Agenda item


To receive presentations from Enfield Council Public Health Team and Enfield Clinical Commissioning Group.


To receive a report from Khalida Aziz, Christopher Salt and Dr Catherine Heffernan, NHS England and NHS Improvement.


RECEIVED a presentation from Enfield Council Public Health Team, NHS England and Enfield Clinical Commissioning Group


NOTED that:


1.    Cllr Uddin (Cabinet Member for Public Health) gave an overview and highlighted the importance of immunisation for children and adults. Enfield Council is currently below the 95% target for immunisations, a position mirrored across London

2.    Stuart Lines (Director of Public Health) explained that the process of immunisation was complex in respect of who is responsible for commissioning, delivery and scrutiny. In addition to Enfield Council, NHS England and Enfield CCG both have a role to play in the provision of immunisations.

3.    Dr Catherine Heffernan, (Public Health England) advises NHS London on immunisation programmes and works closely with national and regional colleagues. 

4.    Sarah Woodhall (Speciality Registrar in Public Health - LBE) summarised the joint immunisation plan for Enfield and the key actions and successes, including the positive feedback from school nurses as consent rates increased.

5.    Deborah McBeal (Deputy Chief Officer – Enfield CCG) informed the Panel that the CCG don’t commission this service but act as a support to the GP Member practices.

6.    The CCG have recently recruited to the post of Immunisation Lead, who will analyse why take up is low and will work with vaccine hesitancy groups. In addition, Practice Nurses have recently had a training session on how to improve take-up by those who are reticent to have the treatment.

7.    A dedicated page on the CCG intranet provided practices and primary care networks with information on immunisations.

8.    CCG IT systems are being used to generate reminders and this was supported by NHS England who commented that when invited, most people would respond positively.

9.    Debbie Green (NHS England) commented that access to mobile telephone numbers is vital as a means of providing reminders, rather than by letter. In addition, the power of a recommendation from a GP or Health Visitor is very useful. Ease of access to the immunisation service was also noted as being very important to encourage increased take-up.

Cllr Boztas thanked everyone for the comprehensive presentation and the following issues and comments were raised: -


Gabriella Mitchell (Public Health Strategist – LBE) informed the panel of the work being undertaken in nurseries and schools to encourage parents of young children. Schools (especially faith schools) had shown an increase in immunisations.

In response to a question relating to why children had only one opportunity to have the flu-jab in schools, it was confirmed that ‘catch-up’ sessions were offered.


Views were sought on making MMR immunisation compulsory as in other countries, for example, Germany. The panel were informed that there were arguments for and against and it would be necessary to be all inclusive without any groups being excluded.


A statement was made about difficulties gaining access to a GP, with the shortage of GP numbers currently in Enfield. In addition, health related poverty was highlighted as an issue and the important role of the Health Visitor was acknowledged.


NHS England confirmed that work is being carried out within extended hubs to improve access.


In response to a Healthwatch Enfield question on gaining patients views and encouraging greater take-up, NHS England confirmed that they are working to address this. Locally, Enfield Public Health Team have worked with the Parent Engagement Panel and the Faith Forum.


It was identified that there has been a culture-shift in schools to provide the flu vaccine, making the process part of everyday school life. Parents would welcome the fact that the vaccine is administered without injection and in a familiar environment.


NHS England noted that when the flu-vaccine is offered in pharmacies, the take-up increases. This avoids any issue with GP access.


NHS England were able to confirm that there is no longer any perceived issue linking the MMR immunisation and autism.


The low take-up in London compared to the rest of the country was highlighted. It was felt important to approach families who have refused immunisation services, to gain their views, although it was appreciated that this would be a difficult task.


The consequences on non-vaccination should be promoted in the same way as programmes relating to polio and diphtheria were in the mid-20th Century.


NHS England commented that when the effects of flu or measles are explained to parents, there is a positive response. These diseases are serious and can lead to fatalities. 


AGREED to note the presentation and the comments above.





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