal training. 

Yet the government’s response to its consultation on vaccination has said it will “allow a wider range of trained personnel to administer COVID-19 or flu vaccines.” The commitment that “the new national protocol should include, where appropriate, the requirements for the supervision of an additional experienced vaccinator,” but it doesn’t go far enough.  

Any expansion in the groups of staff able to deliver vaccines should be overseen and organised by NHS organisations or local authorities. Partnership working with Trade Unions should be through the NHS Social Partnership Forum with the pay, terms and conditions of new recruits set in line with Agenda for Change rates as appropriate. 

Training non-health workers to give vaccines should be only a last resort, with options such as bringing health workers back from retirement considered first. 

4. Persuade and support people to get the vaccine 

The Test and Trace programme has not supported people to do the right thing. People are still not being given the level of sick pay they need to self-isolate and are then hit with large fines for not complying.  

We need a completely different approach when it comes to the vaccine, based on persuading people to take the vaccine and not forcing them to. 

Crucially, getting vaccinated must not be made a condition of employment or access to public services. And maximum compliance should be achieved through giving staff paid time-off to get vaccinated. 

5. Build public trust

A high level of engagement and compliance will be essential for the vaccination programme to be successful.

Trust and confidence in the vaccination system is most likely to be maximised by a system designed and led by public health professionals.  

Public health experts should lead on communications around vaccination roll out and the impact. This will help avoid the politicisation of announcements and ensure that public expectations are realistic. And there should be a public debate about who is prioritised for the vaccine.

To support these steps, sign the TUC’s petition calling for a vaccine programme led by public health professionals, not private contractors.  

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