The Royal Australian College of General Practitioners (RACGP) has warned against a return to “business as usual” in the wake of the COVID-19 pandemic and urged leaders to heed vital lessons from the vaccine rollout.
It comes via the RACGP’s response to the Australian National Audit Office (ANAO) performance audit of Australia’s COVID-19 vaccine rollout. The response outlines:
priority populations including Aboriginal and Torres Strait Islander people, residential aged care workers and people with a disability experiencing difficulties accessing the vaccine
a need for improved communication with the public to boost education, awareness, and vaccine confidence
the problems of a lag time in communications which resulted in general practices not being prepared for changes to the rollout, including eligibility criteria.
RACGP President Dr Karen Price said that lessons from the COVID-19 vaccine rollout must not be forgotten.
“The COVID-19 pandemic has highlighted the critical role that GPs play in Australia’s healthcare system,” she said.
“The resourcing of this sector enables high quality, efficient healthcare delivery by highly trained and committed professionals and their teams. Practices have done a tremendous job in the vaccine rollout; however, it has not been easy. Something that was particularly concerning involved the delays in vaccinating priority populations. For example, residential aged care workers were initially vaccinated at their place of employment but then this was changed to residents only and workers were left to their own devices to pursue other vaccination options.
“It’s particularly important we improve vaccine education and access for Aboriginal and Torres Strait Islander people. Whilst more than 85% of all people in Australia aged 16 and over are fully vaccinated, that figure sits at just 57% for Aboriginal and Torres Strait Islander people.”
Dr Price said that more could have been done to heed the RACGP’s calls and boost vaccine confidence in the community.
“Our own survey in June this year found that 92% of members said that improvement was needed in relation to ‘public awareness and education’,” she said.
“A vacuum was left in which anti-vaxxer groups could disseminate their misinformation. We called on all governments to strengthen their campaigns to boost vaccine confidence for this very reason. The Federal Government did produce a new advertising campaign in July urging people to ‘arm yourself’; however, by that point many were already suffering from ‘information overload’ and vaccine confidence had taken a hit.
“It’s vital that we learn from this episode so that next time a public health crisis emerges we are ready with a comprehensive, well-targeted, nation-wide campaign.
“We also need to improve communication efforts with different segments of the population – a one-size fits all approach does not work. Different communication styles and approaches for culturally and linguistically diverse people and Aboriginal and Torres Strait Islander people were not considered until it was apparent that existing strategies were not working.”
The RACGP President said that GPs deserve greater resources and support.
“In terms of logistics, GPs frequently reported that expected vaccine deliveries did not arrive on time or fewer doses were received than ordered and this resulted in practices having to cancel vaccine appointments,” she said.
“Some practices also reported receiving doses close to their expiry due date because of the delays in delivery. These same delays also meant practices had difficulty determining whether they should order further doses.”
Dr Price said that general practice must be front of mind on major decisions.
“Effective communication by all governments and their partners in the rollout with general practice must be improved across the board,” she said.
“GPs, practice managers, nurses, receptionists, and administrative workers have enough on their plate without spending valuable time interpreting new rules.
“Repeated changes to vaccine eligibility criteria left many patients bewildered and general practice teams were often the target of patient frustrations, including aggressive and threatening behaviour. Governments must have nimble communication channels into practices so that we are not put in the position of learning about changes from our patients.
“Federal, state and territory eligibility criteria were eventually aligned, which made the entire process more straightforward. However, maintaining consistency across jurisdictions should have been a priority from day one.
“Changes to the vaccine rollout came without warning in the middle of a working day when we were flat out not only delivering vaccines but providing usual healthcare and this played havoc with our booking systems and wait times.
“When eligibility changes were made, many practices would be inundated with booking requests. The problem is that the announcements did not correspond with increased allocations of vaccines, so we were left in the unenviable position of having to manage irate patients who laid the blame on us.
“Consider too that the fact sheet covering Medicare Benefits Schedule vaccine items is 27 pages long. I hold concerns that any compliance campaign around vaccinations, including rules around co-claiming, will risk public health at a time when GPs are needed more than ever before. General practice is the backbone of the vaccine rollout, and we should not be taken for granted.
“The RACGP acknowledged the value of having a senior GP in Professor Michael Kidd AM in the role of Deputy Chief Medical Officer during the pandemic. In subsequent roll-outs, the RACGP would like to see greater GP representation at all levels of government and policy making in response to not only pandemics, but other disasters impacting the health of the community including fires and floods.
“The pandemic and vaccine rollout are not over. GPs will be managing patients with mental health concerns as well as those who have delayed or avoided consultations and screenings, managing ongoing vaccine boosters and potentially yearly vaccines. As always, we will be there for our patients, but we will need the full support of the Government to get the job done.”