Agenda item

This report provides an update on the NHS England Commissioned Childhood Immunisation Programme in Medway.

Discussion:

The Committee received a report, which set out an update on the NHS England Commissioned Childhood Immunisation Programme in Medway. 

It was noted that the Committee considered an update report on childhood immunisations on 5 October 2017 and at the request of the Committee, the current report set out:

·         the measures NHS England had taken to ensure that Medway children were being immunised against vaccine preventable diseases;

·         action undertaken locally to verify that data collection and reporting of immunisation in Medway was accurate; and

·         current, validated data showing the percentage of children in Medway who had received specified vaccinations in the age cohorts of one, two and five.

The Director of Public Health drew the Committee’s attention to the formation of the Medway Immunisation Programme Board, as set out at Appendix 1 to the report and introduced Dr John Rodriguez, the Consultant in Public Health and Kent and Medway Screening and Immunisation Lead, NHS England and Dawn Hollis, Commissioning Manager, NHS England South (South East).

The Committee was advised that as part of the re-procurement of Community and Schools Based Immunisation Services for 0 -19 Year Olds, catch up clinics would be provided at a variety of community based clinics, which in addition to other opportunities that already existed, would provide a further opportunity for parents to vaccinate their children.  It was added that NHS England had been working with the Council on its 0-19 Healthy Child Programme procurement, which included Key Performance Indicators (KPIs) in relation to immunisation rates. It was suggested these services could contribute to improving vaccination uptake.  Lastly, the Committee was advised that NHS England was working with NHS Digital on a Child Digital Strategy which aimed to improve data flows nationally.

Members raised a number of points and questions including:

·         Data reliability – In response to a question about the reliability of the data, the Consultant in Public Health and Kent and Medway Screening and Immunisation Lead, NHS England explained that at this juncture the data was as reliable as possible having gone through three main levels of data cleaning before publication. However, it was recognised that the reliability could be improved. The Committee was advised that a series of actions were being undertaken to improve the reliability of the data, including the work of the NHS Digital team. The Committee was also advised that in the interim, the Public Health team were cross referencing the immunisation data with other data sets and through working with Clinical Commissioning Groups and Health Visitors improvements were also being made in the registration of children at General Practices and in the Child Health Information System (CHIS).

·         Data transfer – In response to a question concerning improvements in the transfer of data, it was not possible to confirm whether the transfer of data between General Practices and the Child Health Information System had improved. The Committee was advised of actions being carried out to improve data flow, for example cross tabulation. The Consultant in Public Health and Kent and Medway Screening and Immunisation Lead, NHS England stated that in his opinion the true immunisation rates were higher than the published data. He added that this opinion had been drawn from the review of evidence which had not been published.

·         Statistics – Further to a question regarding overreliance on comparative statistics, the Committee was advised that statistics could be a distraction and caution should be observed when relying on simple statistics. However, more detailed statistics could be interrogated to determine patterns.

In response to a question concerning the overall data presented at Tables 1 to 3 of Appendix 1 to the report, in particular whether data reflecting immunisation rates within different areas of Medway was obtainable, the Committee was advised that the statistics were recorded by Practice and queries by Practice could be run within the data sets to evaluate data by area. In this way, Practices with lower immunisation rates had been targeted to improve performance.

It was added that population catchment could affect immunisation rates, but there were many other barriers. Under the new contract for the Community and Schools Based Immunisation Services for 0 -19 Year Olds, levels of deprivation, as a barrier would be specifically targeted.

·         Childhood Immunisation Performance – At the request of a Member, the NHS England officers undertook to set out the reasons why the percentage of Medway children immunised against Meningitis B, who were aged 1 and the percentage of Medway children immunised against Diphtheria/tetanus/pertussis/polio, who were aged 5 was significantly below the England average and the specific actions which could be taken to decrease the gap.

In reference to the Community and Schools Based Immunisation Services for 0 -19 Year Olds, the Committee was advised that under the new Service, work would be undertaken with General Practitioners to offer vaccinations to those who had not already taken up the offer and to understand the barriers to children and parents so that these barriers might be addressed.

In response to a question about reasons why immunisation appeared to be higher in children aged 2 and 5 years, the Committee was advised there were a series of hypotheses for example cohort effects. However, the reasons were not clear. 

·         Governance and accountability of the Medway Immunisation Programme Board – With reference to the governance and accountability of the Medway Immunisation Programme Board, the Consultant in Public Health and Kent and Medway Screening and Immunisation Lead, NHS England explained to the Committee that the Board had been established by NHS England, and individuals would report to their own organisations. He added that the Terms of Reference were in draft form and it was intended for the Board to be a forum for information sharing and joined up working, as many responsibilities for action to improveChildhood Immunisation overlap.

·         Community based clinics – A Member commented that the introduction of community based clinics was pleasing and would enable face to face contact between the practitioner and parents. At the request of a Member, the Commissioning Manager, NHS England South (South East) undertook to provide the details of the location of the community based clinics prior to September 2018 when the new Service would be in place.

·         Feedback from young people – In response to a question concerning  how feedback from young people was being used to inform the procurement of the Community and Schools Based Immunisation Services for 0 -19 Year Olds, the Commissioning Manager, NHS England South (South East) advised the Committee that young people were engaged in creating the specification of the procurement. In addition, the contracts would include Key Performance Indicators (KPIs) on user satisfaction which young people would be asked to evaluate.

·         Emerging Flu Strains – In response to a question in relation to emerging flu strains, such as Australian Flu, the Committee was advised that the current flu vaccination was matched to the specific circulating strains of flu. It was added that it was too early in the current flu cycle to determine the effectiveness of the vaccines offered. However, it was noted that it was better to be vaccinated because if the flu was contracted the illness would be much less severe.

·         Furtherupdate – At the request of a Member, the Chairman of the Committee undertook to discuss the presentation of a further update to the Committee, on the NHS England Commissioned Childhood Immunisation Programme in Medway, at the next agenda planning meeting.

Decision:

The Committee:

a)    noted the actions being taken by NHS England, as set out in Appendix 1 of the report, to improve the uptake of childhood immunisation in Medway.

b)    noted that at the next agenda planning meeting consideration would be given to the Committee receiving a further update on the NHS England Commissioned Childhood Immunisation Programme in Medway.