Recommendations & Conclusions
31 items
2
Recommendation
Forty-Third Report - COVID-19: Planning…
Not Addressed
Despite BEIS’s confidence, concerns remain over the vaccine supply chain. Under the Government’s ambitious plans, everyone who wants a vaccination should be able to have one by Autumn 2021. This will depend on continuing vaccine supply. Whilst BEIS asserts that the UK has access to more doses than it likely …
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Despite BEIS’s confidence, concerns remain over the vaccine supply chain. Under the Government’s ambitious plans, everyone who wants a vaccination should be able to have one by Autumn 2021. This will depend on continuing vaccine supply. Whilst BEIS asserts that the UK has access to more doses than it likely needs if they all work, NHSE&I is less certain when the doses will arrive. BEIS holds detailed supply schedules up to the end of February 2021 but until recently NHSE&I was only able to provide vaccination sites with supply schedules one week in advance. There have been conflicting statements about vaccine supply. BEIS is unequivocal that supply will not be a constraint in meeting the Government’s 15 February target and on current numbers this appears to be on track. The Department is confident that, through its investment of £302 million, of a potential £519 million, in the UK’s manufacturing capacity, the UK could manufacture all the vaccine doses that it might need should this contingency be required. Yet on the same day we took evidence the Secretary of State for Health and Social Care stated that supply of the vaccine is the ‘rate limiting factor’ for deployment plans. 1 Latest figures can be found at: https://coronavirus.data.gov.uk/details/vaccinations 6 COVID-19: Planning for a vaccine Part 1 Recommendation: BEIS should, by the end of February 2021, write to the Committee with its assessment of the risks within the vaccine supply chain and a plan to proactively address these to ensure sufficient doses of vaccine are available through to Autumn 2021.
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Government response AI summary
The government response does not address the recommendation regarding an assessment of vaccine supply chain risks and a plan to address them.
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HM Treasury
3
Recommendation
Forty-Third Report - COVID-19: Planning…
Not Addressed
BEIS has worked quickly to secure access to vaccines but could have been more transparent about how decisions have been made. Transparency is essential to maintain public confidence and ensure taxpayers’ money is being well spent. BEIS has managed significant uncertainty and worked at pace to purchase vaccines, but it …
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BEIS has worked quickly to secure access to vaccines but could have been more transparent about how decisions have been made. Transparency is essential to maintain public confidence and ensure taxpayers’ money is being well spent. BEIS has managed significant uncertainty and worked at pace to purchase vaccines, but it could have been more transparent about how key decisions were made. The Chair of the Taskforce was appointed directly by the Prime Minister. While we recognise that a full competition was not an option at the height of the pandemic our witnesses could not explain why she was chosen or the reasoning behind the appointment which appears to be a personal decision by the Prime Minister. Transparency and openness about such key appointments is important and helps hold decision makers to account.) Almost a fifth of the 200 individuals on the Taskforce have recorded at least one conflict of interest although most are minor. To ensure the UK could access vaccines once they were approved, BEIS has made £914 million worth of upfront payments to enable pharmaceutical companies to start manufacturing vaccines at scale, but this could be lost if the vaccines are not approved. It has also agreed to provide each pharmaceutical company with broad ranging indemnity cover against adverse effects arising from their vaccine. In evidence witnesses were clear that had the indemnities not been provided this would have put the UK behind other countries in securing vaccines. Recommendation: BEIS should, by the end of March 2021, review its decisions about how to invest taxpayers’ money and its appointments processes to identify what it would repeat and what it will change in future. As part of this, BEIS should examine its experience of using the Taskforce model to inform its own and government’s future skills requirements and to ensure accountability arrangements are robust. BEIS should, by the end of April 2021, lay out its learning so the rest of government can improve the
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Government response AI summary
The government response does not address the recommendation for BEIS to review its investment decisions, appointment processes, and the use of the Taskforce model.
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HM Treasury
4
Recommendation
Forty-Third Report - COVID-19: Planning…
Not Addressed
DHSC, NHSE&I and PHE will continue to face significant challenges in making sure they can get the vaccine to the right people at the right time. Each vaccine will require different plans for deploying because each has different characteristics. Getting the vaccine to the right place to allow it to …
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DHSC, NHSE&I and PHE will continue to face significant challenges in making sure they can get the vaccine to the right people at the right time. Each vaccine will require different plans for deploying because each has different characteristics. Getting the vaccine to the right place to allow it to be administered is challenging. For example, the Pfizer Inc and BioNTech SE vaccine must be stored at -70°c, whereas the vaccine developed by the Astra-Zeneca Ltd—University of Oxford partnership can be stored at between 2°c and minus 8°c. BEIS considered the logistics of deployment as part of deciding which vaccines to purchase but prioritised whether the vaccine itself would work. Despite these challenges, 97.3% of vaccine deliveries so far have been made on-time and in full. The Former Chair of the Taskforce explained that the MHRA had compressed parts of the process while ensuring the efficacy and safety of the programme. NHSE&I is working to ensure any surplus vaccines are redistributed to those areas most in need and is using large vaccination sites and community pharmacies to help smooth distribution at a local level. NHSE&I is COVID-19: Planning for a vaccine Part 1 7 confident that it has in place the workforce it needs to meet its 15 February target, with around 80,000 people trained and ready to administer vaccines. Convenience and location of vaccine centres will be important in encouraging people to take up the offer of a vaccine, particularly in hard to reach groups. We were informed that 21 mobile army units of 101 Logistics Brigade were deployed. Local GPs and community leaders will play a crucial role in making sure people are willing and able to take up the offer of a vaccine and PHE has committed to working with local government to ensure that no community gets left behind. Recommendation: By the end of February 2021 DHSC, NHSE&I and PHE should write to us with their assessment of the main challenges and risks to the ongoing deployment of the vaccine pro
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Government response AI summary
The government's response is a non-sequitur, referring to HM Treasury's breach of capital expenditure rather than providing an assessment of vaccine deployment challenges and risks as requested.
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HM Treasury
5
Recommendation
Forty-Third Report - COVID-19: Planning…
Accepted
There is a risk that NHSE&I and DHSC’s plans for the vaccine programme will not meet public expectations. NHSE&I recognises that its goal to vaccinate the first four priority groups by 15 February is a huge task which it appears to be on track to deliver. As no-one can be …
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There is a risk that NHSE&I and DHSC’s plans for the vaccine programme will not meet public expectations. NHSE&I recognises that its goal to vaccinate the first four priority groups by 15 February is a huge task which it appears to be on track to deliver. As no-one can be forced to have the vaccination, NHSE&I will determine the programme’s success based on the number of people offered a vaccine rather than the number of people who are vaccinated. The daily vaccination totals published by government, however, are based on the number of vaccines administered, not offers made. We are concerned that using these could create confusion among the public about progress with the vaccine programme. NHSE&I has lengthened the time between individuals’ first and second doses of the vaccine from 3 to 12 weeks. It asserts that this delay is not linked to the introduction of new lockdown measures, but “basic maths” that it is better to have more people with single dose protection than a smaller number with double dose protection. NHSE&I currently expects around 25% of people will not take-up the offer of a vaccination but is hopeful that actual take-up rates will be higher. We are nonetheless concerned about how vaccines will be deployed across parts of the country with different age demographics, local need and people with vulnerabilities. NHSE&I recognises that there is a trade-off between equity of access and the speed of deployment and that it cannot allow one part of the country to race ahead of another. Recommendation: NHSE&I and DHSC need to immediately set out in detail what they are planning to achieve so the public has a better understanding of what the daily progress reports mean in practice. It should clearly set out: the definition of ‘vaccinated’ and ‘offered a vaccination’; and expected take up rates across both doses and across different cohorts, for example by age and ethnicity. Progress should also be reported at local, regional, devolved and UK levels in a consi
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Government response AI summary
The government agrees with the recommendation, stating it has already implemented it by publishing the Covid-19 Vaccine Delivery Plan and the COVID-19 Vaccine Uptake Plan, and provides clear daily and weekly data, including breakdowns by age, region, ethnicity, and cohort.
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HM Treasury
6
Recommendation
Forty-Third Report - COVID-19: Planning…
Accepted
Public confidence in the vaccine programme is crucial to its success yet some members of the public and health professionals were confused by the messaging about when and how people can access a vaccine. The number of people who choose to have the vaccine will ultimately be determined by public …
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Public confidence in the vaccine programme is crucial to its success yet some members of the public and health professionals were confused by the messaging about when and how people can access a vaccine. The number of people who choose to have the vaccine will ultimately be determined by public trust in the vaccines. Clear communication is essential to enable the public, Parliament and health professionals understand what is going on within the vaccination programme, but is challenging because the situation is evolving so rapidly. We have previously found that a lack of information during the pandemic, or repeatedly changing and 8 COVID-19: Planning for a vaccine Part 1 updating guidance, can be confusing and frightening for those affected. NHSE&I had not yet developed a Frequently Asked Questions section for its website at the time of our evidence session nor has it put in place a rebuttal unit to deal with negative publicity or fake reporting about the vaccines. NHSE&I acknowledges it needs to be vigilant about the potential for fraudsters to take advantage of the more vulnerable in society in offering fake vaccines. Recommendation: NHSE&I and DHSC need to immediately develop clear and straightforward communication, including comprehensive FAQs, to help the public navigate the constantly changing situation. This should be publicised to the public and those who can help inform the public such as GPs, Clinical Commissioning Groups and MPs, as well as setting up a unit to quickly rebut false claims about the vaccines. COVID-19: Planning for a vaccine Part 1 9 1 Part 1 – Securing the UK’s access to potential vaccines
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Government response AI summary
The government agrees with the recommendation and states it has already implemented it, detailing ongoing efforts in clear public communication, provision of information on NHS.UK and GOV.UK, sharing FAQs with partners, and establishing cross-government units to counter misinformation.
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HM Treasury
1
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department for Business, Energy and Industrial Strategy (BEIS), the Department of Health and Social Care (the Department), NHS England and NHS Improvement (NHSE&I), Public Health England (PHE) and the former Chair of the …
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On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department for Business, Energy and Industrial Strategy (BEIS), the Department of Health and Social Care (the Department), NHS England and NHS Improvement (NHSE&I), Public Health England (PHE) and the former Chair of the Vaccine Taskforce, on the government’s preparations for potential COVID-19 vaccines.2 The evidence session took place on the 11 January, our report is based on the evidence that we took at the time.
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Government response AI summary
The government response refers to an unrelated PAC conclusion about BEIS's expenditure, completely failing to address the committee's introductory statement about the basis of its report.
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HM Treasury
7
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
BEIS created a Vaccines Taskforce (the Taskforce) in April 2020 to support the research and development of potential vaccines, select which vaccines to purchase, secure the UK’s 7 Committee of Public Accounts, CPVID-19: Supply of Ventilators, HC 685, 25 November 2020 8 Q 33, C&AG’s Report, para 20–21, 3.8–3.10 9 …
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BEIS created a Vaccines Taskforce (the Taskforce) in April 2020 to support the research and development of potential vaccines, select which vaccines to purchase, secure the UK’s 7 Committee of Public Accounts, CPVID-19: Supply of Ventilators, HC 685, 25 November 2020 8 Q 33, C&AG’s Report, para 20–21, 3.8–3.10 9 Q 33, C&AG’s Report, para 10, 1.6 10 C&AG’s Report, para 16, 2.5 11 Qq 42–43 12 Q 43 13 Qq 47–49, C&AG’s Report para 17, 2.8–2.9 COVID-19: Planning for a vaccine Part 1 11 access to sufficient quantities of vaccines, and develop manufacturing capacity to ensure supply.14 It explained that creating the Taskforce allowed it to very quickly give a potential vaccine the senior focus, governance and skills needed to respond to the pandemic.15 The Taskforce consists of pharmaceutical industry experts, academics and civil servants from across government. At December 2020, the Taskforce had 201.7 full-time equivalent staff, including 79.9 full-time equivalent staff recruited from outside the civil service. We asked how BEIS was ensuring that it was able to keep hold of, or ensure access to, the skills and expertise it needed. It responded that to date it had not encountered any problems with this as the best way to motivate and retain people was to give them something that really mattered to work on and the issues the Taskforce was dealing with was the “absolute No.1 national priority”.16
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Government response AI summary
The government response reiterates the committee's description of the Vaccines Taskforce's creation and purpose, and does not provide new information or address the committee's implicit query about retaining skills and expertise.
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HM Treasury
8
Conclusion
Forty-Third Report - COVID-19: Planning…
Accepted
The Chair of the Taskforce took up the unpaid post in May 2020. The Chair was appointed by, and reported directly to, the Prime Minister until the term expired at the end of 2020.17 We asked the former Chair about criticisms of their appointment and their potential political connection. The …
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The Chair of the Taskforce took up the unpaid post in May 2020. The Chair was appointed by, and reported directly to, the Prime Minister until the term expired at the end of 2020.17 We asked the former Chair about criticisms of their appointment and their potential political connection. The former Chair told us that they had been clear at the outset that they were not a vaccines expert and that their experience was in “taking novel science and turning those into therapeutics”.18 They explained that, in essence, this meant demonstrating that treatments were effective and safe, ensuring they could be manufactured, and in getting the regulatory approvals needed so that they could be administered . They noted that there were other vaccine experts available, and others may have been better qualified, but that their “venture capital skillset and biotech mindset” had been what was needed for the Taskforce.19 We noted that in a pandemic it was not necessarily possible to undertake a full-recruitment process, but asked whether there should have been more discussion about, or others should have been involved in, the appointment of the Chair. The former Chair told us that they were not privy to what process took place. BEIS similarly told us that it was not privy to the process for this specific appointment and that, in non-emergency circumstances, it would still expect to undertake a normal recruitment process.20
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Government response AI summary
The government agrees with the committee's observations, stating BEIS has considered its decision-making and appointments processes, implemented improvements for robust decision-making, and will consider replicating these improvements and sharing lessons learned with other departments.
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HM Treasury
9
Recommendation
Forty-Third Report - COVID-19: Planning…
Accepted in Part
Our report on Government’s procurement and supply of personal protective equipment during the pandemic found that a failure to be transparent had opened up Government to accusations of poor value for money, conflicts of interest and preferential treatment of some suppliers, and risked undermining public trust in government procurement and …
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Our report on Government’s procurement and supply of personal protective equipment during the pandemic found that a failure to be transparent had opened up Government to accusations of poor value for money, conflicts of interest and preferential treatment of some suppliers, and risked undermining public trust in government procurement and the use of taxpayers’ money.21 BEIS recognised that the involvement of a range of different people being brought in to support government’s decisions created the potential for conflicts of interest. BEIS and the Taskforce share a register of conflicts of interest between their HR Department and Programme Management Office each week. By December 2020, 38 individuals within the Taskforce had registered at least one conflict of interest.22 We asked the Departments how they were ensuring that conflicts of interest were properly managed. Both the Department and BEIS explained that their approach 14 Qq 99, 112, C&AG’s Report, para 2, 1.1, 3.1–3.2 15 Qq 99–100, 116–117 16 Qq 101–102, C&AG’s Report para 3.1–3.5 17 Qq 109–110, C&AG’s Report, para 3.11 18 Qq 110–114, 118–121 19 Q 109 20 Qq 110–111, 117 21 Committee of Public Accounts, COVID-19: Government procurement and supply of personal protective equipment, HC 928, 10 February 2021 22 Q 106, C&AG’s Report, para 3.7 12 COVID-19: Planning for a vaccine Part 1 was the same as for any other area of their work and that they had standard procedures in place to deal with conflicts of interest.23 BEIS told us that the majority of the conflicts of interests within the Taskforce were attributable to members of staff who had been brought in from the private sector, but that in most cases the potential conflicts of interest were small. It explained that it had needed to scale up its business-as-usual conflicts of interest system to deal with the quantity of people coming in, but that this was “not particularly because they have been more conflicted that usual, but because there have been more of the
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Government response AI summary
The government agrees with the implied recommendation on transparency and conflicts of interest, outlining process improvements for decision-making, expert appointments, and managing conflicts within the Taskforce, while committing to future consideration of replicating these improvements and reporting lessons learned by April 2021.
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HM Treasury
10
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
We asked what premium the UK had paid for its access to the vaccines and their development at speed. BEIS asserted that the UK had not paid any premiums for access to the vaccines, as at the time the contracts were signed it was not possible to know what the …
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We asked what premium the UK had paid for its access to the vaccines and their development at speed. BEIS asserted that the UK had not paid any premiums for access to the vaccines, as at the time the contracts were signed it was not possible to know what the final costs would be, but that it had secured access to the vaccines by negotiating “quickly and early”.26 On the issue of the price of vaccines in future, it expected that its negotiating position would improve over time as more vaccines were approved and available.27 Of those signed by December 2020, the UK’s contracts with pharmaceutical companies included: Astra Zeneca UK Limited and the University of Oxford for 100 million doses, signed in August 2020; Pfizer Inc and BioNTech SE for 40 million doses, signed in October 2020; and Moderna Inc for 7 million doses, signed in November 2020.28 BEIS told us that, since the NAO report, it had signed contracts to provide access to a further 10 million doses to the vaccine produced by Moderna Inc.29 We asked how Departments and the Taskforce had determined the doses they would need for each vaccine and why the UK had ordered such different quantities of the different vaccines. The former Chair of the Taskforce told us that this had been based on advice from the Joint Committee on Vaccination & Immunisation that it should look to vaccinate 30 million people in the high priority groups one to nine, equivalent to needing to secure access to 60 million doses if two doses were needed. They explained that the differences in the quantities ordered from manufacturers was a combination of the number of doses available and when those doses were expected.30 DHSC policy is to vaccinate the entire population of the UK against Covid-19.
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Government response AI summary
The government response is a verbatim, truncated repetition of the committee's conclusion, providing no further information on vaccine procurement prices or quantities.
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HM Treasury
11
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
In response to our questions about whether the UK now had access to enough doses of vaccine or would need to go back to buy more from other suppliers, the former Chair of the Taskforce told us that the “we have more doses than we are likely to need, if …
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In response to our questions about whether the UK now had access to enough doses of vaccine or would need to go back to buy more from other suppliers, the former Chair of the Taskforce told us that the “we have more doses than we are likely to need, if they all work”.31 BEIS confirmed that was “absolutely confident” that supply would not be a constraint in achieving the mid-February target, even if take-up rates were higher than 23 Qq 103, 105–6 24 Q 106 25 Q 107 26 Q 29 27 Q 34 28 C&AG’s Report, para 2.2 29 Qq 32, 73 30 Q 30 31 Q 31 COVID-19: Planning for a vaccine Part 1 13 expected.32 BEIS explained that it was too early to say what would happen to any surplus doses as it depended on whether all those it had access to were approved for use, and what happened during the roll-out of the vaccines. It confirmed that it had, however, tried to ensure as much flexibility as possible in its contracts with pharmaceutical companies to allow it not to take-up vaccines or to consider alternative options.33
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Government response AI summary
The government response reiterates the committee's observation that the UK has more vaccine doses than likely needed if all work, but does not provide its own specific update or position.
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HM Treasury
12
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
On 11 January 2021, the Secretary of State of Health and Social Care stated that “the supply of the vaccine is currently the rate limiting step”.34 NHSE&I recognised that ensuring everyone who wants a vaccination can have one by Autumn 2021 will depend on continuing vaccine supply.35 Given this, we …
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On 11 January 2021, the Secretary of State of Health and Social Care stated that “the supply of the vaccine is currently the rate limiting step”.34 NHSE&I recognised that ensuring everyone who wants a vaccination can have one by Autumn 2021 will depend on continuing vaccine supply.35 Given this, we asked why Government did not yet have a timetable for when vaccines would be delivered. The former Chair of the Taskforce told us that, as part of procuring the vaccines, it had agreed a timetable for the expected supply of vaccines, but that this had taken place before the manufacturing of the vaccines had been fully scaled-up. BEIS confirmed that it was working daily with suppliers and had detailed schedules for the supply of vaccines until the end of February, and was “increasingly confident” about the schedules for March.36
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Government response AI summary
The government response is a verbatim, truncated repetition of the committee's conclusion, offering no additional information on vaccine supply timetables.
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HM Treasury
13
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
Manufacturing the vaccines is the responsibility of pharmaceutical companies. In order to ensure that vaccines can be provided quickly to the UK and reduce the risks to its supply of the vaccine, BEIS calculated that it needed to invest £519 million to provide manufacturing capacity for producing the vaccines within …
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Manufacturing the vaccines is the responsibility of pharmaceutical companies. In order to ensure that vaccines can be provided quickly to the UK and reduce the risks to its supply of the vaccine, BEIS calculated that it needed to invest £519 million to provide manufacturing capacity for producing the vaccines within the UK. By 8 December 2020, it had committed £302 million to manufacturing projects, including: £127 million to the Cell and Gene Therapy Catapult Manufacturing Centre; £93 million to the Vaccine Manufacturing and innovation Centre; and £42 million to fill and finish facilities. BEIS told us it was confident that, if it needed to, the UK now had sufficient capacity, and a full contingency, to manufacture all the vaccine doses that it might need.37 32 Qq 71–72 33 Q 32 34 Health and Social Care Secretary’s statement on coronavirus (COVID-19), 11 January 2021 35 Qq 5, 22 36 Qq 70–71 37 Qq 45–46, C&AG’s Report, para 18, 2.14–2.15 14 COVID-19: Planning for a vaccine Part 1 2 Part Two – Deploying the vaccines
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Government response AI summary
The government response is a verbatim, truncated repetition of the committee's conclusion, providing no further details or updates on vaccine manufacturing capacity.
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HM Treasury
14
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
Government plans to have offered a first vaccine dose to everyone in the top four priority groups identified by the Joint Committee on Vaccination and Immunisation by 15 February. This includes: all residents in a care home for older adults and their carers; all those 80 years of age and …
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Government plans to have offered a first vaccine dose to everyone in the top four priority groups identified by the Joint Committee on Vaccination and Immunisation by 15 February. This includes: all residents in a care home for older adults and their carers; all those 80 years of age and over and frontline health and social care workers; all those 75 years of age and over; and all those 70 years of age and over and clinically extremely vulnerable individuals; and is equivalent to around 12.2 million people.38 In January 2021, the Government announced that it would likely take until spring to offer the first dose of the vaccine to the remaining priority groups, equivalent to around 27 million people in England. It planned to offer a vaccine to the remaining adult population by the autumn.39
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Government response AI summary
The government response is a verbatim, truncated repetition of the committee's conclusion, failing to engage with its content regarding vaccine rollout targets.
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HM Treasury
15
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
We asked NHSE&I whether the timetable for the roll-out of the vaccine was realistic, and how fast it could reach those groups on the priority list. NHSE&I told us that over the first three weeks of the programme, it had administered around 1.1 million doses across the country. and that …
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We asked NHSE&I whether the timetable for the roll-out of the vaccine was realistic, and how fast it could reach those groups on the priority list. NHSE&I told us that over the first three weeks of the programme, it had administered around 1.1 million doses across the country. and that the speed of vaccinations had tripled over the last week, with 1.2 million vaccinations, meaning that 2.3 million vaccinations had now been administrated in England and 2.5 million across the UK.40 As of [date] over [10] million had been delivered. We commended the progress that had been made to date, but noted that there was still a huge amount of work to do to meet the government’s target. NHSE&I expected the number of vaccinations to further accelerate in the coming weeks as supply of the vaccines increased and confirmed it was on course to have offered a vaccine to everyone in the first four priority groups by 15 February as planned.41
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Government response AI summary
The provided government response is truncated and merely repeats the committee's observations about the vaccine roll-out without addressing them or offering any new information.
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HM Treasury
16
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
NHSE&I is planning its deployment of vaccines in the face of high levels of uncertainty because information about the COVID-19 vaccines is still changing. It needs to keep its plans under review to ensure it can respond to the latest information about which vaccines have been approved, which groups in …
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NHSE&I is planning its deployment of vaccines in the face of high levels of uncertainty because information about the COVID-19 vaccines is still changing. It needs to keep its plans under review to ensure it can respond to the latest information about which vaccines have been approved, which groups in society need to be vaccinated, how many doses will be available, and when and how those vaccines will need to be deployed. The NAO found that it remained uncertain whether the vaccination programme would need to take place more regularly, for example becoming an annual programme.42 We asked Departments whether they now thought than an annual vaccination programme would be needed. BEIS confirmed that it was considering this, but that it was not an urgent or critical question at present as it had “plenty of doses to be getting on with, not only for this year, but likely for next year as well”.43 It explained that while it had needed to work at speed for the current programme, it expected to be able to take time to “survey the field” and plan for any future annual vaccination programme.44 In response to our questions about when these decision would need to be made, BEIS told us “not for a while”.45 The Department explained that plans for the vaccination programme in future will also depend on how the virus develops and any new variants, and it would respond as information became available.46 38 Q 17–18, Department of Health and Social Care, UK COVID-19 vaccines delivery plan, 13 January 2021 39 Qq 5, 19, Department of Health and Social Care, UK COVID-19 vaccines delivery plan, 13 January 2021 40 Qq 3, 8, 18 41 Qq 3–4, 6, 16, 22 42 Q 37, C&AG’s Report, para 5, 28, 4.13–14 43 Q 33 44 Qq 33, 36 45 Qq 35–36 46 Qq 37–38 COVID-19: Planning for a vaccine Part 1 15
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Government response AI summary
The government response is a verbatim, truncated repetition of the committee's conclusion, offering no specific updates on plans for an annual vaccination programme or response to changing vaccine information.
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HM Treasury
17
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
Decisions about who will be vaccinated were taken by the Secretary of State for Health and Social Care, as is the case with all vaccination programmes, based on advice from the Joint Committee on Vaccination and Immunisation.47 The Joint Committee identified nine priority groups for the first phase of vaccinations …
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Decisions about who will be vaccinated were taken by the Secretary of State for Health and Social Care, as is the case with all vaccination programmes, based on advice from the Joint Committee on Vaccination and Immunisation.47 The Joint Committee identified nine priority groups for the first phase of vaccinations to maximise the effectiveness of the programme and prevent further deaths from COVID-19. These groups were predominantly based on age in light of evidence that this was the single greatest risk of mortality from COVID-19. When the groups were announced, the Joint Committee recommended that the second phase of the vaccination programme should focus on preventing further hospitalisation and acknowledged that vaccinating those at increased risk of exposure due to their occupation could also be a priority.48 In its written evidence to us, the Nuffield Council on Bioethics told us that it would be important that Governments were transparent about their prioritisation strategies for delivering vaccines and good communication about the values, evidence and criteria behind those decisions would be key.49 We also received written evidence from JKS Bioscience Limited, which told us that, as well as older people, the vaccine programme should prioritise: medical staff and care staff; school teachers and staff; University students, staff and researchers; and workers and consumers.50
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Government response AI summary
The government response is a verbatim, truncated repetition of the committee's conclusion, providing no new information on vaccine prioritisation decisions or advice.
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HM Treasury
18
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
We asked what progress had been made in identifying who would be prioritised in the next phase of the vaccine programme and whether those in key services, for example education, transport and those working in supermarkets, would be given priority. NHSE&I told us that, while these were decisions for Ministers …
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We asked what progress had been made in identifying who would be prioritised in the next phase of the vaccine programme and whether those in key services, for example education, transport and those working in supermarkets, would be given priority. NHSE&I told us that, while these were decisions for Ministers and the Joint Committee, it thought that there was a strong case for asking the Joint Committee to consider specific groups, particularly teacher and other key workers, once the first priority groups had been vaccinated.51 The Department explained that, to support those decisions, it would be important to know more about the extent to which the vaccines stop the transmission of the virus, as well as the extent they stop people getting sick and how long protection from the vaccines lasts.52 Getting the vaccines to the right people at the right time
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Government response AI summary
The government response is a verbatim, truncated repetition of the committee's conclusion, failing to address the content or provide an update on vaccine prioritisation.
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HM Treasury
19
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
Each potential vaccine will require different plans for deploying it to the public because each vaccine has different characteristics. This includes the temperature vaccines need to be stored at, their shelf-life once open, and any preparatory work needed before they are administered.53 The Pfizer Inc and BioNTech SE vaccine, for …
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Each potential vaccine will require different plans for deploying it to the public because each vaccine has different characteristics. This includes the temperature vaccines need to be stored at, their shelf-life once open, and any preparatory work needed before they are administered.53 The Pfizer Inc and BioNTech SE vaccine, for example, must be stored at minus 70°c. In comparison, the vaccine developed by the Astra-Zeneca Ltd—University of Oxford partnership can be stored at between 2°c and minus 8°c. The former Chair of the Taskforce confirmed that the Taskforce considered the logistics needed to administer a vaccine as part of determining which vaccines to buy, but that its overriding concern had been whether the vaccine itself would work.54 PHE acknowledged that delivering the Pfizer vaccine was “the most tricky” but was confident that its previous experience 47 C&AG’s Report, para 1. 48 Department of Health and Social Care, Joint Committee on Vaccination and Immunisation: Advice on priority groups for COVID-19 vaccination, 30 December 2020, updated 6 January 2021 49 PFV0004 – Written Evidence submitted by Ms Richella Logan on behalf of Hugh Whittall, Director of Nuffield Council on Bioethics, 50 PFV0001 – Written Evidence submitted by Karl Simpson, Director JKS Bioscience Limited 51 Q 7 52 Qq 9–10 53 C&AG’s Report para 2.2, 4.4–4.7 54 Q 65 16 COVID-19: Planning for a vaccine Part 1 of delivering vaccinations programmes meant it had the skills and expertise it needed to deal with each vaccine.55 We asked about anecdotal reports of teething problems with the roll-out of the vaccines, including double vaccines appearing at GP practices, or people expecting one type of vaccine and receiving another. NHSE&I told us that it investigated any mistakes to work out what had happened and how to ensure they were not repeated. It emphasised, however, that 97.3% of the vaccine deliveries, and 98.15% of all deliveries related to the vaccine programme, had been on time and in
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Government response AI summary
The government response reiterates the committee's observations about the differing logistical requirements for vaccine deployment based on their characteristics, without adding new information or committing to further action.
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HM Treasury
20
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
In September 2020, NHSE&I estimated that it could need up to 46,000 additional staff to deliver the COVID-19 vaccination programme, including 26,000 vaccinators and 20,000 administrative staff. It planned to fill these posts through a combination of existing primary care staff and targeted local recruitment campaigns.57 At the time of …
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In September 2020, NHSE&I estimated that it could need up to 46,000 additional staff to deliver the COVID-19 vaccination programme, including 26,000 vaccinators and 20,000 administrative staff. It planned to fill these posts through a combination of existing primary care staff and targeted local recruitment campaigns.57 At the time of our evidence session, the Department had recruited 80,000 people to deploy the vaccines.58 NHSE&I told us that while the workforce needed for the programme had been “of real concern”, the response to its call for volunteers and clinical staff had been “incredibly successful – more so than we could ever have imagined”. Over 200,000 people expressed an interest in supporting the vaccine programme. Not all of those who volunteered will be deployed immediately, but NHSE&I told us that it was confident it had the staff it needed to scale-up the programme as planned.59 Local distribution
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Government response AI summary
The government response reiterates the committee's conclusion about the estimated staffing needs for the vaccination program and the successful recruitment efforts, but provides no new information or specific government action.
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HM Treasury
21
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
The NHSE&I concluded that it was not possible to deliver both the COVID-19 and seasonal flu vaccinations solely through existing arrangements such as GP practices and community pharmacies. In response, it developed three new delivery models to take account of different groups and different regional needs. Each region must choose …
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The NHSE&I concluded that it was not possible to deliver both the COVID-19 and seasonal flu vaccinations solely through existing arrangements such as GP practices and community pharmacies. In response, it developed three new delivery models to take account of different groups and different regional needs. Each region must choose the delivery models that best suit local conditions.60 We asked NHSE&I what oversight it had of local decision making about the programme and how it was taking into account the different proportions of priority groups in local areas.61 NHSE&I recognised that it would be unfair for one part of the country to run significantly ahead of others and that it was conscious of the trade-off between ensuring complete equity in the supply and availability of vaccines and in ensuring as many people were vaccinated as quickly as possible. It explained it was working to ensure that all Primary Care Networks (PCNs) were able to vaccinate those over 80 and care home residents. Where PCNs had been able to successfully vaccinate all those over 80 in their area, it had so far redistributed vaccines to those PCNs who had a larger group of people over 80 to vaccination and who still needed doses. It confirmed, however, that “as soon as we are at reasonable coverage”, it expected to be able to talk to the Chief Medical Officers about pushing out as many vaccines as possible.62
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Government response AI summary
The government response reiterates the committee's conclusion on NHSE&I's development of new vaccine delivery models and the importance of local oversight, but offers no new information or specific government action.
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HM Treasury
22
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
We were concerned that this approach risked creating a ‘stop-start’ system where the logistics for vaccinations people were in place, but would be difficult to get up and running again if the roll-out was paused while other areas caught up. NHSE&I confirmed 55 Qq 63–65 56 Q 67 57 C&AG’s …
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We were concerned that this approach risked creating a ‘stop-start’ system where the logistics for vaccinations people were in place, but would be difficult to get up and running again if the roll-out was paused while other areas caught up. NHSE&I confirmed 55 Qq 63–65 56 Q 67 57 C&AG’s Report, para 4.13 58 Q 77–78, Department of Health and Social Care, UK COVID-19 vaccines delivery plan, 13 January 2021 59 Qq 77–78, Department of Health and Social Care, UK COVID-19 vaccines delivery plan, 13 January 2021 60 C&AG’s Report, para 26, 4.8–4.11 61 Qq 68, 81 62 Q 81 COVID-19: Planning for a vaccine Part 1 17 that it was bearing in mind the importance of having a smooth distribution in addition to vaccinating priority groups as soon as possible. It noted that the mix of delivery models, including mass vaccination centres and community pharmacies, would be essential in helping smooth the distribution of vaccines in local areas and meet the needs of the population in each area.63 NHSE&I changed how it communicated with PCNs about what and how many vaccines would be delivered each week, including communicating directly with vaccine sites to ensure information was not delayed. It told us that, as of the end of the day, it would also have shared information with PCNs on the supply of vaccines available over the next two weeks rather than only the next week, so that PCNs could better plan ahead. It explained that it would contact individual PCNs if additional supply became available and would focus any additional supplies on PCNs with the largest populations of the priority groups being vaccinated to ensure that they had enough to vaccination patients in “roughly the right order” without holding up overall deployment.64
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Government response AI summary
The government response reiterates the committee's concern about a 'stop-start' vaccination system and NHSE&I's confirmation of considering smooth distribution, but provides no new information or specific government action.
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HM Treasury
23
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
In its written evidence to us, the Nuffield Council on Bioethics noted that COVID-19 had a disproportionate impact on groups who already had unmet health needs, such as poorer and BAME communities, those living in care and those with learning disabilities. It explained that it was important that plans for …
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In its written evidence to us, the Nuffield Council on Bioethics noted that COVID-19 had a disproportionate impact on groups who already had unmet health needs, such as poorer and BAME communities, those living in care and those with learning disabilities. It explained that it was important that plans for the allocation and distribution of the vaccine carefully considered these groups in order to avoid exacerbating existing inequalities.65 We asked PHE how it was ensuring that communities, vulnerable groups, or those with specific needs such as people with learning disabilities, were not being left behind by the vaccine programme. PHE recognised that COVID-19 risked amplifying the impact of inequalities, particularly those with learning disabilities, and committed to writing to us about what specifically it was doing to support those affected.66 63 Q 82 64 Qq 67–68 65 PFV0004 – Written Evidence submitted by Ms Richella Logan on behalf of Hugh Whittall, Director of Nuffield Council on Bioethics, 66 Q 89 18 COVID-19: Planning for a vaccine Part 1 3 Part Three – Public confidence and communication Expectations for the vaccines programme
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Government response AI summary
The government response reiterates the committee's conclusion regarding the disproportionate impact of COVID-19 on vulnerable groups and PHE's recognition of the issue, but does not provide its own specific response or update.
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HM Treasury
24
Conclusion
Forty-Third Report - COVID-19: Planning…
Not Addressed
NHSE&I recognised that its goal of vaccinating the top four priority groups by mid- February was a huge task.67 We noted that it would be essential for Departments to be clear in the language they used to describe progress with the vaccine programme to avoid over-promising and under-delivering. We asked …
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NHSE&I recognised that its goal of vaccinating the top four priority groups by mid- February was a huge task.67 We noted that it would be essential for Departments to be clear in the language they used to describe progress with the vaccine programme to avoid over-promising and under-delivering. We asked what counted as a vaccine having been offered and how it was monitoring and reporting progress. NHSE&I explained that it could not force people to take the vaccine, so was monitoring progress on the basis of how many people had been offered a vaccine.68 It planned the roll-out of the vaccine on the assumption that 75% of people who are offered the vaccine will take it.69 We were concerned by the potential for confusion between expected take-up and figures currently in the public domain about the number of people who will be vaccinated. If, for example, 25% of each cohort choose not to take-up the offer of a vaccine, then the programme would not be able to meet the expected number of people being vaccinated.70 NHSE&I told us that national data on the roll-out of the vaccine had been published each week and would now be published on a daily basis. It confirmed that it expected to publish localised data by region, and by local authority if possible, within the next 7–10 days.71 However, while government aims to have offered a vaccine to 12.2 million people by 15-February, its daily and weekly progress reports only include statistics on the number of “announced vaccinations” i.e. vaccinations that have been administered rather than how many have been offered.72
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Government response AI summary
The government response reiterates the committee's observation and concern regarding the clarity of language used to describe vaccine progress, but does not provide its own specific response or planned actions.
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HM Treasury
25
Conclusion
Forty-Third Report - COVID-19: Planning…
Acknowledged
When it was first rolled-out, the vaccine programme included a three-week break between people receiving their first and second doses. In December 2020, the Government announced that the second dose of the vaccine would be administered 12 weeks after the first dose.73 We asked why this decision had been made …
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When it was first rolled-out, the vaccine programme included a three-week break between people receiving their first and second doses. In December 2020, the Government announced that the second dose of the vaccine would be administered 12 weeks after the first dose.73 We asked why this decision had been made and whether it would be reviewed in light of the current, or future, lockdowns. The Department explained that the decision was based on the advice of the Joint Committee on Vaccination and Immunisation and the Chief Medical Officers and “basic maths” that it was better to get a first dose to as many vulnerable people as possible and delay the second dose, than to give second doses to the same people. It emphasised that the second dose was still very important to vaccinating people against the virus, but the more the virus spread, the more important it was to maximise the number of people who had the first dose. It confirmed that its decision was not explicitly linked to the lockdown, and it would “keep all those things under constant review as the evidence develops”.74 67 As of 10 February, in the UK, 12,646,486 people had received a first dose and 516,392 people had received a second dose, indicating that the government is on track to achieve this target. https://coronavirus.data.gov.uk/ details/vaccinations 68 Q 6 69 Q 6, C&AG’s Report, para 4.2 70 Q 74 71 Qq 3, 20–23 72 NHS England – Data on CVID-19 Vaccinations 73 Statement from the UK Chief Medical Officers on the prioritisation of the first does of COVID-19 vaccines, 30 December 2020 74 Qq 51–52 COVID-19: Planning for a vaccine Part 1 19 Expected take-up of the vaccine
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Government response AI summary
The government accepts the committee's conclusion by reiterating that the 12-week gap between doses was based on independent JCVI advice to maximise the early impact of the vaccination programme.
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HM Treasury
26
Conclusion
Forty-Third Report - COVID-19: Planning…
Accepted
In 2019–20 the long-established seasonal flu vaccination programme had a take-up rate of 72% among those aged 65 years and older, and up to 45% for those aged 64 years or younger. NHSE&I explained that it was using the flu vaccine as an indicator for expected take-up of the COVID-19 …
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In 2019–20 the long-established seasonal flu vaccination programme had a take-up rate of 72% among those aged 65 years and older, and up to 45% for those aged 64 years or younger. NHSE&I explained that it was using the flu vaccine as an indicator for expected take-up of the COVID-19 vaccine programme as both targeted the same age group. In addition, the COVID-19 vaccine programme was being rolled-out at a time of increased concerns about the virus in the older population. NHSE&I recognised that, while a useful indicator, take-up rates of the flu vaccine would not determine take-up of the COVID-19 vaccines, but asserted that early signs of take-up among those aged 80 and above were very strong. It confirmed that its plans for the supply of vaccines meant the enough would be available should take-up rates be higher than expected.75
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Government response AI summary
The government accepts the conclusion, stating that Public Health England, in partnership with NHS England and Improvement, continues to develop insights into vaccine hesitancy using academic experts, behavioural scientists, regular polling, and qualitative research.
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HM Treasury
27
Conclusion
Forty-Third Report - COVID-19: Planning…
Accepted
PHE recognised that people trust their local GP, local faith groups and community groups so public health organisations and local government will have an important role to play to encourage people to take-up the vaccine. Flu vaccination programmes have also shown the importance of convenience and location to the take-up …
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PHE recognised that people trust their local GP, local faith groups and community groups so public health organisations and local government will have an important role to play to encourage people to take-up the vaccine. Flu vaccination programmes have also shown the importance of convenience and location to the take-up of vaccines, particularly within harder to reach communities.76 We therefore asked about reports that people had received letters sending them to mass vaccinations which were not close to where they lived. The Department confirmed that while people had been invited to larger-scale vaccination centres, this was “simply an additional option that some people may choose to avail themselves of” and that those individuals would also receive an invitations from their local GP service to have the vaccine at a more convenient location if they would prefer.77 Communication about the vaccine programme
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Government response AI summary
The government accepts the importance of convenience and trusted local sources for vaccine uptake and is working to provide choices for vaccination locations (GP practices, pharmacies, mass centres) and culturally sensitive messaging through local authorities and community leaders.
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HM Treasury
28
Conclusion
Forty-Third Report - COVID-19: Planning…
Accepted
The number of people who choose to have the vaccine will ultimately be determined by public trust in the vaccines.78 Our previous reports have shown the importance of clear and consistent communication and that a lack of information during the pandemic, or repeatedly changing and updating guidance, can be confusing …
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The number of people who choose to have the vaccine will ultimately be determined by public trust in the vaccines.78 Our previous reports have shown the importance of clear and consistent communication and that a lack of information during the pandemic, or repeatedly changing and updating guidance, can be confusing and frightening for those affected.79 The Department of Health & Social Care is responsible for developing a communications plan and communicating with the public about the vaccination programme. It established a cross-Government communications team, including representatives from the Vaccine Taskforce and the Cabinet Office, to consider communication about the vaccine. The Department of Health & Social Care explained that communication about the COVID-19 vaccine programme was more difficult than with other vaccine programmes because the situation was evolving so rapidly. In June 2020, Public Health England emphasised the need for attitudinal research to inform the communications strategy, but this research was not complete in time for the first vaccinations. PHE confirmed that it still planned to undertake a range of attitudinal surveys, and was working with Newcastle University and the London School of Hygiene & Tropical Medicine as part of this as well as undertaking weekly polling through YouGov.80 75 Qq 72, 92, C&AG’s Report para 24 76 Q 88 77 Q 12 78 C&AG’s Report, para 24, 4.3 79 Committee of Public Accounts, COVID-19: Government procurement and supply of personal protective equipment, HC 928, 10 February 2021 80 Qq 88, 124, C&AG’s Report, para 24, 4.3 20 COVID-19: Planning for a vaccine Part 1
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Government response AI summary
The government accepts the importance of public trust and clear communication, detailing its ongoing efforts to provide public information via NHS.UK and GOV.UK, sustained communications campaigns informed by polling, and cross-government work to counter myths and misinformation.
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HM Treasury
29
Conclusion
Forty-Third Report - COVID-19: Planning…
Accepted
Research commissioned by PHE showed that about two-thirds of the population were very likely to take-up the vaccine, around 10% were unlikely, and the rest were uncertain. For those who were uncertain or unlikely to have the vaccine, efficacy and safety were the key issues. We asked witnesses what were …
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Research commissioned by PHE showed that about two-thirds of the population were very likely to take-up the vaccine, around 10% were unlikely, and the rest were uncertain. For those who were uncertain or unlikely to have the vaccine, efficacy and safety were the key issues. We asked witnesses what were the key risks to public confidence in the COVID-19 vaccines. NHSE&I that these were very similar to other vaccine programmes that the NHS ran successfully each year, but that the scale of the programme and the newness of the supply chain were different. The Department of Health & Social Care recognised the need for clear messaging to enable the public to understand progress with the vaccine programme and be assured that the vaccines were being deployed safely and properly.81
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Government response AI summary
The government accepts the importance of clear communication and outlines ongoing efforts, including detailed public information on NHS.UK and GOV.UK, proactive communications campaigns based on polling, sharing information with community leaders, and cross-government work to counter misinformation.
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HM Treasury
30
Recommendation
Forty-Third Report - COVID-19: Planning…
Accepted
We were concerned by reports of confusion among health professionals and the public about what to expect from the vaccine programme and when. We asked NHSE&I how it was ensuring clear lines of communication so that people had access to accurate information quickly and easily.82 NHSE&I explained that its messaging …
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We were concerned by reports of confusion among health professionals and the public about what to expect from the vaccine programme and when. We asked NHSE&I how it was ensuring clear lines of communication so that people had access to accurate information quickly and easily.82 NHSE&I explained that its messaging was first and foremost “you will be contacted”, in contrast to seasonal flu vaccinations where people could present themselves to their local pharmacist. We similarly asked NHSE&I whether it had a rebuttal unit to dispel any myths about the vaccine programme, or a Frequently Asked Questions section on its website to answer queries from the public. NHSE&I agreed that including FAQs about the vaccine programme on its website would be sensible and committed to introducing this immediately.83
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Government response AI summary
The government accepts the need for clear communication, including FAQs, and details its ongoing efforts to provide public information via NHS.UK and GOV.UK, proactive communications campaigns, and the sharing of FAQs with partners and community leaders.
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HM Treasury
31
Conclusion
Forty-Third Report - COVID-19: Planning…
Accepted
NHSE&I explained that it would give people “more than one channel and more than one chance” to come forward for a vaccine. It expected to have to go back to people who did not come forward after being contacted to understand why they had not responded and give them another …
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NHSE&I explained that it would give people “more than one channel and more than one chance” to come forward for a vaccine. It expected to have to go back to people who did not come forward after being contacted to understand why they had not responded and give them another opportunity to take-up the vaccine.84 It similarly planned to use different ways to try to make sure that those who were vaccinated returned for their second dose, including pre-empting any issues by booking both appointments at the same time and putting in place procedures to identify and contact anyone who didn’t come to their second appointment.85 We were alarmed by reports of an individual calling on a house, charging money and administering a fake vaccination and how NHSE&I would ensure that such instances were not repeated. NHSE&I recognised the need for “great vigilance” on this, but that it was ultimately a matter for the police and the Home Office.86 81 Qq 87–88 82 Qq 81–86 83 Qq 79–80 84 Q 89 85 Q 59 86 Qq 11, 89 COVID-19: Planning for a vaccine Part 1 21
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Government response AI summary
The government states it has worked closely with various bodies on clear public communication regarding vaccine development and rollout, maintaining proactive information campaigns to inform the public, address vaccine hesitancy, and tackle misinformation to prevent scams.
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HM Treasury