Recommendations & Conclusions
20 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
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
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