‘The uptake and how people have reacted has been very positive’
GP surgeries are at the frontline of the Covid vaccination rollout as it moves onto more priority groups. Health correspondent Mark Smith this week spoke to staff at one South Wales surgery who are trying to keep pace with demand...
IT’S 2pm on Wednesday at Taff’s Well Medical Centre and the practice is a hub of socially-distanced activity.
A steady flow of masked-up patients are sat in the spacious waiting area eagerly anticipating their first dose of the coronavirus vaccine.
Behind the scenes two practice nurses have got a busy afternoon of appointments ahead of them, but take the time to greet each patient with a smile before they enter a medical room to be immunised.
Since January 8 the practice off Cardiff Road has vaccinated more than 1,300 people in the community from the top five priority bands set by the Joint Committee on Vaccination and Immunisation (JCVI).
They have made such good progress they are now onto group six – adults aged 16 to 65 years in an at-risk group – and are getting through between 150 and 200 patients a week.
Dr Ian Morris, who has worked at the GP practice for the best part of 17 years, said the rollout has worked well on the whole – but it has not been without its challenges.
“Our practice manager runs the whole [vaccination] process, we have one member of administration staff who rings the patients and books in appointments, and we then have two full-time nurses and a healthcare support worker on hand to vaccinate,” he explained.
“We’ve kept the afternoons pretty quiet so just Covid vaccine slots can take place. It makes it easier to socially distance in the waiting room. Then any nursing duties such as dressings, ECGs and bloods can be done in the mornings.
“They are coping with it quite well despite their increased workload, and they get a decent time per vaccination for any questions to be answered. It’s going well and we’ve been quite organised.”
Dr Morris, who was previously a GP in Tonyrefail for six years, said there has been very little in the way of vaccine hesitancy among his registered patients.
“The patients can’t get here quickly enough,” he added.
“I’d say there’s only been a handful who have refused to have their vaccine, and their reasons are still not clear – but it is a personal choice.
“There hasn’t been a big anti-vax crusade locally. You look at our surgeries and they are absolutely rammed with people wanting it.”
While he admits mass vaccination centres are better equipped for fast vaccine turnaround, Dr Morris said they are managing patient flow well in the circumstances.
Their current one-way system involves patients arriving through the main entrance, spending a few minutes in the waiting room for their name to be called, a short consultation before vaccination and then leaving through a side door after the jab is administered.
“The only issue we’ve really had is supply,” admitted Dr Morris.
“We had one week where we didn’t get any supply which was a disappointment, but since then we are getting pretty much what we want. It seems very efficient.”
Early on in the pandemic, he said the practice based on the outskirts of Rhondda Cynon Taf (RCT) was quick to adapt and had measures in place to keep potential Covid patients away from everyone else.
“In the first month or so there was an awful lot of concern and worry about patients with Covid coming into the surgery, so we set up a ‘contamination room’ which was previously a consultation room that no-one used,” he said.
“If a patient called up who was suspected of having Covid, they’d stay in the car, we’d bring them in through the back way and we’d go straight into the contamination room. They were then seen by one doctor and the whole room was cleaned down afterwards. So they were not in reception or the waiting room.
“We have even examined people in their cars. Some had oxygen saturation levels that were quite low so they were sent straight into hospital.
“I have been concerned for my own family’s safety, taking the virus home and infecting them with it. But we have had excellent supplies of PPE [personal protective equipment] from the very start, so we’ve felt pretty well controlled and covered.”
Like many parts of the country, there has been a reluctance among patients to visit their GP surgery for routine and non-Covid related medical problems.
In the weeks and months ahead, Dr Morris has a genuine concern about the volumes of patients he and his partners may encounter.
“We believe many have kept medical conditions to themselves and we are worried there’s going to be a flood of patients coming in who’ve had symptoms for many months,” he said.
He added that “long Covid”, diagnosed when people have symptoms for more than 12 weeks, is already taking up much of his time and will continue to do so.
“Long Covid will be as busy for us as Covid. Already our day-to-day consists of patients who had the virus three or four months ago and are still quite symptomatic – the main ones being very low energy levels, breathlessness, joint pains and headaches.
“I think some hospitals are talking about setting up long Covid clinics. There will need to be physicians dedicated to this condition [to ease the burden on primary care].
“Another problem will be patients who think they have long Covid but they could have some other medical problem. They need to come to their GP to have other things ruled out.
“Referrals are going to be a nightmare.”
He concluded that the way GP surgeries operate on a day-to-day basis will change forever – many for the better – as a result of the pandemic.
“Post-Covid a normal surgery will include some email consultations, some telephone consultations, some virtual – which we’d never done before – and some face-to-face. It’ll be a mix, and I think that will probably suit patients.
“If you have 18 people all sitting in the waiting room getting more and more annoyed it’s a bit frustrating. If you are a working person why should you need to leave the office for an appointment and miss hours of work?”
Bethan Jones, a senior practice nurse at the medical centre for the past six years, said her patients had been “very keen” to have the vaccine as soon as possible and were constantly chasing up potential appointments.
“It’s busier than it would normally be, because we’re trying to do everything all at once, but we’re a pretty good team and we’ve mucked in and helped each other out,” she said.
“I’ve only had one or two patients who’ve had concerns and have wanted to chat prior to their vaccination. Everyone else has been very keen.
“The uptake and how people have reacted has been very positive and most are excited to be receiving it.”
As a nurse, she said the welfare of her patients was always put before herself – even when the first cases began to arrive in the area.
“We had all the safety procedures in place and we were fully kitted out in PPE. I don’t think I genuinely came into work feeling unsafe.”
Bethan said she feels there is now a “light at the end of the tunnel” as the vaccine rollout continues to be ramped up. Latest figures from Public Health Wales show that close to 890,000 people have had their first dose and nearly 70,000 their second.
One of the patients who was ready and willing to be vaccinated on Wednesday afternoon was Taff’s Well resident Jan Stephens, 66.
“I was pleased to be called. I was taking on board all the positive information coming in from the television, newspapers and online about the vaccine and I was keen when my time came,” she said.
“I think the overriding emotion is relief. I know I’m now on the road to being safe, and that also means keeping my friends and family safe and my immediate community.”
Jan said she was “very lucky” to have managed throughout the pandemic with a garden to keep her busy and a lovely family by her side.
“There will be a time when we can come out of lockdown and do other things, so that’s we’re all working towards together. I think it’s very important to take the vaccine. For those who don’t want to we’ll have to work harder to keep them safe.”
Meanwhile across Cwm Taf Morgannwg University Health Board, six community vaccination centres will open in Bridgend, Maesteg, Llantrisant, Ystrad, Mountain Ash and Merthyr from March 1. A seventh is opening in Aberfan at the end of March.
They will begin by administering dose two for health and social care workers and people aged 70 to 74.
The health board is reminding people to bring their appointment letters with them, their vaccination card and ID.
When the vaccination centres have finished second doses, they will begin inviting priority groups 7, 8 and 9 for their first doses.
A spokesman said: “GPs are contacting groups 5 and 6 for them to have their vaccines at their own surgery. There is no need for you to contact your GP practice as they are working through their patient lists as quickly and as safely as possible and will be in touch with you.
“The health board’s frontline staff are receiving their second doses in the hospital vaccination centres, and the health board’s mobile vaccination teams are revisiting care homes for older adults across Cwm Taf Morgannwg offering residents and staff second doses.”