Issue - meetings

i.              Influenza and Local Vaccination Update - Emdadur Rahman, Primary Care Development Manager, Enfield Directorate, North Central London Clinical Commissioning Group

ii.            Partner updates

RECEIVED the Enfield Integrated Care Partnership Screening and Immunisations Task and Finish Group flu update and presentation introduced by Deborah McBeal, Dr Hetul Shah and Vee Scott, North Central London Clinical Commissioning Group.

NOTED

1.    The update from the stakeholder meetings, which were held fortnightly, recognising the time lag due to reporting timelines.

2.    Current data was reported verbally: figures showed improvement across all domains.

3.    Data was tracked in close to real time and gave an understanding of where further efforts were required and focus for flu campaigns.

4.    Lower than hoped for vaccination rates for pregnant women were escalated to the team at North Middlesex Hospital and there was a recovery plan in place.

5.    Early vaccine distribution issues, which had been nationwide, had now been resolved.

6.    Vee Scott, NCL CCG provided a communications and engagement update and thanked partners for working together. A creative approach had been taken, including animations which had been translated into the top six languages, and there had been more engagement. Support had also been given to GPs, with weekly webinars and updates and scripts.

IN RESPONSE

7.    In response to queries regarding capacity and supply issues, it was confirmed that good flows of vaccine were now coming through, and surgeries were fully open and operational, though sometimes flu clinics were fully booked and patients had to wait for the next one. Criteria were in place in respect of those eligible to receive the flu vaccine from the NHS. The Chair suggested it would be helpful to receive a formal written assurance which could be forwarded to MPs and constituents.

ACTION:  Dr Hetul Shah

8.    The success of flu vaccination campaigns and high demand this year was noted as a positive situation and a good example of integration working. Vaccination rates were already ahead of where they were at the end of last year’s season and targets had been exceeded. Also, vaccine orders were made by GPs a year in advance and the deliveries were received in batches. For next year it may be preferable to spread out the campaigns and therefore demand.

9.    Councillor Uddin welcomed the comprehensive update and raised the importance of keeping working, particularly with the voluntary sector, to reach all communities to promote flu vaccination. Parin Bahl on behalf of HealthWatch confirmed the need to work smarter and differently to reach communities. The Chair offered use of Council software which cross referenced with the electoral register to help with targeted work.

Dudu Sher Arami Consultant in Public Health, London Borough of Enfield. Dr Catherine Heffernan, Principal Advisor for Commissioning Early Years, Immunisations and Vaccination Services, Hon. Associate Professor for Public Health (LSHTM), Public Health England) and NCL CCG Representative.

To note the recent letters sent by The Leader to the Secretary of State for Health and NCL CCG requesting details of activity to ensure provision of influenza vaccination in Enfield. Discussion of current activity around influenza vaccination issues at national and local level.

RECEIVED the presentation introduced by Dudu Sher-Arami, Consultant in Public Health.

NOTED

1.    Following the last Board meeting, the Leader of the Council had written to NCL CCG and to the Secretary of State for Health requesting details of activity to ensure provision of flu vaccine in Enfield.

2.    Since the last meeting, there had been collaboration with the CCG and a huge amount of work had taken place involving joint working with the Council, CCG, voluntary sector partners and others, which it was hoped would result in a high vaccine uptake.

3.    Peter Lathlean, Deputy Head of Primary Care Commissioning, NCL CCG, provided an operational update. A flu working group met fortnightly. He confirmed that nationally there was enough vaccine stock to meet patient demand. There was a more targeted approach this year, and detection around clinical risk groups.

4.    Vee Scott, NCL CCG provided a communications and engagement update.

IN RESPONSE

5.    In response to queries regarding availability of vaccine, its roll out over different time periods for different groups and the logistics may have led to some confusion for patients, and there was a need for clear communication. It was confirmed that NCL CCG to date had delivered 51,000 flu vaccinations in four weeks. In respect of the over 65’s, flu vaccine was ordered sufficient for 80% of the eligible population; which was a good position. There was a slight shortage for the under 65’s, but work was being done to secure additional vaccines. Ambitions had grown for vaccination uptake this year, and the pace of the delivery of the flu vaccination programme was accelerated.

6.    There was a plan in place in Enfield for 100% vaccination of staff and residents of care homes.

7.    Provision and access to data day by day was key.

8.    GPs were using innovative ways to deliver vaccinations this year, including drive-through, out of hours service, and outdoor marquees, and had seen increased take-up by patients.

Dudu Sher-Arami, Consultant in Public Health – to note

Brief discussion of flu season preparation in preparation for Winter 2020/21.

RECEIVED the presentation and slide by Dudu Sher-Arami, Consultant in Public Health.

NOTED

1.    Enfield had historically low immunisation uptake: lower than the average for London and England.

2.    They did not want vaccination preventable diseases to occur because people were staying at home and keeping away from healthcare settings.

3.    Concerns were being discussed with PHE and NHSE, commissioners of immunisation services, with subsequent work to update Enfield Immunisation Plan post Covid and focussing on timely action and improvement in uptake, coverage and access.

4.    There was about to be a pan-London communications campaign, and innovative models for delivery. Information regarding expansion to 2020’s immunisation programme was awaited.

5.    Flu was an important topic as a second wave of Covid-19 could coincide with the flu season. It was important to ensure as high an uptake of immunisation as possible and that the campaign started early and was as well co-ordinated as possible.

IN RESPONSE

6.    Vivien Giladi expressed concerns and asked for reassurance around early delivery of communications regarding flu vaccination. There was a need for new strategies to encourage people to get flu vaccinations in a way they were convinced was safe. Board members agreed flu immunisation was a key priority and there was a need to move with urgency.

7.    The Chair considered a target for the borough to get to would be helpful, and mechanisms to increase numbers taking up the vaccination. It was confirmed by Vivien Giladi that the Over 50s Forum would support any target and take part in a working group.

AGREED to develop a mechanism for delivering an increased immunisation take up, and its monitoring.

ACTION: Dudu Sher-Arami / Enfield Health and Wellbeing Board