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Scottish Vaccine Plan “Behind the Curve”, Warns Report

Paper backs more coordination between Scottish and UK Governments

The majority of Scots could be vaccinated by summer next year but only if the Scottish Government radically steps up its preparations, a new report says today.

Published by the think-tank Our Scottish Future, the paper warns that the government is “behind the curve” in its preparations to roll out 4 million vaccinations to Scots over the coming months.

It calls for consistent communication across the UK so that mixed messages do not undermine trust in the vaccine programme.

The report calls for the Scottish Government to boost support for health boards charged with rolling out the vaccine, to recruit more staff to help fulfil the job, and to coordinate its plans more closely with the UK Government.

It also backs the appointment of a specific Scottish Vaccines Minister to oversee the roll out of the programme and work hand in glove with their UK counterpart.

Without extra action, it warns that the problems seen with the Winter Flu vaccination programme will be a “precursor” for the far bigger challenges presented by Covid.

The paper was written by OSF researchers following interviews with key health experts in Scotland and the rest of the United Kingdom. It is based on the published proposals already outlined by the Scottish Government.

It comes with the first vaccinations set to begin this week. The Scottish Government has previously pledged to vaccinate 1 million people by January, although it is not yet clear whether this remains an achievable target given vaccine supply and capacity.  

The OSF report says the Scottish Government must learn the lessons from failures in the “test and protect” programme 

Its main conclusions are:

* It is not implausible, and planning should have certainly started, to be able to vaccinate the majority of the Scottish population by late spring / summer 2021 

* However, the Scottish Government’s national framework is “lacking in detail, planning and adequate forward thinking.” Specifically, there is “no real plan” on how to prioritise and engage with the 1.9 million Scots in the so-called ‘third wave’ of the programme – under 65s who are not engaged in frontline health or care.

* Both the Scottish and UK Governments need to coordinate messaging better to boost trust in and compliance with the programme.

* More support staff need to be recruited to support the 2000 vaccinators being identified to carry out the programme

The report says: “Health Boards will require substantial support from the Scottish Government to avoid the same problems that occurred with the flu vaccine, in a roll out 4 times the size, requiring multiple doses. Faster and more efficient vaccination will inevitably save lives, making this process all the more critical. Additional resources, best practice sharing, guidance and technology will be required to ensure the 2020 flu vaccination was a dress rehearsal, not a precursor.”

It concludes: “So far, the Scottish government looks to be behind the curve against strategic and operational requirements, known about for months. Coordination mistakes – ‘devolve and forget’ from Whitehall – combined with a separate communications agenda could lead to further confusion and poor delivery. Issues seen throughout the pandemic could be replicated if the Scottish Government devolve responsibility to health boards without sufficient support.”

Describing the next month as “critical” if plans are to be put in place, the report’s recommendations call for: 

* Deeper coordination between the UK and Scottish governments as the vaccine is rolled out

* A common plan for communicating the benefits of the vaccine to the public at large

* Specific task forces to be established in Scotland to maximise vaccine uptake in traditionally harder to reach communities that have been most negatively impacted by the virus

* Greater resources to be given to Scottish Health Boards to operationalise the roll-out

* Investment to set up of an effective centralised booking and data management platform

*  The appointment of a new Vaccine Minister. 

The paper concludes: “We are at a critical juncture in the fight against the COVID pandemic, but on a path towards a vaccine that can help to turn the tide. Vaccinating Scotland remains an unprecedented challenge. However, there is still a valuable month left to put the right strategy, resources and operations in place to maximise the speed at which the vaccine can be dispensed. This paper therefore argues that greater urgency is required to plan the vaccine rollout, and likely implications, than is being seen today.”

Professor Jim Gallagher, chairman of Our Scottish Future added: “Scotland’s governments have struggled to deal with the Covid crisis. The medical and economic toll Scotland has paid has been among the worst in Europe.

“But the UK government’s highly successful vaccination strategy – for once, genuinely world-beating – presents an opportunity to turn the corner. Now it’s up to the Scottish Government to vaccinate Scotland, and they need a much fuller strategy, clear communications and an operational plan for a logistical programme unprecedented in its complexity where speed is of the essence. A Scottish Vaccines Minister needs to take unequivocal responsibility for delivery. Scotland cannot afford for this to fail.”

“We have to learn the lessons from the way Scotland struggled with rolling out adequate volumes of testing, and with the most recent flu vaccinations. Above all, we need a consistent, UK wide messages to persuade people that vaccination is necessary and safe.”

Commenting on the paper, Professor Hugh Pennington of Aberdeen University added: “This authoritative and detailed analysis demonstrates the urgent need for Scotland and the UK to collaborate to the full now that the roll out of life-saving vaccines is imminent.”

The paper was written by Evie Robertson, who has previously worked with the World Health Organisation and with Academic Health Solutions. In writing this report, she sought evidence from senior public health figures in Scotland.

A full copy of the report is available here.

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