A large portion of Auckland's GPs and urgent care clinics will be ruled out of providing Covid-19 vaccinations because they have to be able to provide up to 75 immunisations a day.
Royal New Zealand College of General Practitioners' medical director Dr Bryan Betty said 75 vaccinations in a day "would be a lot for many surgeries".
"Some would be able to do it, not all. I think there needs to be some flexibility around this," he said.
A Northern Region Health Co-ordination Centre webinar last week with about 300 primary care providers included a slide indicating only 15 GPs and urgent care clinics would be part of the rollout - three in the Waitemata DHB, two in Auckland and 10 in Counties Manukau.
But a centre spokeswoman said 16 practices and clinics came forward when they called for expressions of interest as part of an "early adopter" model and agreements were now being finalised with 13 of them.
"Further primary providers will be required to support the programme over the coming months and we are encouraging primary care providers to submit expressions of interest for this work. Those that are chosen will need to have an established cold chain and be able to deliver up to 75 vaccinations a day."
While that requirement would rule out a large number of clinics, Betty said it was essential general practices were involved in the rollout to make sure uptake was as high as possible.
"Without a mixed model that is general practice plus large vaccination centres plus other avenues there is a chance that we'll fall behind in the vaccination programme and that's not a great outcome," he said.
"We want to maximise our chances of this succeeding and we want to maximise the ability of patients and people to access the vaccine efficiently and in a timely manner and that requires, I think, engagement with the general practice community."
Betty said there had been confusion over the role of general practice in the rollout and he had heard anger from some members who felt they had been cut out of the process by their DHBs.
But in the last two weeks the Ministry of Health had made clear its intention that general practices would be part of the rollout either individually or in clusters, he said.
"The Ministry and the DHBs need to be acting in a way that reduces barriers to general practice giving this vaccine. They need to encourage as many general practices as possible to be engaged in this because at the end of the day if we end up in a situation where we have to have yearly boosters we need to set up a system that works repeatedly and involves as many general practices as possible."
Betty said barriers to GPs being involved so far included the requirement surgeries be able to carry out a set number of vaccinations in a day and the huge amount of administration required to gain and record written consent for each dose.
"We want to see this succeed. We want to work with the DHBs and the Ministry on this to get it across the line and there needs to be goodwill on both sides."
The Northern Region Health Co-ordination Centre presentation last week also revealed plans for six super vaccination centres across the city's three district health boards which could each immunise up to 1000 people a day, 10 medium sites which could give up to 500 doses a day and outreach facilities for aged
Already up and running were large centres in Highbrook and Mt Wellington as well as medium sites in the CBD, Otara, Manurewa Marae and Waitakere Hospital.
Another super vaccination centre was earmarked for Birkenhead on the North Shore while the locations of the other three remained vague. Medium sites were planned for North Harbour, "pacific site west", Ranui, Glenn Innes, Mangere and Pukekohe.