COVID-19 vaccination sites: information and guidance on setting up and managing the booking capacity of each site




Version 2, 20 May 2021

Publications approval reference: C1277

This guidance is correct at the time of publishing. However, as it is subject to updates, please use the hyperlinks to confirm the information you are disseminating to the public is accurate.

Any changes since v1 (7 January 2021) are highlighted in yellow.

1. Introduction

1.1 This standard operating procedure has been developed to provide Vaccination Site operational leads and site managers with information and guidance on setting up and managing the booking capacity of each site.

2. General information

2.1 The National Call Recall Solution comprises the following:

  • National Booking System (NBS)
  • Call/Recall Call Centre (issue of letters and follow on calls)
  • Operations Centre (for assisted Booking via telephone 119 service).

2.2 The NBS provides the system function to enable individuals to book their appointments for vaccination against COVID-19 at a vaccination site, either online or by telephone through the Operations Centre (via 119). Some PCNs also use NBS for the management of vaccination appointments for cohorts 10-12.

2.3 The NBS is complementary to other existing Primary Care Network (PCN) and secondary care booking services where vaccinations are already being delivered.

2.4 Q-Flow is the administration programme and booking engine which sits behind and interacts with the NBS. The NBS (Q-Flow) website for vaccination sites has more information, as well as a dedicated user guide.

2.5 The key NBS parameters are:

  • The NBS manages multiple vaccination types
  • Invites are released to match vaccination site capacity to avoid under/over booking
  • The Medicines and Healthcare products Regulatory Agency (MHRA) has authorised the COVID-19 Vaccine (AstraZeneca), COVID-19 mRNA vaccine (Pfizer/BioNTech), and the COVID-19 mRNA vaccine (Moderna) on a two-dose schedule. For further information:
  • JCVI guidance published on 30 December 2020 states that all Vaccination Centres and Community Pharmacies should ensure second dose appointments are booked in by the twelfth week post the first dose. The Vaccination Programme decision is to open bookings from week 11 post the first vaccination dose with an expectation that most second doses are completed in the 12th week.
  • On 15 May 2021, the government updated this instruction in response to advice from the independent JCVI, to accelerate second doses for priority cohorts 1-9, bringing forward second dose appointments for remaining people in these priority groups from 12 to 8 weeks. Those aged under 50 will continue to get their first dose, with their second dose at 12 weeks, as has been the deployment strategy so far. This guidance is available in full here.
  • In response to the updated guidance, the NBS configuration for second dose intervals for AstraZeneca has been amended from 77-84 days to 56-84 days. The interval for Pfizer and Moderna continues to be set at 77-84 days, as few people in cohorts 1-9, who would be expected to book their second dose via NBS, have had Pfizer and Moderna as a first dose. This will be updated for this group at a later stage.
  • JCVI guidance defines the vaccination priority groups of the different phases of the COVID-19 vaccination programme
  • Following recent JCVI guidance, pregnant women should be offered the Pfizer-BioNTech vaccine or Moderna vaccine and they can now book appointments on the NBS at a site that offers PfizerBioNTech or Moderna following a series of screening questions.
  • All vaccination sites offering the Moderna or Pfizer BioNtech vaccines must ensure that pregnant women are able to book appointments, based on age and clinical group. Public Health England’s Green Book has been updated to reflect this advice. Further advice is here.
  • Every woman who is pregnant or thinks she might be, should be offered a discussion on the potential risks and benefits of vaccination with a clinician, so that she can make an informed choice about whether to receive it. Pregnant women will be able to have a conversation with a healthcare professional at their vaccination appointment or can speak to their maternity team or GP service.
  • Individuals must be registered with a GP in England in order to book a COVID-19 vaccination on the NBS. Commissioners will identify individuals who may not be registered with a GP, for instance homeless people or travelling communities.
  • Individuals using the NBS will be required to book both doses at the time of booking. As of current guidance, individuals who have received their first vaccination dose will receive the second dose of the same vaccine.
  • The NBS will offer a choice of second dose appointments at sites that deliver the same vaccine as individuals have received at their first dose, provided appointments are available in the required 77 to 84-day window.
  • The NHS will contact individuals directly within priority cohorts 1-9 whose second dose appointment is due on or after 25 May (where that is more than 8 weeks after their first dose), who have booked via the NBS to encourage them to rebook an earlier appointment.

3. Invitation to book a vaccination appointment

3.1 Based on JCVI guidance, eligible individuals will receive a notification (text/letter) with an invitation to book a vaccination appointment either online or to call 119. Further information about the 119 call appointment booking process for call handlers is contained in this video.

3.2 NBS checks eligibility against NIMS and directs citizens to available appointments for which they are eligible. This includes these scenarios:

  • Individuals in an eligible cohort are directed to all available appointments within a 60-mile radius.
  • Individuals under 40 (excluding clinically vulnerable and clinically extremely vulnerable) are directed to Pfizer-BioNTech vaccine or Moderna vaccine appointments, not AstraZeneca, as per JCVI guidance.
  • Individuals who declare that they are pregnant are directed to the Pfizer-BioNTech vaccine or Moderna vaccine appointments, as per JCVI guidance.
  • Individuals who have previously had a first dose PfizerBioNTech vaccine are displayed second dose Pfizer-BioNTech vaccine appointments. This is true for all vaccine types.

3.3 Call centres can expect to be contacted by health and social care workers (HSCW) wishing to book their second dose in a Vaccination Centre or Community Pharmacy if their first dose was delivered in a VC or CP. Anyone who has not booked their first dose via NBS will have to wait 24 hours after their first dose to book their second dose appointment. This is because their first dose vaccination is recorded in the Point of Care System and will not show in the NBS until the following day.

3.4 Individuals can book appointments up to midnight the day before the appointment; it is recommended to vaccination sites that a back-up list of the day’s appointments is produced at the start of each day in case access to Q-flow goes down.

3.5 People will predominantly book their appointments via the NBS. However, a number of eligible individuals may not be able to use the NBS, or individuals may be vaccinated as part of ensuring reduced vaccine waste and community pharmacy-led sites can also undertake local booking with permission from the commissioner under the terms of the LES. In these instances, patients can be vaccinated and added manually to the  Outcomes4Health/Pinnacle Point of Care system. Within 24 hours of that record being created, the patient will then be able to book their second dose appointment via the NBS in the same way as any other patient. For further information, please see the SOP for COVID-19 local vaccination services deployment in community settings and the Operating Framework for Vaccination Centres.

3.6 It is expected that the vaccination site will have local arrangements in place to fill appointments not being booked through the NBS for example, engaging with local health and social care workers to fill empty slots or utilise ‘walk-in’ operating models. Further guidance on outreach models is currently being developed.

3.7 Patients with NBS appointments must also be checked-in on the NBS system. The NBS (Q-Flow) website for vaccination sites has more information, as well as a dedicated user guide.

4. Provider set-up

4.1 NBS regional managers have previously been responsible for creating sites within Q-flow. From Wave 13 onwards, sites have been created centrally by the national team. Creating the site in Q-flow will enable site managers to subsequently add site attributes and appointment availability, which will then be visible to the public through the NBS.

4.2 The national team will register the vaccination site by adding the COVID19 vaccination centre Organisation Data Service (ODS) code, site address and creating the relevant accounts for the user(s) allocated the role as site manager. Site managers are sent their login details by approximately one week prior to the expected go live date.

4.3 The Vaccination Centre, Community Pharmacy or PCN site manager(s) will log into Q-Flow using the user account(s) to set up their site attributes and create appointment availability on the NBS.

4.4 There are step-by-step videos and training materials to guide site managers through the process. Please see section 14 on Training.

Registering the site and its attributes

4.5 Site managers are responsible for updating accessibility and transport information about the site they manage. A site’s longitude and latitude details are inputted at the point of site creation, corresponding to the address provided. Site managers should check this is correct as site coordinates are used to calculate distance from postcodes entered by individuals into the NBS.

4.6 Individuals booking vaccination appointments can choose a site that meets their accessibility needs and transport requirements. They will be informed of the distance from the site to the postcode entered.

User access for workforce

4.7 Site managers will need to set up user accounts for any other site managers, arrival stewards and assessment clinicians at their sites who will be using Q-Flow, setting relevant roles and permissions.

4.8 Site managers should deactivate the user accounts of any site staff who no longer work at the vaccination site to remove their access to the patient data held in NBS. Instructions for doing this are in the ‘Edit a user’s account’ section at

5. Approach to managing appointment capacity

5.1 Site managers at Vaccination Centres should publish two weeks (or as otherwise agreed at regional level) of appointments at a time in which individuals can book their first vaccination appointment; this is to avoid DNAs, cancellations and reduce confusion.

5.2 When booking through NBS, people are required to book both their first and second doses. As such, site managers should publish a further three weeks of appointments during the appropriate second dose window to allow people to book their second appointment and provide additional capacity for the second appointment of HSCW/walk-ins. This will ensure an extra week of appointments to allow for the flexibility of people having a 7-day window to book their second appointment). For AstraZeneca clinics, the appropriate second dose window can be calculated as starting 56 days from the first clinic and ending 84 days from the last clinic. For Pfizer-BioNTech vaccine or Moderna clinics, the appropriate second dose window can be calculated as starting 77 days from the first clinic and ending 84 days from the last clinic.

5.3 Site managers should not differentiate between first and second vaccination appointments initially (unless agreed at regional level). Any appointments not utilised as second appointments in the second dose window will eventually be filled as first appointments, but only once appointment capacity has been scheduled during this period where people can book corresponding second dose appointments.

5.4 Site managers at Community Pharmacies and PCNs should publish one week of appointments at a time in line with confirmed vaccine deliveries (or as otherwise agreed at a regional level), with corresponding second dose appointments. For AstraZeneca clinics, the appropriate second dose window can be calculated as starting 56 days from the first clinic and ending 84 days from the last clinic. For Pfizer-BioNTech vaccine or Moderna clinics, the appropriate second dose window can be calculated as starting 77 days from the first clinic and ending 84 days from the last clinic.

5.5 Site managers should add additional availability each week as the site receives confirmation of vaccine supply – noting sites should only release appointments where vaccine allocation is confirmed (along with the corresponding second dose period).

5.6 Site managers should ensure that sufficient second dose appointments are available on any given day. This is:

  • to enable individuals that may not have booked their second dose to do so.
  • so that people in cohorts 1-9 who need to re-book a second dose appointment within 8 weeks of their first dose appointment following updated guidance given on 15 May 2021 can do so.

5.7 Site managers should ensure that 20 second dose appointments are available on any given day for Pfizer-BioNTech clinics. Smaller sites can offer a lower number in accordance with their second dose allocations and capacity. Second dose capacity for Astra Zeneca clinics will be agreed at regional level.

6. Managing appointments

6.1 Site managers can view and print the calendar, view appointment details and cancel a booked appointment.

6.2 It is important to print out site appointments at the beginning of each working day. This will provide a back-up in case internet connection is lost, bearing in mind that appointments on a given day can be booked the day before up until midnight.

6.3 The appointments list for each day can be accessed in two ways, either by printing appointments via the calendar, or using the Unit Appointments Listing report.

7. Cancelling appointments

7.1 Individuals can cancel appointments via the same NBS online function or call centre as when they booked. For individuals, cancelling an appointment on the day is not possible. Vaccination sites, however, can cancel appointments on the day.

7.2 If the site needs to cancel an appointment, the site manager must log onto the system and complete the cancellation. Please see further information here.

7.3 If an email address or mobile number for the user is held on the system, they will automatically receive a notification about the cancellation. If only a landline number is held, site staff will need to phone the individual to confirm the cancellation and advise them to re-book using the same method used previously.

7.4 If no contact details are held, it is likely the individual will attend their appointment. Please refer to the FAQ document on the Vaccine Booking Service for further information.

7.5 Vaccination sites are not expected to re-book appointments for individuals whose appointments they cancel. Individuals should book themselves through the NHS website or by calling 119.

7.6 It is not currently possible for sites to cancel appointments in bulk.

8. Did-Not-Attends (DNAs)

8.1 If an individual did not attend (DNA) their appointment, it is their responsibility to re-book their appointment from the day after their missed appointment.

8.2 If an individual did not arrive for their appointment and therefore are not checked-in, they will be recorded as a ‘DNA’ on the Unit Appointments List report. Individuals can then rebook their appointment from the day after their missed appointment.

8.3 The Unit Appointments List report on Q-flow can help calculating the number of DNAs on any given day. If an appointment has not been checked in by 11:00pm, it will be automatically changed to the ‘DNA’ status by midnight. The data collection via the Unit Appointments List report requires a site to use the check in app to record individuals who have attended.

8.4 Individuals reported as ‘DNA’ for their first appointment will not automatically have their second appointment cancelled. This is because a ‘DNA’ notice on NBS is not sufficient evidence that an individual has not been vaccinated.

9. Individual check-in and validation

9.1 Arrival stewards will operate the ‘check a vaccination appointment’ app, accessed through a smart device. Stewards will need to log in at the start of their shift and confirm the VC they are working at to gain access to the appointment records for that day. The app is available here. The app provides instructions about the questions to ask and the information to enter.

9.2 The process for service user check-in can be found here.

9.3 Some individuals may arrive for their appointment with a print-out of the appointments they had selected without having “confirmed” their appointment on the NBS. They would not have a booking reference and therefore no appointment recorded for them. These individuals are eligible to receive the vaccine and should be vaccinated. The NBS has been updated and the requirement to confirm appointment details has been removed.

9.4 Following individual appointment check-in, there may be other check-in processes in place to ensure the safety of everyone and to support the assessment of citizens prior to vaccination.

9.5 Once an appointment is booked the status is ‘expected’.

9.6 At the point the individual is checked in by the check-in app the status becomes ‘waiting’.

9.7 Waiting status automatically changes to ‘completed’ after 11pm on the day the appointment was checked in. NBS does not check against Qflow to confirm the vaccination was conducted, it confirms only that the appointment is completed. It is therefore possible that an individual may attend their vaccination appointment and not subsequently be vaccinated (e.g. consent not given following screening questions).

9.8 If an individual is not checked in, the appointment status automatically changes to ‘no show’ after 11pm on the day of the appointment.

9.9 The information captured via the check-in app (e.g. individuals who have booked an appointment and attended, and those that did not attend) directly feeds into Foundry with the result that vaccination sites no longer need to provide those figures in the SitReps.

10. Vaccinating people without NBS appointments

10.1 A vaccination site may sometimes vaccinate someone who did not have an appointment on NBS, for example, a HSCW, a volunteer at the site or a carer for someone who did have an appointment. The vaccination site should advise this person to make a booking for their second dose via the NBS or by calling 119 from the day after their first dose.

10.2 A vaccination site does not have to create an appointment on NBS if they are vaccinating someone who does not have an appointment.

11. Health and social care workers

11.1 Eligible frontline health and social care workers aged 18 and over can book through the self-declaration route in the NBS, and local systems must continue to ensure local provision for all eligible health and care workers.

11.2 As set out in this letter of 11 February, when using the online or telephone service, social care workers will need to self-declare at the point of booking and will be asked for identification and written authorisation when they attend their vaccination appointment. Appropriate forms of identification include a work photo ID card, authorisation letter from the local authority, a signed letter of authorisation from their employer or wage slip that is dated within the last 3 months. Where work photo ID is not available, alternative photographic identification is required to support verification. All vaccination sites are expected to follow this approach.

11.3 The NBS continues to be open to booking by unpaid carers who are eligible on the National Immunisation Management Service (NIMS), i.e. who are flagged on the system as being carers. Whilst unpaid carers do not need an NHS number or to be registered with a GP to be eligible for the vaccine, please note an NHS number is required to book through NBS. Unpaid carers booking via this route do not need to provide identification.

12. Reporting

12.1 Site managers and regional managers can access a report showing the number of booked appointments at each site across any date range. This will help to manage capacity going forwards.

13. Vaccination Service Desk

13.1 In the event of system failure and the Q-Flow system cannot be accessed or the check-in app is offline, individuals should be checked-in manually using the calendar printed at the beginning of the day and reconciled by the end of the day.

13.2 There is a single point of contact Vaccination Service Desk operated by ATOS for technical and data queries and issues. The service can be accessed by email at or by phone on 0300 200 1000, which is staffed from 06:00 – 22:00 every day (including bank holidays).

14. Training

14.1 Details of site manager training sessions for sites in the run up to go-live will be cascaded via the NBS Onboarding team. Guidance can be found here.

14.2 Site managers have been invited to join the ‘Covid Vaccination IT Systems Training Future’ NHS workspace. This is an online, collaborative workspace for colleagues working across health and care on the Covid Vaccination programme. You can find there all the training materials in relation to the IT systems being used including guidance documents, videos, FAQs. Information regarding future training sessions or drop ins, available to all vaccination sites, is on the NHS Futures platform’s training calendar.

14.3 If you are not already a user of the Future NHS collaborative platform, where the workspace is hosted, you will need to sign up as a user before you can access content on the workspace.

14.4 If you have colleagues who would like to be invited to the workspace they should email