Agenda item

To receive a presentation for discussion, from NHS England, on ante-natal, and new born and immunisation and screening programmes in Enfield. 

The Board received a report reviewing ante-natal, new born immunisation and screening programmes in Enfield 2015 from Joanne Murfitt, Head of Public Health, Health in the Justice System and Military Health, (London Region, NHS England). 

Joanne Murfitt presented the report to the board highlighting the following:

·       The report provided an overview of the universally provided immunisation and screening programmes.

·       Enfield had a young population and it was felt to be particularly important to focus on antenatal and new born programmes.

·       NHS England wanted to promote early antenatal booking and screening so that any issues could be detected and addressed at an earlier stage.

·       The data provided was based on Barnet and Chase Farm Hospital Trust before amalgamation with the Royal Free. 

·       Pertussis (whooping cough) was an area of concern as it had recently caused 3 baby deaths.  NHS England was offering a service level agreement to increase take up of the pertussis vaccine. 

·       There had been anxieties created by the press campaign about the ineffectiveness of last year’s flu virus but this had only been one strain, vaccines had been effective against two other strains.  Work was needed to counteract the bad press and to make sure uptake of the vaccine was kept up. 

·       Increasing uptake of antenatal hearing tests was also a priority.

·       Two new vaccines were being introduced: the Meningococcal ACWY to replace the Men C from September 2014 for Year 8 girls, with a catch up in years 12 and 13: and Meningitis B for babies.

·       The majority of vaccines are provided through GP surgeries which is putting a strain on their services.  Also the offer is now incredibly complicated.  NHS England were keen to find ways to make the delivery easier, to improve uptake and increase coverage, particularly to vulnerable people whose lives are often already chaotic. 

·       Consideration was being given to offering the HPV vaccine given to 12-13 year old girls, to boys as well. 

·       There was a lot of effort being made on increasing the vaccination of 70 and 79 year olds against shingles.

·       Flu vaccinations were doing reasonably well – 36 out of 60 local pharmacists were now offering them.

·       A major push was also on to increase vaccine uptake amongst people with long term conditions especially liver and respiratory disease. 

·       Flu vaccinations were now being offered to school age children.  Special Schools in Enfield had not taken up the offer.  Help to encourage these schools to do so would be appreciated. 

·       The immunisation and screening programme for Enfield was quite generic and more work was needed to make sure that it was adapted to the borough’s specific circumstances and to enable NHS England to provide help and training where it was most needed. 

2.       Questions/Comments

2.1     Mo Abedi felt that it would be useful if good practice, particularly in working with different populations, could be shared across GP’s in Enfield: a tailored approach was needed. 

2.2     More children were likely to have been immunised than official figures suggested, as not all vaccinations were documented.  In Hammersmith and Fulham research had been done and found that the real figures were actually 10% higher that the documented figures. 

2.3     Enfield used to have a full time co-ordinator dedicated to working in the borough, now there is only one co-ordinator for 5 boroughs.  Joanne Murfitt said that there were fewer resources and this was challenging, but in these circumstances it was essential to share good practice and take a more co-ordinated and targeted approach working closely with partners.  There was a hope and an expectation that they would be able to promote, publicise and support initiatives, including making sure that initiatives were included in contracts.  An immunisation action plan was being putting in place to ensure more could be done. 

2.4     Persuading mothers to present at 10 weeks was even more difficult when very late presentation was already a problem in parts of the borough.  Many believed that they did not need to present until 12 weeks.  Currently, 84.4% of women in Enfield, presented by 12 weeks and 6 days.  There was a big job to be done to change this perception and to persuade mothers of the need to present earlier.  Information was being provided through NHS England and through a poster campaign but this needed more specific targeting.  The possibility of providing information at the point of sale for pregnancy tests in pharmacies was being explored. 

2.5     Work was being done through the Change and Challenge Programme and through the family nurse partnership.  

2.6     The recent confusion over the issue of the shingles vaccination offer to 70 and 79 year olds was highlighted.  It was unfortunate but a targeted message will help to address any confusion. 

2.7     Concern was expressed about the decrease in immunisation rates among over 65’s in Enfield and across London.  NHS England were not concerned as the decrease was small and they were intending to focus on those with long term conditions and pregnant women.

2.8     The number of people accessing the flu vaccine via pharmacists, although only 5% of the total, had increased. 

2.9     Joanne Murfitt thanked everyone for their support and helpful comments and emphasised the will to work in partnership with the Board, the CCG, as well as schools, care contractors and staff. 

AGREED to note and support the work of NHS England (London) are doing to increase screening and vaccination coverage and screening and immunisation uptake in Enfield.