Agenda item

To receive the report of Louisa Bourlet, Community Health Development Officer.

RECEIVED the report of Louisa Bourlet, Community Health Development Officer.

Cllr Alev Cazimoglu, Cabinet Member for Health & Social Care introduced the report and said that she was very excited to receive the funding of £485k through Public Health to the London Borough of Enfield (LBE) from the Department for Levelling Up, Housing and Communities (DLUHC). It goes to the core of what the service does which is around tackling inequalities which is one of the main objectives and provides an opportunity to address this.

Dudu Sher-Arami, Public Health Director and Louisa Bourlet highlighted the main parts of the report which informed the panel of the vaccination uptake across Enfield, focusing on the disparities in uptake. Information was also provided on the development of an immunisation action plan, which will cover primary care, early years, schools, care homes and many other aspects of the system in its entirety. It is envisaged that this will be a living document with adaptations and development as a continued process. The work of the Vaccine Champions has been a fantastic opportunity and there has been a range of really innovative projects that local voluntary sector organisations have conducted on behalf of Enfield Council. Vaccine is one of the most effective products of health intervention in terms of outcomes and also the cost effectiveness so there is a very good evidence base for promoting this strongly to everybody who is eligible for vaccination.

Questions and comments were invited from Panel members.

The Chair asked how the £485k grant would be used and deployed. Officers advised that a small amount had been used to fund the coordination of the programme from within the team, but the vast majority has been allocated to local voluntary sector organisations to fund work to promote vaccinations and other health issues. There has been a stringent process with the Department for Levelling Up in terms of the proposals and processes established to distribute the money to the local voluntary sector organisations. Further detailed information was also provided on the types of projects that have been funded. Monthly reports are provided to the Department of Levelling Up on how and where the funding is being spent which provides an added level of scrutiny.

Cllr Milne said that he hopes this is creating a base of contacts and a baseline with hard-to-reach groups for early health intervention going forward. Officers agreed and said that moving forward it is about building on the relationships and the work that has already taken place to address the other types of health challenges that exist in the borough. 

Cllr Yuruk asked for clarification on the vaccine update figures in her ward. Dud advised that she did not have this information to hand but would forward this to Cllr Yuruk following the meeting. Action: Dudu Sher-Arami

Cllr Yuruk asked which groups of people are generally more resilient to receiving vaccinations in Enfield. Officers advised that the groups with a particularly low uptake in the borough are Black African, Black Caribbean, Gypsy Roma Traveller (GRT) and some Eastern European communities. All the work that has taken place around vaccines has been informed by a very close following of the intelligence available, which has tracked the process of the uptake, and this looks at ethnicity, age, language spoken and other demographic factors.

Cllrs Stevens acknowledged the great work that has taken place on a really important topic which is laying the groundwork for other Public Health measures. She went on to ask for clarification on the data provided on page 45 of the report and officers provided a detailed explanation.

In regard to childhood immunisations Cllr Supple referred to the data detailed in section 13, page 42 of the report and asked whether in a years’ time, and with the impact of the work taking place, would these figures improve. Officers said it is difficult to predict as it is a complex issue with a lot of challenges around mistrust and misinformation which take time to overcome. However, it was hoped that with the work taking place and the development of the immunisation action plan, an increase in uptake will be seen in the most deprived groups, but this would continue to be closely monitored and if the work taking place is not having an impact, then this will need to be addressed.

In response to a question raised by Cllr Supple regarding childhood immunisations and how much interface work is taking place with health visitors, school nurses, home schooled children and children missing from the register, officers advised that the Immunisation Screening Group, that overseas the work taking place in decreasing the inequality in vaccine uptake,  includes representatives from midwifery, 0-19 service, school nurses, and the school age vaccine provider (BEH) and therefore there is confidence that this group has the right people feeding into it and active to inform the Immunisation Plan and each organisation will be held to account for the actions identified in the plan. With regards to children missing from the register, there is a process within the council working with Children’s Social Care to communicate and offer vaccines to those children that are home schooled as well as others that are not attending mainstream schools.

In response to a question from Cllr Adeleke regarding sharing good practice across boroughs in terms of the vaccine uptake, it was advised that there is a PAN London group looking at this, but it is a complex area as there are various projects taking place with small communities which are often difficult to replicate in other areas.

With regards to the uptake of childhood immunisations the Chair commented on the disparity between the uptake of the various immunisations and sought clarification as to why this was the case. Officers advised that the target set nationally for all childhood vaccination uptake to achieve herd immunity is 95%. It was recognised that Enfield’s vaccination uptake is below what it should be and when compared to other NCL boroughs Enfield is on the lower end for all vaccination uptakes and this partly reflects the demographics of the borough as well as high levels of deprivation which tends to impact on vaccination uptake. Childhood vaccine uptake levels in Enfield have traditionally been low and this is something that needs to improve, and work is taking place with voluntary sector organisations, the NHS, schools, and other partners to achieve this. Officers acknowledged that this is a very serious issue but said that there are lots of different organisations working within the vaccine field to address this. Public Health have a role in terms of strategic leadership, provision of intelligence to inform action and the coordination of what is happening.

In relation to the wards in the borough where there has been a low vaccine uptake the Chair asked if Councillors have been utilised as they are embedded in communities, with good links and could be a useful resource in raising awareness. Officers responded by saying that possibly Councillors had not been used enough but this was a great suggestion and something that could be given some more thought. Action: Dudu Sher-Arami

The Chair said that he had seen a lot of communication (Comms) around the COVID vaccine/uptake and the flu vaccine but was concerned at the lack of communication around childhood immunisations. Officers advised that through some other funding an additional staff member had been employed in the Comms team and they had been very active in providing the COVID and Flu communications work. A range of engagement activities had also taken place around childhood immunisations including writing directly to parents via schools to encourage vaccine uptake, as well as webinars and engagement with parent forums. It was acknowledged however that more communication work could be done, particularly around social media, and it was agreed that this was something that could be looked at as part of the council’s Communication Strategy. Action: Dudu Sher-Arami

Cllr Adeleke asked how much interlinking is there between the Public Health team and other departments across the council that have any sort of impact on health e.g., housing, environment etc. Officers said that whilst Public Health sits in the People Department it pretty much works across all departments in the council and has links everywhere. Cllr Cazimoglu, Cabinet Member for Health & Social care added that none of the work within the Public Health team is done in isolation and all partners across the organisation are involved to ensure a really good public health outcome.

AGREED that:

1.    Where there are wards in the borough with low vaccine uptake, officers will reach out to Councillors to assist with  improving links and interaction with communities. ACTION

2.    Develop and implement a Childhood Immunisation Social Media Strategy. ACTION

The Chair thanked officers for their detailed report and said that although it was recognised that there are challenges their efforts to move forward with this are appreciated.