Agenda item

The NHS is responsible for vaccination. The Board will discuss the Clinical Commissioning Group’s activity and plans for Covid and flu vaccination in the borough and consider what further support the health partners can provide.

Councillor Coleman briefly provided context to the discussion highlighting challenges around increasing flu vaccination take up which had been prevalent for the past 5 years, what activity had been undertaken by the CCG address this and how the council could provide support.  Sue Roostan referenced the local plan which had been jointly agreed between H&F CCG and the council and submitted to the North West London (NWL) Collaborative of CCGs. This was a “live” document which would incorporate improvement around vaccine take up. Presenting data on improved local uptake Sue Roostan offered assurance that ongoing work was having an impact. The new vaccination site at the Novotel had by 24 March administered vaccinations 6370. It was recognised that there was significant ongoing work being undertaken jointly between the CCG and local authority to support groups that were reluctant or had refused the vaccine and that this contributed to a much broader piece of work across NWL.

Locally the use of pharmacy sites was also being considered (subject to review) as was the deployment of pop-up clinics and how these could be strategically placed around the borough.   As the vaccination programme developed there would be a shift in focus to second dose vaccinations and the delivery, availability and supply of vaccines had been planned to mid-April.

Linda Jackson added that it was important to recognise that this was an on-going journey and that process had been continually refined.  There had been challenges in identifying H&F residents that had refused an offer of the vaccine and the reasons for that choice. Joint engagement work with the GP Federation within the borough included follow-up phone calls with residents and the provision of support where needed ranging from transport to home visits.  It was anticipated that this was potentially a model that could be successfully replicated for other vaccination programmes such as flu and childhood immunisations.  Long term, the work would also help inform the Vaccine Equity Plan and continued joint working.

The Board was informed about the significant work being undertaken with the borough’s Faith Forum, community and voluntary groups speaking with community leaders to help communicate information about vaccination which had been very successful and would inform the Vaccine Equity Plan. Linda Jackson reported that the mass vaccination site had been a very successful piece of work and thanked all partners for their commitment and hard work. 

Councillor Coleman commented that the borough had been unfairly criticised for having lower vaccination rates compared to neighbouring boroughs.  Sue Roostan responded that in the previous three months H&F CCG had proactively engaged with hugely diverse communities and that open and continued dialogue was essential. The range of screening work undertaken within the NHS invited public engagement which helped with prevention and earlier diagnosis.  Lower H&F vaccination rates could be attributed to several factors including target setting within a fixed time frame, particularly in the 80+ group  or people waiting to see how others would be impacted but there had been some good signs of improvement amongst other cohorts with daily numbers increasing. Sue Roostan commended the work of the Primary Care Network (PCN) sites which had been operational 12 hours a day.

Councillor Quigley sought further information about the actual number of those who had received the vaccine from the clinically extremely vulnerable group and why this rate was not higher as many within this group will have be shielding for about a year and would be keen to be vaccinated at the earliest opportunity (Linda Jackson confirmed 11, 856 within the borough had been vaccinated). Sue Roostan explained that the lower than expected 76% rate could be attributed to a coding issue and that some would have been identified in other cohorts according to age.  Dr James Cavanagh assured Councillor Quigley that every individual with the cohort had been offered a vaccine inferred that more nuanced conversation was required to understand reasons why it had been refused. This could be attributed to beliefs, or in some cases relatives with medical power attorney who had refused the vaccine. 

Vanessa Andreae reiterated that every patient had been contacted unless they lived overseas. It was highlighted that there was marked difference within the cohort between refusing the flu vaccine and refusing the Covid-19 vaccine.  As part of the Covid-19 vaccination process people were required to report whether they had received a flu vaccine within the past 7 days, and many had remarked that they have never had one and would refuse to have it in future.

Councillor Coleman reported that there had been considerable work within the borough to remove barriers and which also provided information that helped to understand why people refused to be vaccinated and to avoid assumptions as to reasons for refusal.  Councillor Coleman shared his concern about vaccine take up within some minority ethnic communities and the decades of social and historical mistrust of government institutions which had in some cases informed decisions to refuse Covid-19 vaccination. 

Toby Hyde commended the work of the Primary Care Network working jointly with the local authority to deliver the vaccination programme locally.  Many of these teams involved had already worked extremely hard in the past 12 months and were now trying to get as many people vaccinated as possible.  Many minority ethnic community healthcare staff reflected the point made by Dr Cavanagh and that it was necessary to have more nuanced dialogue as to why vaccination had been refused.

 In many cases, the reasons why some were more reticent than others about vaccination pre-dated the pandemic that it would take some time and longer- term engagement to fully address the issue.  It was reported that a mass vaccination site had recently been opened at the Novotel and that there had been a significant number of bookings with 6300 vaccinations provided this week.  The Board highly commended the extraordinary work undertaken by those involved and acknowledged how challenging this had been. 

Councillor Coleman also commended Linda Jackson for negotiating the provision, which had initially been declined but which was eventually agreed to following sustained representations from the borough.  Linda Jackson reported that vaccine take up on the first operational week of the Novotel site was significantly better than the numbers reflected across North West London with a 100% of bookings completed on day one.  This emphasised the importance of understanding the needs of the local population of a borough and for this to be evidence based, recognising that every borough was different.

Merril Hammer enquired if mobile vaccination units would be deployed in more deprived parts of the borough.  Sue Roostan responded that there were plans to undertake a more targeted approach with the borough through funding that would be made available from NWL working with communities.  Vanessa Andreae added that funding had been received to run two pop-up clinics which had been delivered by the Bush Doctors practice.  This was offered to residents with learning disabilities to enable them to access a clinical site staffed by clinicians that were familiar to them. 

A separate pop-up clinic had provided vaccines to 40 people within the 80+ cohort that could not make the journey to the Richford Gate site confirming that adjustments had been made to ensure more tailored delivery responding to identified need within the local population, within the challenging parameters of vaccine transportation and storage.

Jim Grealy enquired if the electronic information boards could be redeployed at busy public sites such as parks to ensure that a cultural expectation of getting the vaccine could be developed.  Linda Jackson welcomed the suggestion and confirmed that the dot matrix boards could be utilised in this way however this would have to align with delivery according to the eligibility criteria.  A general message about having the vaccination would not be ideal but careful messaging about this was potentially helpful.

RESOLVED

1. That the HWBB considered the plan and the proposed planning numbers to

reach the community within the JVCI priority group; and

2. That the Board receive update at the next meeting on the progress made.