NHS Fife has drawn up an action plan to prevent a repeat of this year’s flu jabs debacle.
An independent review has found patients suffered significant distress and anxiety when the vaccination programme was launched in September.
The health service’s reputation was also damaged as phone lines were jammed by thousands of people trying to book appointments at once.
NHS Fife has already implemented a number of the review’s recommendations and pledged to learn lessons before the rollout of the coronavirus vaccination from next month.
Chief executive Carol Potter and chairwoman Tricia Marwick apologised just days into the programme when it became clear the board was not prepared for the huge demand and had not recruited enough staff.
Staff have since turned the “very difficult situation” around and have delivered more than 90,000 flu vaccines.
There is absolutely no doubt that at the beginning of the flu programme we were extremely disappointed it didn’t go better than it did.”
NHS Fife chairwoman Tricia Marwick
GP surgeries normally deliver the jabs but this year the board introduced community clinics to ensure coronavirus physical distancing requirements were in place.
Patients received letters asking them to book appointments by phone, text or email.
The system immediately ran into problems and was branded shambolic and chaotic.
— The Courier (@courier_fife) September 23, 2020
The review was carried out by the board’s head of corporate governance Dr Gillian MacIntosh and independent reviewer Barbara Anne Nelson.
It found that despite an early recognition of potential difficulties, there were “significant issues” relating to communications, staff numbers and a failure to anticipate patient demand.
No-one was in overall control of the planning and there was confusion over who was responsible for delivering the vaccination programme.
“The programme should have been treated as if it were a major transformational change project.”
Only eight call handlers were seconded and they were swamped by 126,000 calls in a day after Public Health Scotland unexpectedly released 75,000 appointment letters at once.
An extra 72 staff had to be brought in from other services and they worked overtime to clear the backlog.
— The Courier (@courier_fife) November 17, 2020
The programme was launched at the same time as the Scottish Government asked for the remobilisation of health services, creating further risks as staff “borrowed” from their normal roles could be pulled back.
At one point directors had to work through the weekend after discovering on a Friday evening there were not enough staff to cover the following Monday’s clinic.
The review found demand for flu jabs was exceptional across Scotland and other health boards also experienced difficulties.
These lessons have been learned for the Covid-19 programme.”
It said: “The programme should have been treated as if it were a major transformational change project, with widespread support from across the organisation and the resultant investment in resource.
“Instead, at core, it could be considered that the programme was seen as business as usual.”
Recommendations include identifying a separate workforce for large-scale immunisation programmes and ensuring rotas are managed centrally to prevent unexpected shortages.
It also recommends improving the clarity of roles and responsibilities, enhancing IT support for major programmes and improvements to communications.
Mrs Marwick welcomed the review’s findings and said it would be published on NHS Fife’s website.
She said: “There is absolutely no doubt that at the beginning of the flu programme we were extremely disappointed it didn’t go better than it did.
“The review document is honest, it’s straightforward and it gives recommendations and, more importantly, gives us the kind of assurances we need that not only is the flu programme on track but these lessons have been learned for the Covid-19 programme.
“The clinical governance committee will have ongoing scrutiny to ensure the recommendations are carried out in full.”
Labour MSP Alex Rowley, who raised the issue in the Scottish Parliament, said: “I hope they realise the amount of unnecessary worry they caused for so many pensioners across Fife.
“They have apologised and that’s accepted but I really hope they have learned lessons and when we start to see a Covid vaccine rolled out it will be done without these problems.”