Agenda item

Immunisation in Lincolnshire

(To receive a report from Dr Tim Davies from NHS England, which provides details of the local arrangements for the delivery of immunisations to the population.  Also, Tony McGinty, Interim Director of Public Health to provide a presentation to the Committee concerning the Scrutiny of the National Immunisation Programme in Lincolnshire)

Minutes:

Consideration was given to a report from Dr Tim Davies, NHS England Screening and Immunisation Lead, Public Health England, which provided the Committee with details of the local arrangements for the delivery of immunisations to the population of Lincolnshire and its current performance with regard to vaccination programmes.

 

The Chairman welcome to the meeting Dr Tim Davies, NHS Screening and Immunisation Lead, Public Health England, Dr Jharna Kumbang, Consultant in Communicable Disease Control, Public Health and Tony McGinty, Interim Director of Public Health.

 

Tony McGinty, the Interim Director of Public Health provided a short presentation, which outlined to the Committee the Lincolnshire Health Protection Assurance Process; and provided details relating to the National Immunisation Programmes in Lincolnshire.

 

It was highlighted that as a result of concerns raised by the Lincolnshire Health and Wellbeing Board, the information provided to the Committee focussed on the vaccination programme for those under the age of five years of age.

 

Dr Tim Davis, NHS Screening and Immunisation Lead, Public Health England advised the Committee that immunisation programmes for children up to the age of five had uptake targets of 95%.  It was noted that this uptake target needed to be high with diseases such as measles to ensure a good level of immunity. 

 

Details pertaining to the routine immunisation schedule along with selective immunisation programmes; and additional vaccines for high risk individuals was detailed in Appendix A to the report.  It was highlighted that NHS England was responsible for the commissioning and system management of the routine immunisation programme through its local offices.  It was highlighted further that local authorities through their Director of Public Health (DPH) had a duty to provide advice and advocacy to protect the population of Lincolnshire; and that NHS Clinical Commissioning Groups (CCGs) had delegated authority for co-commissioning primary care; and also needed to have oversight and scrutiny of the routine vaccination programmes.

 

Table one on page 31 of the report provided information relating to the uptake of immunisations by age group for 2015/16, 2016/17 and quarter one for 2017/18.  The table highlighted that generally the performance of childhood immunisations measured at one year was good, with an uptake at or around the 95% target.  The Committee noted that the uptake of vaccines at age two years and five years were areas where improvement could be made.

 

Figure 1 - Trend in the uptake of MMR by CCG - on page 32 of the report identified that Lincolnshire East CCG had had the lowest uptake.  It was highlighted that this pattern was reflected in all of the under 5 vaccination programmes.  It was noted further that in figure 3 - Uptake of immunisations at 1 year compared to peers and national average for 2013/14 and 2016/17 and figure 4 – Uptake of immunisations at 5 years compared to peers and national average for 2013/14 to 2016/17, Lincolnshire's performance was above the national average.

 

The Committee noted that immunisation was a parental choice; and that nationally there was a slow decline in uptake rates for childhood vaccinations.  It was felt that the decline was as a result of a number of issues such as the complexity of the programme; problems accessing primary care; and the lack of visibility of some of the diseases that immunisations were given for; and also there was a small rise in the number of individuals who did not believe in the need for vaccinations.

 

Page 34 of the report detailed actions that were being taken to increase the uptake of childhood vaccinations in Lincolnshire. 

 

In conclusion, the Committee was advised that there was a comprehensive programme of immunisations being delivered across Lincolnshire, which was minimising the risks of harm to the local population.

 

During discussion, the Committee raised the following points:-

 

·         The need to ensure that working parents had the opportunity to take young children for their vaccinations.  The Committee was advised that there needed to be easy access to primary care; and flexibility to attend immunisation sessions;

·         Whether the provision of a record book for each child would help encourage parents to get their children immunised.  The Committee was advised that the red book was still in existence; a copy of which was given to all new mothers, this was not welcomed by all mothers as it used to be.  It was noted that there was good progress in developing an electronic immunisation record for Lincolnshire children;

·         A suggestion was also made for the need to have a more informative approach to immunisation as this would help to alleviate any fears parents of young children might have.  Clarification was given that repeat immunisations would not cause any harm.  A further point raised was the impact of social media; an example given was that the MMR vaccine contained gelatine and it was confirmed that this was the case.  There was agreement that there was a need to do more promotional work;

·         Access to immunisation records – The Committee was advised that since 2013 efforts had been made to develop comprehensive immunisation records.  Confirmation was given that Child Health Records now had all immunisations records for those practices on System-One in Lincolnshire.  It was noted however, that there were 25 practices that were not on this system; and that work was ongoing with regard to this matter;

·         Teenage Vaccination uptake in schools – The Committee was advised that the uptake of teenage vaccinations in schools had been in excess of 80%.  It was reported that primary schools could not be used to help increase the immunisation rates for five year olds, as the vaccines needed to be given to the children prior to starting school;

·         One member enquired as to what the potential risk was if the required numbers of children were not vaccinated.  The Committee was advised that the overall objective of immunisation was to eradicate the disease; and therefore the target of 95% for a disease such as measles would be pursued.  It was reported that actions were being taken to try to increase the uptake of children's vaccinations.  A request was made for the inclusion of figures to accompany the percentages provided in future reports.  The Committee noted that chicken pox was not part of the national immunisation programme, as some evidence had suggested that a chicken pox vaccine might cause more harm, particularly in relation to causing the onset of shingles;

·         A question was asked as to why children in the Lincolnshire East CCG area had the lowest rates of immunisation compare to the rest of Lincolnshire.  The Committee was advised that there was no documentary evidence available pertaining to ethnic minority groups.  The Committee was advised that all practices had been visited to obtain information relating to how childhood immunisation services were organised.  The outcomes of this exercise would then be used to inform development visits in Lincolnshire East CCG to focus on what was good and what could be done better drawing on the experience of peer practices within the county.  The Healthwatch representative confirmed that the one issue the Healthwatch survey had established was that quite a few people had not been invited to attend routine vaccinations, but there had been insufficient information for NHS England to follow up on.  A suggestion was made that invitations for immunisation should be sent out on practice headed paper.  Confirmation was given that invitations should be sent from practices.  Reference was also made to the fact that key members of practices were not now available.  It was highlighted that previously Health Visitors had been instrumental in liaising with new mothers regarding immunisation.  The survey had also identified that there was a lot of deprivation in the Lincolnshire East CCG area;

·         Whooping cough vaccination – The Committee was advised that the whooping cough vaccine was given to pregnant women, to help protect their babies until they could be vaccinated; and

·         One member enquired as to what elected members could do to help get the message out to the communities they represented.  The Committee was advised that there was literature available in surgeries, which if members wished could be incorporated in to their newsletters. The Committee was advised further that more would be done on social media.  A further suggestion was made for information to be sent to members of the Committee so that they could send it out to district councils through business brief.

 

The Chairman extended thanks to the presenters for their informative update.

 

RESOLVED

 

1.    That the report presented be received.

 

2.    That a report concerning Immunisation in Adults be presented to a future meeting.  (For the said report to include figures to accompany percentages quoted).

 

3.    That information relating to immunisation be circulated to all members of Committee.

Supporting documents:

 

 
 
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