The fragmentation of the vaccination system has been highlighted as one of the key contributors to the low uptake of immunisations. But in Derbyshire a strong working relationship has been established between the council’s health protection team and the regional NHS England immunisation service.
What was done?
The key step to forging a close work relationship is the fact that representatives from each service attend the others’ quarterly programme board meetings.
Public Health Lead for Health Protection, Jane Careless, said: “It has given us a great insight into the challenges the immunisation team is facing and has alerted us to areas where there has been low uptake or when certain issues are developing that we can help with. “We have made sure we are positive – it is too easy to attend meetings and highlight problems without coming up with solutions. Councils are ideally placed, because of the partners we work with and services we commission, to help come up with those solutions and help the immunisation service navigate the system.”
Ms Careless said the work has helped keep vaccination levels up by paving the way for a “series of small, strategic steps and measures”. “It is about marginal gains – we have managed to help the service maximise their reach and work to improve uptake.” There has been a particular focus on MMR, with a working group set up by the regional NHS England team and council health protection team, as well as representatives from local GP surgeries and the 0 – 19 service, which includes health visitors and school nurses. This has led to staff at nurseries and children’s centres promoting MMR. The immunisation service has also been connected with the home education service, to ensure information is shared about when children are being educated away from school.
“We realised we needed to improve information and access to immunisation services for those who are home educated. We have worked with the immunisation service and wider council to provide home educated children and families with information regarding immunisation and improve referral processes”, Ms Careless added.
Other steps taken include the sexual health service reminding clients about the HPV vaccine and the NHS 111 service introducing a flu vaccination reminder prompt as part of their call waiting messages – a step that has now been adopted nationwide.
What else is happening?
The council has also helped the immunisation service carry out a survey of parents’ attitudes towards vaccination. It was promoted by health visitors, in newsletters and across council-commissioned services and media channels.
Ms Careless said: “We do not have big pots of money to spend, but that does not mean we cannot make a difference. Given how responsibility for services is divided it is really important to develop good relationships. “The regional NHS England teams work across such large footprints that it is essential that councils use their local knowledge to help.”
Public Health Lead for Health Protection
Derbyshire County Council