THE delivery of the winter flu vaccine in Scotland has been “poorly managed and patchy” and lessons must be learned before a Covid vaccine is ready, according to a leading care expert.

Dr Donald Macaskill, chief executive of Scottish Care, called for a consistent national policy after the Herald revealed that some health boards - including NHS Greater Glasgow and Clyde - have been using an IT system originally designed for childhood vaccinations, which prioritises youngest patients first.

As a result, patients in the over-65s cohort are being invited for appointments starting with 65-year-olds and working up through people in their 70s, 80s, and 90s.

This means many elderly people will be vaccinated weeks later than they were in previous years when the delivery of the winter flu vaccine was handled by GPs through their practices.

Some have been told they are unlikely to get the jag before December.

READ MORE: Anger over flu vaccination rollout dubbed 'absolute shambles'

The Scottish Immunisation Recall System (SIRS) system also provides no way of identifying those with underlying conditions within the over-65s age group who should be prioritised for flu vaccination.

Dr Macaskill said: “This is very piecemeal around the country. Every health board has adopted its own vaccination policy.

“Some of the health boards have progressed vaccinations for residents very significantly. Other health boards are not allowing nursing staff in care homes to engage in what we call pay vaccinations.

“We are very concerned that the rollout has been as poorly managed and patchy as it is.

“This is another tool to protect elderly residents and critically to protect staff.

“We’ve got to do better. If this is a prototype for the vaccinations which we hope will come in the Spring for Covid, we’ve got to learn the lessons really quickly.

“It is not working the way it should be working and we need to get national consistency at local level.”

This is the first winter that flu vaccination is being handled by health boards following an agreement struck between the BMA trade union and the Scottish Government when the new GP contract was agreed in 2018.

Responsibility for delivering immunisations was transferred from general practice to health boards amid attempts to relieve GP workload, although it was a move that some doctors - especially those in rural and deprived areas - opposed.

Under the new regime, patients are sent letters stipulating a date and time to attend for vaccination at a community hub.

The distribution of these letters is overseen by NHS National Services Scotland but it is up to health boards to “determine the order in which each cohort of patients receives their letters”.

Local health and social care partnerships (HSCP) provide the premises and staff to deliver the vaccine.

However, the Herald has been contacted by patients who received their letters after their appointment date had already passed.

Another said their letter arrived in the post at 1.35pm on Tuesday with an appointment time four minutes later.

“I went and got it okay, but there were people there who had got their letters the day after the jab was due,” they said.

READ MORE: The real reason winter flu vaccines are being delivered differently this year - and it has nothing to do with Covid 

Another received a letter for an appointment the same day at a time she was unable to attend, but “couldn’t get through” on any of the helpline numbers given to reschedule.

Meanwhile, an immunisation centre in Aberdeenshire was left almost empty following “computer glitches” affecting the dispatch of appointment letters.

“They are very quiet,” a source told the Herald. “They are taking walk-ins who are learning about the availability by word of mouth and social media.”

Due to the expansion of the flu vaccination programme this year, GPs are still expected to vaccinate ‘at risk’ individuals in the 18 to 64 age group.

But this is also uneven.

One woman, from Fife, told the Herald: “My GP isn’t giving the flu jab. You have to go online.

“My husband gets it due to heart condition. It’s coming up three weeks since he completed online form. Zip. Not a word.”

Scotland’s chief nursing officer, Professor Fiona McQueen, said there had been “some hiccups”.

Scottish Government officials, including Health Secretary Jeane Freeman, are now in talks with affected health boards about how to prioritise vaccinations.

Prof McQueen said: “In the conversations we’re having with Glasgow and other boards, it will be to agree that the most vulnerable should be vaccinated as early as possible.

“We clearly don’t want to disrupt other arrangements that we have in place, but that will be the dialogue: to make sure the oldest, the frailest, and those with predisposing conditions would be vaccinated earlier than others who are not in that category.

“It’s perhaps not surprising that we’re having some hiccups this year because it’s the biggest programme we’ve been expected to deliver.”

Nicola Sturgeon added: “The most important thing here is that people who need the flu vaccine and are eligible for it will get vaccinated within the time frames required.”

It came as the First Minister confirmed 1429 new cases of Covid-19, with a positivity rate of 16.4 per cent.

She also urged Scots to avoid travel to Blackpool amid a spike in cases linked to coach travel to the seaside town.

The number of people in hospital with Covid rose by 43, to 570, while the number in intensive care rose by 14 to 49.

Ms Sturgeon also confirmed that there had been 15 new deaths among patients who have tested positive for Covid in the past 28 days. Half of these were in patients aged younger than 80, said Ms Sturgeon, including some under the age of 60.