Dr Marcus van Dam, GP in North Yorkshire, and Dr Rachel Gaywood, GP in Devon, describe how they have provided Covid-19 vaccinations and other support for people with intellectual disability.

Dr Marcus van Dam, GP at the Danby Surgery in Whitby, North Yorkshire

This is how it worked for us. We’ve given 200 Oxford vaccines on a Saturday, 12th January, in the locality in Yorkshire.

Two providers, each have several accommodations / houses. The argument was that their social care staff (half of the total number) needed doing now and there were several older ones, some with Down’s syndrome and others clinically high risk, and some people with more severe LD. Our view was that those others who technically were due later we simply should do at the same time, also because we are unsure about the exact severity of learning disability (moderate vs severe) in several cases, and from an equality point of view, we’d have immunised some in a house and some not. Furthermore, if we do them all at once we save a lot of staff and doctor time rather than having to keep organising and running sessions. The PCN and CCG supported this approach, and maybe we have also been a little lucky because the area received a large allocation that week.

We emailed the consent forms for staff and residents to care managers beforehand and they managed to do that side, going through the easy read leaflet with their residents. They were keen and pulled out all the stops to make it happen. Some families emailed their consent / support in case of LPA or Best Interest which we simply attached to the form. We took an enabling rather than scrutinising approach. It was remarkably easy.

We planned a rota in the village hall, with two doctors and a nurse immunising, each with an admin to record it on the pinnacle software on laptops, and we also visited two care homes for the more frail. We allocated a time slot for each house (= social bubble) where residents and staff were done together, so staff could support residents and provide reassurance, and help clarify the occasional consent or medical question.

Some staff took the next day off (lethargy and headaches) and whilst the residents seemed fine, some were also reported to be more tired the next morning, but nobody needed a doctor’s call, except unfortunately one with known epilepsy had a prolonged seizure the next day and was admitted.

Another important aspect was that there was a palpable sense of psychological relief, and the whole session had a lovely air of ’together we are getting protected and things are getting better now’, even if it was understood that other protective measures would continue. This is also a good argument for immunising people with learning disabilities, to help them cope emotionally. They may not have had many cases in recent months because they huddled together to keep out the virus, and whilst that kept them safe it also caused a lingering sense of threat and anxiety and to now be protected thanks to the vaccine makes people less anxious. The uptake was remarkable, hardly anybody declined.

Dr Rachel Gaywood, GP at Pembroke House Surgery and Strategic Clinical Advisor for Learning Disability/Autism for NHS Devon CCG.

In Devon we have been doing a number of things to encourage vaccine uptake.
We have made a video of a person with LD having their vaccine and one about what a liaison nurse does.

We have provided support across the county from the LD liaison nurses and CCG.

Some PCNs have had specific LD days with longer appointments, quieter buildings etc.

I have spent a couple of days out and about with the liaison nurses vaccinating people in their own homes and some in cars etc if that's the reasonable adjustments they need!

The challenges are mostly around reasonable adjustments within the massive machine that is the vaccination programme!

First published on this site in April 2021.