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High risk/cohort 7 - GP doesn't seem too interested

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    #212
    is_that_so
    Registered Users Posts: 32,136 ✭✭✭✭is_that_so


    iamwhoiam wrote: »
    Or GPs stepping up and taking care of their at risk patients . .

    And what was the HSEs excuse before the ransomware attack ? There was a serious flaw long before that happened
    It must be accepted or we will never learn from it
    I agree on that first one. TBF it looks like a multitude of factors, the first one being the HSE assuming that Group 7 would be taken care of by GPs. While some aspects of the rollout may seem slow, it's no easy task to add up to 150K into the vaccine management programme. Even so the levels we are up to now would likely care of that group very fast, once they are in the system.


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    #213
    iamwhoiam
    Registered Users Posts: 16,073 ✭✭✭✭iamwhoiam


    is_that_so wrote: »
    I agree on that first one. TBF it looks like a multitude of factors, the first one being the HSE assuming that Group 7 would be taken care of by GPs. While some aspects of the rollout may seem slow, it's no easy task to add up to 150K into the vaccine management programme. Even so the levels we are up to now would likely care of that group very fast, once they are in the system.

    Yes a huge let down by some GPs . What a pity that some enterprising individuals didn’t think to involve Pharmacist to fill that gap quickly and effectively


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    #214
    Trish_MB
    Registered Users Posts: 14 ✭Trish_MB


    I'm surprised that they can't create sister portal for GPs access only, based on current one allowing age cohorts to register. As far as I know this system is outside HSE one, not affected by cyber attack.

    Best in all of this is fact that HSELive ignores questions about cohort 7 portal and stopped to reply to them. I see a lot of queries about it daily left without HSE reaction, while they reply to any other questions within 2h at max.


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    #215
    [Deleted User]
    Posts: 0 ✭ [Deleted User]


    iamwhoiam wrote: »
    Or GPs stepping up and taking care of their at risk patients . .

    And what was the HSEs excuse before the ransomware attack ? There was a serious flaw long before that happened
    It must be accepted or we will never learn from it

    Smaller gps outside Dublin just got fed up of the stop start supplies and having to cancel and rebook vaccine patients for which they are paid up to €15 a head less
    A situation that impacted their normal gp services and income because of having to devote 2 days to it and on days that they've had to cancel,getting very few of their non cohort patients in


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    #216
    bodhrandude
    Registered Users Posts: 12,396 ✭✭✭✭bodhrandude


    I wouldn't be surprised to see a news report of someone with a shotgun forcing a GP to vaccinate them.

    If you want to get into it, you got to get out of it. (Hawkwind 1982)



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    #217
    iamwhoiam
    Registered Users Posts: 16,073 ✭✭✭✭iamwhoiam


    Marine Layer wrote: »
    Smaller gps outside Dublin just got fed up of the stop start supplies and having to cancel and rebook vaccine patients for which they are paid up to €15 a head less
    A situation that impacted their normal gp services and income because of having to devote 2 days to it and on days that they've had to cancel,getting very few of their non cohort patients in

    Personally I think all GPs had a duty of care to their high risk patients fed up or not . Shame on some of them for abandoning them


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    #218
    [Deleted User]
    Posts: 0 ✭ [Deleted User]


    Meanwhile in Cork
    This was posted in the vaccine appointment thread this evening
    Daniel2021 wrote: »
    Age: 32
    Location: Cork
    Registered: Didn't register with HSE but GP had excess doses and allowed any patients 30+ to register. Registered on their site last night.
    Appointment: Today
    Vaccine: Pfizer


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    #219
    fun loving criminal
    Registered Users Posts: 1,456 ✭✭✭fun loving criminal


    Marine Layer wrote: »
    Meanwhile in Cork
    This was posted in the vaccine appointment thread this evening

    How does a GP have a surplus? If they have their vulnerable patients vaccinated, the most logical thing to do is ring another medical practice and see if they have any patients that need a vaccine. Christ, they're really giving the two fingers to those in cohort 7.


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    #220
    Wolf359f
    Registered Users Posts: 5,704 ✭✭✭Wolf359f


    fun loving criminal wrote: »
    How does a GP have a surplus? If they have their vulnerable patients vaccinated, the most logical thing to do is ring another medical practice and see if they have any patients that need a vaccine. Christ, they're really giving the two fingers to those in cohort 7.

    GP could have a surplus simply down to the fact there's 6 doses in a vial and they could have 57 patients, meaning 3 spare doses. It seems the easiest thing to do is just pick random patients etc... than choose their highest risk (assuming they are finishing up 70+ and not doing cohort 4/7)

    I don't criticize GP's for opting out of Cohort 4/7 due to constantly being let down by deliveries and their staff being inundated with calls and being harassed etc...
    But there should have been a system in place for all Cohort 4/7 to be identified well in advance and any GP opting out could just send their list off to a MVC to arrange appointments etc...


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    #221
    is_that_so
    Registered Users Posts: 32,136 ✭✭✭✭is_that_so


    Wolf359f wrote: »
    GP could have a surplus simply down to the fact there's 6 doses in a vial and they could have 57 patients, meaning 3 spare doses. It seems the easiest thing to do is just pick random patients etc... than choose their highest risk (assuming they are finishing up 70+ and not doing cohort 4/7)

    I don't criticize GP's for opting out of Cohort 4/7 due to constantly being let down by deliveries and their staff being inundated with calls and being harassed etc...
    But there should have been a system in place for all Cohort 4/7 to be identified well in advance and any GP opting out could just send their list off to a MVC to arrange appointments etc...
    GPs too have also received more than expected. Not sure how you imagine two groups with very disparate health issues, who had never been quantified before would be identified in a manner to be added to a national system. GPs may not be fully to blame but there was a plan that they would be doing Groups 4 & 7 and then many of them weren't so some of this group then fell through the cracks.

    You might also fault the HSE but in fairness to them you can't just produce a new process or pathway overnight, when it turns out the system you thought was in place is falling apart.


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    #222
    iamwhoiam
    Registered Users Posts: 16,073 ✭✭✭✭iamwhoiam


    In my opinion any GP who opted out should have ensured his high risk patients were being vaccinated elsewhere or a system in place for them . If they were not convinced that there was an alternative then they should have looked after them

    Frontline didn’t opt out when things got tough , they worked extra shifts , they didn’t see family they simply carried on .
    Some GPs just threw in towel and gave up on their high risk patients and gave no alternative or information .
    Its a pandemic , it’s important so step up and be there for your most vulnerable would be my advice to any GP who opted out because it didn’t suit them
    Yes some were stressed so were ambulance crews and A and E staff and ICU staff . They got on with it and carried on
    Shame on any GP who couldn’t be bothered with some extra work for a few weeks


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    #223
    odyssey06
    Registered Users Posts: 27,947 ✭✭✭✭odyssey06


    is_that_so wrote: »
    GPs too have also received more than expected. Not sure how you imagine two groups with very disparate health issues, who had never been quantified before would be identified in a manner to be added to a national system. GPs may not be fully to blame but there was a plan that they would be doing Groups 4 & 7 and then many of them weren't so some of this group then fell through the cracks.
    You might also fault the HSE but in fairness to them you can't just produce a new process or pathway overnight, when it turns out the system you thought was in place is falling apart.

    The system was never in place though... it should have been up well before the hack.
    The gap between them knowing gps werent doing the cohorts and the hack was too long.

    When the system went down a fallback process with letters should have been adopted.

    "To follow knowledge like a sinking star..." (Tennyson's Ulysses)



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    #224
    is_that_so
    Registered Users Posts: 32,136 ✭✭✭✭is_that_so


    odyssey06 wrote: »
    The system was never in place though... it should have been up well before the hack.
    The gap between them knowing gps werent doing the cohorts and the hack was too long.

    When the system went down a fallback process with letters should have been adopted.
    And I made the point that it is neither quick nor easy to do that, not from a systems perspective. The HSE say they had started on that pathway. The vaccination programme had enough to deal with from unreliable suppliers to managing groups that were in the system. It is designed, as we've seen, to go through age groups in descending order and is doing so pretty well.


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    #225
    iamwhoiam
    Registered Users Posts: 16,073 ✭✭✭✭iamwhoiam


    is_that_so wrote: »
    And I made the point that it is neither quick nor easy to do that, not from a systems perspective. The HSE say they had started on that pathway. The vaccination programme had enough to deal with from unreliable suppliers to managing groups that were in the system.

    They should have started last year not waited until the rollout was started . I would think that was glaringly obvious . As for having enough to do then delegate delegate delegate


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    #226
    odyssey06
    Registered Users Posts: 27,947 ✭✭✭✭odyssey06


    is_that_so wrote: »
    And I made the point that it is neither quick nor easy to do that, not from a systems perspective. The HSE say they had started on that pathway. The vaccination programme had enough to deal with from unreliable suppliers to managing groups that were in the system. It is designed, as we've seen, to go through age groups in descending order and is doing so pretty well.

    I reject that really. Of course they could have been accomodated if they were made a priority and they were not. Cohort 4 and 7 are higher risk than healthy 50 somethings. The system is not designed well if it fails to deal with one of its priorities and cant respond to events.
    Yet we have seen mvcs reallocated because of regional mismatches.
    These cohorts have been handled dreadfully by the hse and the gps that abandoned them.

    "To follow knowledge like a sinking star..." (Tennyson's Ulysses)



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    #227
    is_that_so
    Registered Users Posts: 32,136 ✭✭✭✭is_that_so


    iamwhoiam wrote: »
    They should have started last year not waited until the rollout was started . I would think that was glaringly obvious . As for having enough to do then delegate delegate delegate
    Last year we didn't even know when it was all going to start and they had a huge Number 1 priority, vaccination of care homes and frontline staff. As Groups 4 & 7 were to be done by GPs and hospitals in a sort of separate system it was up to them to identify the groups, the main plan didn't need to concern itself with them.


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    #228
    is_that_so
    Registered Users Posts: 32,136 ✭✭✭✭is_that_so


    odyssey06 wrote: »
    I reject that really. Of course they could have been accomodated if they were made a priority and they were not. Cohort 4 and 7 are higher risk than healthy 50 somethings. The system is not designed well if it fails to deal with one of its priorities and cant respond to events.
    Yet we have seen mvcs reallocated because of regional mismatches.
    These cohorts have been handled dreadfully by the hse and the gps that abandoned them.
    There are multiple factors at work here, my own feeing is that it was more of a GP thing to pass them off to the HSE to figure out. Anyway they will get done, some sooner by age in the portal and the rest when the IT is back up.


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    #229
    iamwhoiam
    Registered Users Posts: 16,073 ✭✭✭✭iamwhoiam


    is_that_so wrote: »
    Last year we didn't even know when it was all going to start and they had a huge Number 1 priority, vaccination of care homes and frontline staff. As Groups 4 & 7 were to be done by GPs and hospitals in a sort of separate system it was up to them to identify the groups, the main plan didn't need to concern itself with them.

    They could have sorted the lists of high risk group and organised the GPs and hospital consultants to start organising the lists long before vaccines arrived . They lesser detail of how and where would then have run smoother if the ground work was done.I thought that would be obvious that doing the groundwork first will always aid the process when the time comes .I know for a fact that some GPs were still sorting lists in April , I mean for heavens sake they had time to be proactive long before that .Well done to other GPs who did and were proactive and organised and put their patients first .

    The lists were not even ready when the plan was put in place and cohorts chosen by NIAC . They decided that they would have two cohorts and out them in groups 4 and 7 ahead of all other groups with almost nothing in place to insure it ran smoothly .
    We now end up with young cancer patients etc waiting while GP's are vaccinating 30 year olds with extra doses


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    #230
    is_that_so
    Registered Users Posts: 32,136 ✭✭✭✭is_that_so


    iamwhoiam wrote: »
    They could have sorted the lists of high risk group and organised the GPs and hospital consultants to start organising the lists long before vaccines arrived . They lesser detail of how and where would then have run smoother if the ground work was done.I thought that would be obvious that doing the groundwork first will always aid the process when the time comes .

    The lists were not even ready when the plan was put in place and cohorts chosen by NIAC . They decided that they would have two cohorts and out them in groups 4 and 7 ahead of all other groups with almost nothing in place to insure it ran smoothly .
    We now end up with young cancer patients etc waiting while GP's are vaccinating 30 year olds with extra doses
    NHPET worked on the vaccination group lists and they did offer a health rationale for each group. NIAC didn't exist at the time. I don't disagree with some of your ideas here but when you've got such a very wide range of conditions, a simple hospital or GP approach was an obvious choice. If there are failings, it's there you'll find most of them.


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    #231
    iamwhoiam
    Registered Users Posts: 16,073 ✭✭✭✭iamwhoiam


    is_that_so wrote: »
    NHPET worked on the vaccination group lists, NIAC didn't exist at the time and they did offer a health rationale for each group. I don't disagree with some of your ideas here but when you've got such a very wide range of conditions, a simple hospital or GP approach would have been favoured. This is what they chose so if there are failings it's there.

    My mistake NPHet then, they should have delegated the job of sorting lists long before the vaccines arrived . Good organised groundwork is the key to any undertaking


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    #232
    Flinty997
    Registered Users Posts: 11,545 ✭✭✭✭Flinty997


    I think people have unrealistic expectations of the GPs here. There were struggling with workloads before Covid. Not enough doctors and admin staff. Most of the admin staff are not well paid and most GPs do not have good office systems.


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    #233
    fun loving criminal
    Registered Users Posts: 1,456 ✭✭✭fun loving criminal


    Stephen Donnelly received his vaccine and was privileged to receive it.

    He makes me sick as minister for health while those in group 7 continue to wait.


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    #234
    iamwhoiam
    Registered Users Posts: 16,073 ✭✭✭✭iamwhoiam


    fun loving criminal wrote: »
    Stephen Donnelly received his vaccine and was privileged to receive it.

    He makes me sick as minister for health while those in group 7 continue to wait.

    Personally I think all Ministers should have had it long ago .


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    #235
    PCeeeee
    Registered Users Posts: 1,465 ✭✭✭PCeeeee


    iamwhoiam wrote: »
    Personally I think all Ministers should have had it long ago .

    With respect, that makes no sense if they are young and healthy.


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    #236
    iamwhoiam
    Registered Users Posts: 16,073 ✭✭✭✭iamwhoiam


    PCeeeee wrote: »
    With respect, that makes no sense if they are young and healthy.

    It does to me . We need to have a functioning Government in a pandemic .
    I object to HSE staff who work at home getting it months ago , I personally know of 2-3 young men who work from home in Hse who got it in February . The rational for that was so the HSE could continue to function
    But yes I think higher Government and NPHET should have been vaccinated early

    I have a huge issue with how cohort 4 and 7 were let down but have no problem with Ministers being safe to be honest


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    #237
    PCeeeee
    Registered Users Posts: 1,465 ✭✭✭PCeeeee


    iamwhoiam wrote: »
    It does to me . We need to have a functioning Government in a pandemic .
    I object to HSE staff who work at home getting it months ago , I personally know of 2-3 young men who work from home in Hse who got it in February . The rational for that was so the HSE could continue to function
    But yes I think higher Government and NPHET should have been vaccinated early

    I have a huge issue with how cohort 4 and 7 were let down but have no problem with Ministers being safe to be honest

    I take your point but the risk to Donnelly and therefore to the functioning of Gov is minimal. A


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    #238
    Unrealistic
    Registered Users Posts: 1,245 ✭✭✭Unrealistic


    is_that_so wrote: »
    GPs too have also received more than expected. Not sure how you imagine two groups with very disparate health issues, who had never been quantified before would be identified in a manner to be added to a national system.
    The list of groups and criteria were published in early December so there has been six months to build lists of patients. The groundwork had already been laid prior to that as GPs were defining people as being at risk back in September to call them for flu vaccines. GPs are reporting that they had their lists ready and have been trying to provide them to HSE for weeks/months but no one in the HSE could tell them how this was supposed to be done.

    is_that_so wrote: »
    GPs may not be fully to blame but there was a plan that they would be doing Groups 4 & 7 and then many of them weren't so some of this group then fell through the cracks.

    You might also fault the HSE but in fairness to them you can't just produce a new process or pathway overnight, when it turns out the system you thought was in place is falling apart.
    Two problems with that statement:
    1) While there are anecdotal stories about some GPs having extra doses there are much more widespread reports of GPs not getting the doses they need for their Cohort 7 patients. My own GP reported that situation and advised me to register through the portal as they didn't know when they'd be able to get to me with the trickle of vaccines they were getting. And we know that there had been zero Cohort 7 doses delivered when the HSE started on the general population on April 23. This was a conscious decision by the HSE to rearrange the priority but not admit it. Some GPs choosing not to handle Cohort 7 is a significant issue but still secondary compared to the HSE's deliberate deprioritisation of the High Risk cohorts.
    2) It was possible to put something in place at short notice. The Cohort 7 issue blew up on social media on May 11th. On May 12th, by amazing coincidence, the distraction about some of Cohort 7 having been vaccinated as Cohort 4 was the main news story on Morning Ireland. Then on May 14th the HSE announced that a portal for GPs to register would 'start going live' the following day. It was all quite cagey and wasn't mentioned during the addresses at the press conference. It was in the back pocket as a response when one of the journalists present brought up the issue of Cohort 7. The ransomware attack kicked in that night, so we don't know to what extent that was more PR spoofing or a real launch, but if we take it at face value it was possible to set something up quickly. That Salesforce hasn't been tasked with adding this on to the main portal is a great disappointment.
    is_that_so wrote: »
    And I made the point that it is neither quick nor easy to do that, not from a systems perspective. The HSE say they had started on that pathway. The vaccination programme had enough to deal with from unreliable suppliers to managing groups that were in the system. It is designed, as we've seen, to go through age groups in descending order and is doing so pretty well.
    But the HSE still won't admit they have designed a system that is deliberately circumventing priority groups. They still maintain the fiction that they are abiding by the 9 priority groups. So if they are saying one thing and doing another, and it's about what can be a life or death issue for those impacted, it's not surprising that they are generating huge resentment.


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    #239
    Strumms
    Registered Users Posts: 24,821 ✭✭✭✭Strumms


    fun loving criminal wrote: »
    Stephen Donnelly received his vaccine and was privileged to receive it.

    He makes me sick as minister for health while those in group 7 continue to wait.

    I’ve no issue with the minister for health receiving the vaccine.

    The minister is responsible for the entire health services during an immensely challenging time for the health of the citizens because of a pandemic...


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    #240
    brendanwalsh
    Registered Users Posts: 988 ✭✭✭brendanwalsh


    Donnelly the absolute parasite getting a jab while thousands of those more vulnerable are still waiting to get one. No problem with him getting it, but he has skipped the queue because those more vulnerable are still waiting


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    #241
    namloc1980
    Registered Users Posts: 18,071 ✭✭✭✭namloc1980


    brendanwalsh wrote: »
    Donnelly the absolute parasite getting a jab while thousands of those more vulnerable are still waiting to get one. No problem with him getting it, but he has skipped the queue because those more vulnerable are still waiting

    This is silly. His age cohort is now getting it so why shouldn't he? Should we put the entire programme on hold until every vulnerable person gets it first?


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