How family doctors will speed up Covid-19 vaccinations across Germany from April

Germany's vaccination campaign is to get a major boost soon thanks to more supplies of Covid-19 vacines and allowing doctors' surgeries to give out jabs.

How family doctors will speed up Covid-19 vaccinations across Germany from April
GP Birgitt Lucas administers a Covid vaccination to a patient as part of a pilot project in Hof (Bavaria). Photo: DPA

The country’s sluggish coronavirus vaccine campaign is to gradually gain momentum with the planned inclusion of doctors’ surgeries from April, Health Minister Jens Spahn said on Wednesday.

However, it will take time to build up speed. The number of vaccines given out will not “immediately grow to 20 million a month or to 10 million a week”, Spahn told broadcaster ZDF.

He said that vaccinations can be carried out more flexibly in GPs’ practices. “The doctors know their patients and know who should be vaccinated first,” said Spahn. The next step is vaccinations in workplaces by company doctors.

READ ALSO: When will I be in line for a Covid vaccination in Germany?

On Wednesday, health ministers of the federal and state governments were due to discuss further details and the exact starting date for GP practices to inoculate people.

The ministers also want to clarify how the doses will be distributed among the regional vaccination centres in the states, and the GP practices. The bureaucratic effort for doctors is to be reduced to a minimum, DPA learned from sources.

Up to now, vaccinations have been carried out mainly in vaccination centres and with mobile vaccination teams that travel to nursing homes, for example. In some states there have been successful pilot projects for jabs in doctors’ practices.

How many people have been vaccinated against coronavirus?

While the UK, USA and Israel have forged ahead with their vaccination programmes, Germany and other EU countries have been slowed down by supply shortages and limits set on the use of the AstraZeneca vaccination. That’s been compounded by reservations about the AstraZeneca jab.

READ MORE: Why have tens of thousands of Germany’s AstraZeneca vaccines not been used?

So far, about three percent of people in Germany have been fully vaccinated with both doses, and 6.7 percent have received a first dose. About 8.1 million doses have been administered since the inoculation programme started shortly before the start of 2021.

Screenshot: Our World in Data

Due to low supplies of vaccine doses, there is a priority order to who gets the jab first. The highest priority is given to the elderly, health workers at high risk of infection and people with underlying diseases.

Spahn said: “I have a very high level of trust in doctors that they will vaccinate those patients first who are also most at risk.” Prioritisation would generally continue to be necessary, he said, adding: “Saving lives is not bureaucracy.”

Could people be vaccinated earlier?

The head of the National Association of Statutory Health Insurance Physicians, Andreas Gassen, believes it’s possible to vaccinate 20 million people per month in Germany from April – and bring forward the deadline for offering all adults a vaccine by September 21st.

A first dose for all adults could be offered by the first half of June, and full immunisation by the beginning of August, Gassen told Welt.

The prerequisite for this is a rapid supply of vaccines. With five million doses administered per week in the practices and about 1.5 million vaccinations in centres, “a much earlier date than September 21st” is achievable, he said.

What’s the plan for coronavirus hotspots?

The EU is to receive an extra four million BioNTech/Pfizer vaccine doses over the next two weeks to be deployed to Covid-19 “hotspots”, European Commission chief Ursula von der Leyen said on Wednesday.

The additional package has been negotiated so that EU states can vaccinate in problem regions and slow down more contagious virus variants.

Germany could receive around 18.6 per cent of the additional quota – 740,000 doses.

After the EU announcement, Bavarian leader Markus Söder announced that Bavarian Covid hotspots on the border with the Czech Republic would receive an additional 100,000 doses of vaccine.

Altogether there will be an additional 150,000 doses for the border regions particularly affected by the British variant of the virus.

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EXPLAINED: What to do if you face a long wait for healthcare in Sweden

Sweden theoretically has a "healthcare guarantee" limiting your wait to see a GP to three days, and to see a consultant to three months. The reality is somewhat different. Here's what you can do if you face a long wait.

EXPLAINED: What to do if you face a long wait for healthcare in Sweden

What is Sweden’s ‘healthcare guarantee’? 

Sweden’s “National Guaranteed Access to Healthcare” or vårdgaranti, is a right to care, protected by law, that has applied in Sweden since 2005. You can see the latest version of the relevant laws here and here. Here is a summary of the guarantee on the website of the Swedish Association of Local Authorities and Regions (SKR).

Under the system, all patients are guaranteed:

  • contact with a primary care centre by phone, in-person, or by video-link on the day they seek care 
  • an appointment with a doctor, nurse, physio, or psychotherapist within three days of seeking help 
  • an appointment with a specialist doctor or consultant within 90 days of seeking help 
  • treatment or operation within 90 days, if the specialist considers this necessary 

Does the guarantee mean I have a right to treatment? 

No. If the doctor at the primary care centre, after examining you and questioning you, decides that there is no reason to refer you to a specialist doctor, they do not need to do so. 

Similarly, if the specialist doctor, after examining you, decides that no treatment is necessary, then your case is considered completed.  

Can the waiting times to see a specialist or to get treatment be longer than 90 days? 

Absolutely. In fact, they very often are. 

According to the Swedish Association of Local Authorities and Regions (SKR), in February, 32 percent of patients had been waiting 90 days or more to see a specialist, and 43 percent of those who had seen a specialist had been waiting for treatment for more than 90 days.  

The situation in primary care was a little better, with 80 percent of those seeking care in contact with their primary care centre on the same day, and 83 percent having their case assessed by a doctor or nurse within three days. 

In addition, if you agree with your specialist doctor that you are willing to wait longer for an operation, then that wait doesn’t get counted in the statistics. 

So what can I do if I’ve been waiting longer than the guaranteed time? 

In reality, it’s actually less a guarantee than a target.

In primary care, there is no way for individual patients to complain that they have had to wait too long to see a doctor or nurse, or to cut their waiting times by citing the guarantee. 

“There’s no system for enforcing that guarantee,” says Emma Spak, the primary care doctor who doubles as section chief for SKR’s healthcare division. 

It would make no sense to set up a complaints line for those who have had to wait too long for phone contact with their primary care centre, she points out, when they could instead talk to patients seeking a primary care appointment in the first place. 

“It’s more of an incentive system for the regions,” she explains.

Every primary care unit and every region reports their waiting times to the national waiting time register, and then as part of the access agreement between SKR and the government, the regional health authorities receive a bonus if they meet their waiting times goal, or if they improve their waiting times. “That’s one way of sort of enforcing this guarantee,” she says. 

When it comes to specialist treatment, though, patients do have the right to demand to be examined or treated by an alternative specialist or hospital if they’ve had to wait longer than 90 days.

If your primary care centre issues you a referral to a specialist, and the specialist cannot then offer you an appointment within 90 days, the specialist, at the same time as offering you a later appointment, will often put you in contact with a unit at the regional health authority who will offer to find you an alternative specialist, either within the region or elsewhere in Sweden. 

The regional health authority will then have to reimburse any extra travel or hotel costs incurred by the patient.  

Similarly, if after examining you, a specialist cannot offer you treatment within 90 days, they will normally put you in contact with the same unit. 

Some regions have a phone line for people who have been waiting too long, or else you can contact your specialist or primary care centre and ask for information on seeking an alternative specialist. 

What happens if I don’t want to travel to see a specialist or get treatment? 

If your regional health authority offers you an alternative specialist, either within your region or in another region, so that you can get treated within the 90 day period, and you are unwilling to travel, then you lose your rights under the guarantee. . 

“If you’re in Gothenburg, and they say you have to go to Stockholm to get your treatment, and you say, ‘no, I want to go here, then then you’ve sort of forfeited your right, and you have to take what’s on offer,” Spak says. 

What happens if I agree with my specialist to wait longer? 

If your specialist says that they can treat you in four months, but also offers you treatment elsewhere within the guaranteed 90 days, and you choose to be treated by your specialist, then that counts as a patient choice, which will not then be counted in the statistics. 

“The specialist might say, ‘I don’t think you will get any worse for waiting two months extra, and if you wait five months, then I can make sure that you get your surgery done here, and we can make sure that you get all the aftercare and everything here as well,” Spak says. 

But these patient decisions are also counted in the statistics, and if a region sees a sharp rise in patients choosing to wait, SKR will tend to investigate. 

“If some region all of a sudden has a lot of patients choosing a longer waiting time, then we will call them and ask what’s going on here, because patients don’t tend to want to wait extra,” Spak says.  

Can I get financial compensation if I’ve been waiting too long? 


What other ways are there of speeding up the wait for treatment? 

Don’t underplay your symptoms

When drawing up their timetable for treatment and assessment, specialists will tend to give different patients different wait times depending on the urgency of their case.

For this reason, it’s important not to underplay your symptoms when visiting a primary care doctor, as they will tend to include a few lines on the urgency of your case when they write their referral. 

Stress your flexibility 

If you are unemployed, a student, retired, or have a very flexible job, it is worth telling your primary care doctor about this, because they may write in your referral that you are able to make appointments at very short notice. The specialist may then put you on their list of people to ring if one of their patients cancels. 

“Sometimes I write in my referrals that this patient could easily come at short notice, so please put the patient on the list for people you can call if there’s a time slot available,” Spak says. 

If you haven’t told your primary care doctor this, it’s not too late. You can ring the specialist yourself and tell their receptionist that you are very flexible, and ask to be put on the back-up list. This is particularly useful if you’re waiting for a scan, but you could also potentially work even if you’re waiting for heart surgery or a hip replacement. 

“If they’ve accepted you as a patient, and they’ve made sure that you fulfil the criteria for having that scan or whatever, then you can call them and say, ‘I have a really flexible job, I can come anytime if you have a gap,'” Spak says.

“A lot of people do that, because they can have [back-up] waiting lists. If you tell them ‘I work around the corner and I only need 15 minutes to be there’, then they might call you if someone doesn’t show up.” 

Ring up your specialist 

The queue system tends to be quite ad hoc, with no strict rules over who should be treated first, so it is often possible to reduce your wait by ringing up your specialist a few times a month, just to bring your case to their attention. Sometimes the receptionist will remember a slot that has just come free and bring forward your treatment while you are still on the telephone.