Update for Stakeholders Issue 2, 15 January 2021

Dear Colleagues

Writing this second stakeholder bulletin provides me with an important opportunity to reflect on all that has already been achieved, as well as the tasks still ahead. Please do accept my apologies that this briefing is in the English language only. The fast pace of change on COVID-19 vaccination means that I did not want to delay
sending this update to you. Bilingual information was shared with households earlier this week and is available from the links later in this document.

Just two weeks into 2021 sees some important milestones already being reached. Over 7000 people have now been vaccinated through the Powys vaccination programme. Invitations to every registered patient aged 80 and over have now been sent – these have been sent first class so will arrive in the next few days if they have
not already done so.

Our third mass vaccination centre opened in Builth Wells this week, and arrangements are in place for the Newtown mass vaccination centre to relocate to its new location at Maldwyn Leisure Centre next week. Thank you to the Royal Welsh Agricultural Society and to Freedom Leisure for their support.

Our vaccination capacity is set to expand by the end of next week so that we can deliver up to 4000 doses a week already – although this remains dependent on the More information about the COVID-19 vaccination programme in Powys is available from our website at: http://www.pthb.nhs.wales/coronavirus/covid-19-vaccination supply we receive from national stocks. And, armed forces colleagues have joined the local COVID-19 vaccination programme.

Later next week will also see vaccine supplies delivered to all 16 GP practices, so that the network of GP practice-led vaccination clinics can open in the week beginning 25 January. This follows our first pathfinder service which began vaccinating Presteigne Medical Practice patients yesterday (14 January). We know that all our GP practices are keen join the programme – and with the “wholesale licence” process concluded
this means that all the necessary arrangements are in place for them to begin.

Each priority group is being invited in turn. We continue to ask everyone not to contact their GP, pharmacy, hospital, health board or local authority about an appointment – please do wait to be contacted as this is a very big task to put in place the biggest vaccination programme the country has ever seen.
Our vaccination programme is only possible because of the people who deliver it. It is perhaps easy to think of a vaccination programme in terms of vaccines, centres, clinics and letters. But all of this is only possible because of people. First and foremost, this is the people we are here to serve – you. But all of this work depends on a massive team effort by staff right across the health board and many different partner organisations, as well as an amazing team of volunteers. I think it is fair to say that many staff across the health and care system are very tired after nearly a year of responding to COVID-19. The prospect of the vaccine brings that glimmer of hope as well as new work challenges, so I remain truly grateful to all of you for your patience and support for our team whilst this programme is put in place. Vaccination is by appointment only, and we are following the guidance on priorities set by the UK’s independent Joint Committee on Vaccination and Immunisation (JCVI). This means that vaccination is currently under way for the JCVI’s top priority groups:

• Residents of care homes for older adults – nearly all residents have now received their vaccination
• People aged 80 and over – all registered patients aged 80 and over will have received their invitation letter by early next week
• Frontline health and care workers – to help protect the vulnerable people in their care, who are most at risk of catching coronavirus and developing serious illnesses – information has been sent to employers across the county. By early next week, everyone in these groups will have received their invitation. By mid February our goal is to ensure vaccination for everyone in these groups, as well as:
• People aged 75 and over
• People aged 70 and over
• People who are “clinically extremely vulnerable” – remember that this is a smaller group than the people with underlying health conditions who receive the seasonal flu immunisation.

By the spring, our goal is to offer vaccination to everyone in the remaining national
priority groups:

• all those 65 years of age and over
• all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality – broadly this group includes those who receive the seasonal flu
vaccine, and it also includes “those who are in receipt of a carer’s allowance, or those who are the main carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill”
• all those 60 years of age and over
• all those 55 years of age and over
• all those 50 years of age and over

The Welsh Government’s new national strategy also aims to offer vaccination by the autumn to the rest of the eligible adult population according to the further guidance that the JCVI will produce on priorities.
Whilst good progress is being made in so many areas, I do recognise that there are a number of challenges:
• There is no doubt that travel and transport is a big challenge in a county covering 2000 square miles. Even with three mass vaccination centres established – each needing to serve a large enough catchment to be able to use the Pfizer/BioNTech vaccine – this still means long journeys from the borders of the county. I would encourage everyone who can take up an appointment at a mass vaccination centre to do so – and there is more information about why this is so important later in our bulletin. But, I fully understand that for some people this is not an option, in which case please do get in touch with our booking team to let them know so that we can put alternative arrangements in place including for people whose clinical needs mean that they are housebound.

• Putting in a booking & appointment system at this scale has been a monumental task for our small team here at the health board. I know that there are still teething problems with our phone lines, and with the information in some of the letters people that have been received. The team is working extremely hard to get the systems right so that you can have the booking experience you expect and deserve. I have been truly humbled by the passion and commitment they have brought to this work.

• Again, I need to reiterate this is all dependent on the continued supplies of the vaccine, which is outside our local control. We do have guaranteed supplies of good quantities of the Pfizer/BioNTech vaccine, but as this can only be used in our mass vaccination centres we do encourage as many people as possible to take up the offer of an appointment in Newtown, Builth Wells or Bronllys. There is more information later in this bulletin about our mass vaccination centre model.

So, the key messages for everyone are:

• Everyone in Powys aged 80 and over will have received their invitation for vaccination by early next week. These invitations are for vaccination at the mass vaccination centres. We encourage you to take up this appointment if you can, as it will be the quickest way to receive your COVID-19 vaccination. However, we recognise that travel to a mass vaccination centre isn’t the right option for everyone, and you can use the contact details in your letter to contact us so that we can make alternative arrangements.

• Vaccination of care home residents is nearly complete, which is a great milestone for the county.

• From next week, invitations will begin to people aged 75 and over, with their appointments likely to take place from 25 January.

• Please wait to be contacted, and thank you for your patience.

• Vaccinations are by appointment only, and please arrive as close to your appointment time as possible to help us give everyone the best possible experience at the vaccination centres.

• You will receive your invitation when you are due for your appointment, based on the priority order across the UK).

• Please don’t contact your GP, pharmacy, health board, hospital or local authority about an appointment.

Good progress continues to be made in Powys – we still have the highest levels of vaccination per head in Wales – and we will all see the vaccination programme continue to expand during January and beyond.

Thank you for everything you are doing to Keep Powys Safe – and please do feel free to share this information in your organisations, networks and communities.

Carol Shillabeer
Chief Executive, Powys Teaching Health Board

More information about the COVID-19 vaccination programme in Powys is available from our website at:

What to expect at a Mass Vaccination Centre – a personal view from Susie. We think this post from Susie on Facebook gives a lovely glimpse into the experience of attending a mass vaccination centre with her 95-year-old mum

VACCINATED!!! Wonderful. WHAT a weight off my mind. I know a lot of local folk had a lot of questions. Hope the following will help.

RWAS in Llanelwedd. They’re using the Powys Pavilion [S.E. corner of main ring, next to Members Centre, opposite Principality]. The volunteers show you where to park, having asked for your time slot.
Wheelchairs ready for those – like my 95 year old Mum – who need help to whizz in. Hand sanitising just inside the door; up the ramp / stairs. Booth to check in on the right. Lots of delightful volunteers and some VERY charming R.A.F. chaps to help [the lad I was chatting to was raving about the Caer Beris, who are doing them proud]. Brilliantly organised – and everyone very upbeat. After all, they’re dispensing hope.
There are 9 ‘lanes’ set out the length of the building; dark blue curtains on frames. Bit like a row of wide racing stalls! Carefully distanced seats in front of them: called in to a large lane cubicle; curtains drawn: a few questions inc. have you had a reaction to any other injections before. Choose which arm you want it in [not the side you usually lie on]. Needle is extremely fine. PFIZER vaccine. Pin prick but honestly, didn’t feel anything else. Given precious bank-card sized card with two spaces for vaccination details. Pfizer;
date, batch number. Second one to be filled in when second vaccine given. Thank the nurse. Go out through another curtain at the back of the cubicle to waiting area. Seated and chatted to by R.A.F. lad / volunteers: wait 10 – 15 minutes to make sure there’s no reaction. Go – chairs wiped as soon as we stood up. Volunteer came with us: wheelchaired mum to car, loaded her up; volunteer took wheelchair away. Done and dusted. Home. Both fine.
Thank You

Thank you for taking the time to share your experiences, Susie.

You can follow Powys Teaching Health Board on Facebook, and @PTHBhealth and @BIAPiechyd on Twitter
for the latest social media updates from the health board.

More information about the COVID-19 vaccination programme in Powys is available from our website at:

Our Mass Vaccination Centre model
Mass vaccination centres are a critical part of the vaccination model in the UK, including here in Powys.

The main reason for this is that we have good levels of guaranteed supply of the Pfizer/BioNTech vaccine. But, this vaccine has very stringent requirements for storage, transport and supply. It arrives with us in trays of 975 doses which cannot be split, and is stored at very cold temperatures. When we bring it to a usable temperature it needs to be used within five days.

The second vaccine to receive licensing – AstraZeneca – is not yet available in such reliable quantities. It is much easier to store and transport, which means that we have been able to vaccinate care home residents, and supplies will soon be shipped to GP practices across the county. But, until supplies are ramped up we remain heavily reliant on Pfizer/BioNTech.

You may also have heard that a third vaccine has been licensed for use – Moderna – but this will not be widely available in the UK until the spring.

The specific requirements of Pfizer BioNTech mean that mass vaccination centres need to be located where they can draw on a very large catchment – to deliver nearly 1000 vaccination doses in a short space of time.

We receive very good supplies of the Pfizer/BioNTech vaccine, which we can only deliver from mass vaccination centres. The centres themselves also need to provide an environment that offers safe storage of the vaccine to avoid waste. They must also ensure social distancing for everyone involved – not just when you receive the vaccination, but also to wait safely after the vaccine to check there is no reaction. This reduces the options for where and how these centres are established. Susie’s description above really brings this to life.

Here in Powys we have been able to quickly set up three vaccination centres in the county – Bronllys, Builth Wells, and Newtown – each serving around 40,000 people in the south, mid and north of the county.

We are incredibly grateful for the hard work of our staff and partners to get three vaccination centres set up so quickly, providing guaranteed COVID-19 vaccination appointments for our residents as soon as possible. As a result, over 7000 people have already been vaccinated through the PTHB vaccination programme, and we are on schedule to offer COVID-19 vaccination to Priority Groups 1 to 4 by mid February in line with the national strategy.

But Powys is very large and very sparsely populated, which means that delivering this vaccination programme is challenging for us and for our communities. Even with three mass vaccination centres, this still means that some residents have some distance to travel to get there.

We fully recognise this, which is why we will make sure that our approach is as flexible as possible.

On the one hand we do need as many people as possible to take up the invitation to a mass vaccination centre if they are able to do so. This will be best way to vaccinate as many people as possible as quickly as possible.

But we do absolutely recognise that travel and transport may be an issue for you, particularly in our large county. If you are not able to travel to the mass vaccination centre, then please contact our booking centre to let them know. They will be able to cancel your appointment at our mass vaccination centres and put alternative arrangements in place – although you may need to wait a little longer for a local appointment (this is due to the supply of AstraZeneca, as mentioned above). Rest assured that even if you are unable to contact the booking centre to cancel your appointment, you will still be re-contacted. We do kindly ask you to be patient and wait to be contacted about your alternative appointment.

Your mass vaccination centre appointment will be your quickest opportunity to get the vaccine, so we would encourage you to go ahead if you can, but please do contact the booking centre if this is not the right option for you. A reminder that we all need to follow Hands Face Space whilst the vaccine programme progresses
As the vaccine is rolled out, we all need to follow the safety rules and keep ourselves and our families safe. This is particularly important as there is a new variant of coronavirus that spreads more easily and is circulating in every part of Wales – including here in Powys.

To do this, we all need to meet as few people as possible; wash our hands regularly, wear a face covering and keep our distance from others. We also need to continue to follow the Coronavirus Alert Level 4 guidance in Wales.

By taking these important steps for ourselves, and for those around us, we can all play our part to Keep Powys Safe.

Alongside this, you must self-isolate if you or anyone in your household has symptoms These are: high temperature; a new continuous cough; a loss of or change to your sense of smell or taste.

If you have symptoms then get a test. Local testing units are available across the county – our mobile testing units move this weekend as part of their programme to bring local testing to each part of the county. Home testing kits are available if you cannot travel.

You can book a test online at http://www.gov.uk/get-coronavirus-test. You can book a test by telephone by calling 119 between the hours of 7am and 11pm. Calls are free. If you have hearing or speech difficulties call 18001 119.
If you do test positive then please help our local contact tracing team to stop coronavirus in its tracks. Our local Powys contact tracing team is here to protect your health and the health of others, and is part of our Test Trace Protect partnership between Powys Teaching Health Board and Powys County Council.

We all hope the vaccine will lead to a better and brighter 2021 and an end to this pandemic.

New National Strategy for COVID-19 Vaccination
Welsh Government has published their COVID-19 Vaccination strategy. This sets out the national priorities, infrastructure and timetable for delivering vaccination to the people of Wales.

You can read the strategy on the Welsh Government website: http://www.gov.wales/covid-19-vaccination-strategy

The national priority group milestones are:
• Milestone 1 – by mid February – cohorts 1 – 4. Subject to supply, our aim is to offer vaccination to all care home residents and staff; frontline health and social care staff; those 70 years of age and over; and clinically extremely vulnerable individuals.
• Milestone 2 – by the Spring – priority cohorts 5 – 9. Subject to supply, which becomes more uncertain further into the future, our aim is to offer vaccination to all Phase 1 priority cohorts (i.e. 50+s and clinically vulnerable/at risk).

It is estimated that taken together, these at risk groups represent around 99% of preventable mortality from Covid-19.

• Milestone 3 – by the autumn. Our ambition is to offer vaccination to the rest of the eligible adult population according to the further JVCI guidance that will be produced on priorities. We do not yet know supply for this phase, so there is further planning to do on this milestone that will take account of supply and the further JVCI guidance.

Local delivery in Powys is on target to deliver milestone 1. However, we do recognise that many factors that may affect delivery – such as supply of vaccine – are outside of our control. Our local vaccination plan is due to be discussed at a meeting of our Board later this month, and once published we will ensure it is shared with you via this bulletin.

COVID-19 Vaccination Online Q&A Event with Carol Shillabeer Thank you to everyone who joined our online Q&A event with Carol Shillabeer on 12 January. If you were not able to join at the time, you can watch it back by using this link

They have been helping in a wide range of areas, from logistics and supporting people when they come for vaccination to answering phones and booking people in. In addition to the six personnel working with us in Powys, there are currently another 64 RAF personnel and 14 Army Combat Medical Technicians, under Joint Military Command Wales, deployed as part of the vaccination support force supporting other health boards in Wales and further troops deployed with the Welsh Ambulance Services NHS Trust on driver duties and decontamination tasks. http://www.pthb.nhs.wales/news/health-board-news/vaccination-heroes-military-support

Update on Vaccination of Care Home Residents
Just two weeks into January we have provided vaccination for nearly every resident of a care home for older adults in Powys.

The Immunisation Team visits Plas Cae Crwn in Newtown
Our outreach team has been out and about across the county to vaccinate residents of care homes for older adults. With nearly 1000 older adults living in care homes in the county, this has been a big task and we are very grateful to the residents, care home staff, and our outreach team.

We will need to make some further visits – for example, residents are not able to receive the vaccine within 28 days of onset of COVID infection. So, if someone has recently had the infection we will arrange for vaccination at an appropriate time. Residents of care homes for older adults, alongside care home workers, are the top
priority group for COVID-19 vaccination based on advice from the UK’s independent Joint Committee on Vaccination and Immunisation. So, delivering this many vaccines by mid-January is a really important milestone for the county.

Following the licensing of the AstraZeneca vaccine on 30 December – and with some supplies now beginning to reach the county – we quickly implemented our plan to take the vaccine out to care homes from last week. The AstraZeneca vaccine is easier to store and transport than the Pfizer/BioNTech vaccine, but is not yet available in such good and guaranteed supplies. This does mean that alongside outreach programmes like these, we do need as many people as possible to attend our mass vaccination centres so that we can offer vaccination to as many people as possible as quickly as possible.

Plans are also being put in place for other patients who are unable to leave their homes, and we will share more details soon.


Vaccination Heroes: Our Partnership with RWAS
Wednesday this week saw the opening of the new Mass Vaccination Centre at the Royal Welsh Showground in Llanelwedd, Builth Wells. In its first few days of operation it will see almost 1,000 Powys residents aged 80 and over receive their first dose of the COVID vaccine.

Vaccination under way at the Royal Welsh Showground
Husband and wife Alec and Elizabeth Tompkins both received their vaccines at the centre and expressed how glad they were to have had it and how they hoped that it would help bring things back to normal soon.

The showground at Llanelwedd provides a great central location in Powys for the vaccination centre and has excellent facilities available to make the vaccination process as easy as possible.

As well as the fantastic support from the showground staff in getting set up, health board staff are supported by an army of volunteers as well as by members of the Royal Air Force to ensure that everything runs smoothly.

Carol Shillabeer, Chief Executive of Powys Teaching Health Board said “This really goes to show the benefits of partnership working in Powys. We have been working together with the Royal Welsh Agricultural Society on testing and now we are doing COVID vaccinations. I would like to thank Steve and his whole team for the help and support they have given us over the past year.”

Steve Hughson, Chief Executive of the Royal Welsh Agricultural Society explained that “There have been huge difficulties right across the events sector since COVID struck. We were not able to hold our regular events at the showground last year and there remain huge challenges still ahead. Despite these challenges, the Royal Welsh Agricultural Society is proud to be able to work with Powys Teaching Health Board and to support the work they are doing to combat the virus.

We have hosted a COVID testing facility here on the showground for a number of months now and I am really proud to see the Mass Vaccination Centre opening here on the showground. We are delighted to have been able to play our part in helping the wider community in Powys at this time and we will continue to support in any way we can to help get back to normal and welcome people back to the showground for future agricultural events.”

Working Together Across County Borders
The COVID-19 vaccination programme is provided based on where you are registered with a GP. Some Powys residents are registered with GPs in neighbouring counties. If this applies to you, the health board (Wales) or clinical commissioning group (England) will ensure that arrangements are in place for you to receive your COVID19 vaccination. Health bodies are working together across county borders to make sure that no one misses out.

More information about vaccination programmes in neighbouring counties is available
from our website:

Further Information about COVID-19 vaccination:
More information about our COVID-19 vaccination programme here in Powys is available from the Powys Teaching Health Board website:
http://www.pthb.nhs.wales/coronavirus/covid-19-vaccination/ More information about the national COVID-19 vaccination programme in Wales is available from the Public Health Wales website:
• Iechyd Cyhoeddus Cymru (CY) and Public Health Wales (EN)

The latest information about the number of COVID-19 vaccination doses delivered in Wales is available from the Public Health Wales dashboard – please remember that PTHB has the smallest population of all health boards, and is around a third of the size of the next health boards (Cwm Taf Morgannwg, Hywel Dda):
• Public Health Wales dashboard More information about the Welsh Government’s strategy for COVID-19 vaccination:
• Llywodraeth Cymru (CY) and Welsh Government (EN)

You will receive an invitation when you are due for your vaccination. You don’t need to apply for an appointment – please don’t contact your GP, pharmacy, health board, hospital or local authority about an appointment until you are contacted.