NHS leaders unveil action to boost flu vaccination and manage winter pressures

NHS England, Public Health England, the Department of Health and NHS Improvement have today unveiled measures to boost the uptake of flu vaccinations along with package of new contingency actions to respond to pressures on frontline services this winter. Intensified preparations include:

  • Providing free flu vaccines for hundreds of thousands of care home staff at a cost of up to £10m as well as increasing the number of jabs for young children in schools and vulnerable people
  • Directing NHS trusts to ensure they make vaccines readily available to staff and record why those who choose to opt out of the programme do so
  • Writing to doctors, nurses and other healthcare workers reminding them of their professional duty to protect patients by being vaccinated
  • Setting up a new National Emergency Pressure Panel to provide independent clinical advice on system risk and an appropriate regional and national response
  • The biggest expansion in training for A&E consultants ever with hundreds more doctors over the next four years and other healthcare staff

Many people with flu show no symptoms, meaning healthcare workers who feel fit and healthy can unwittingly infect vulnerable patients. Getting vaccinated is the best way to stop the spread of influenza and prevent deaths. It can also ease pressures that a heavy flu outbreak would place on services such as doctors’ surgeries and busy hospital wards, like those seen recently in Australia and New Zealand.

NHS staff are already offered the vaccination for free to protect patients and the public. This winter, in recognition of how important this is, NHS England will extend free jabs to up to more than one million care home workers and has set aside £10m to fund it.

At the same time, health chiefs will direct all trusts to ramp up programmes to ensure that nurses, doctors and other healthcare professionals get the flu jab – protecting themselves and their patients this winter. Although last year saw record take up more than one in three NHS staff failed to do so, with just one in five being vaccinated in some trusts. This year, NHS trusts are being told to make the vaccine readily available to staff without the need to disrupt their work and record why anyone who decides to opt out chose to do so.

Professor Sir Bruce Keogh, NHS England’s national medical director, Professor Dame Sally Davies, the chief medical officer, Professor Jane Cummings, the chief nursing officer for England, Dr Kathy McLean, NHS Improvement’s executive medical director, Ruth May, NHS Improvement’s executive director of nursing, Suzanne Rastrick, chief allied health professions officer for NHS England, Public Health England’s medical director Professor Paul Cosford have also written to doctors, nurses and other NHS staff reminding them of their professional duty to protect their patients.

Sir Bruce Keogh said: “This is a timely reminder to employers and staff that we all have a professional responsibility to protect ourselves, and by doing so better protect our patients and reducing the pressure on services.”

Dame Sally Davies said: “The harsh reality is that flu can kill and the best way to protect yourself is to get the jab. With more people eligible than ever before and the vaccine available in more locations, people should protect themselves and those around them from flu. Taking a few minutes to get the jab could save your life this winter.”

This action comes alongside a significant expansion of the national flu vaccination programme for key groups, aiming to offer the vaccine to over 21 million people. The national drive marks the start of Stay Well This Winter, an initiative from Public Health England and NHS England to help the most vulnerable people prepare for winter and avoid having to visit hospital due to common winter illnesses. Changes include:

  • Children in school year 4 (aged 8-9 year olds) will be offered the vaccine for the first time, in addition to years 1-3
  • Children over age 4 in reception classes can get their vaccine in school instead of by their GP
  • More maternity services will offer immunisation to pregnant women
  • GPs and pharmacies will now be paid for vaccinating the morbidly obese

Professor Paul Cosford, Public Health England’s medical director, said: “This year we are offering the nasal spray vaccine to more children than ever. Ensuring children get vaccinated is extremely important not only to protect them from flu but also to stop then spreading it to vulnerable groups they come in to contact with. For someone with a long term health condition like asthma or COPD, flu has the potential to turn very serious. We want as many eligible people as possible to get their jab, as it is the best way to protect everyone from flu and minimise the burden on the NHS during the season when it faces the most pressures.”

As part of intensified cross-NHS winter preparations a new National Emergency Pressure Panel will also be established. The panel will be made up of senior NHS England, NHS Improvement and Public Health England Directors, including Sir Bruce Keogh, who will chair it, with some Royal College leaders also invited to join. Pauline Philip, NHS’s national urgent and emergency care director, will be able to call on the panel to determine system risk levels across the country and whether these should be escalated or de-escalated. Their judgement will inform the national and regional actions that will be taken if the NHS faces significant pressures.

Finally, to tackle staffing pressures within emergency departments, a new workforce plan, developed jointly by NHS Improvement, NHS England, Health Education England and the Royal College of Emergency Medicine has also been published. It will increase the number of people starting Emergency Medicine training next year and for the three years after that, specific additional development for all Emergency Medicine trainees, targeted support to improve the clinical education environment in struggling trusts and central investment to develop the role of the Advanced Clinical Practitioner workforce in our Emergency Departments. Commitments include:

  • A minimum of 300 people starting on Acute Care Common Stem-Emergency Medicine (ACCS-EM) programmes each year for the next four years.
  • HEE will work with RCEM to recruit an additional 100 doctors per year for four years into other training programmes to develop skills in emergency medicine
  • A total of 400 people entering emergency medicine training for a period of four years from next year as compared to 300 this year.
  • The physician associates (PAs) training pipeline will increase significantly over the next few years: there will be 3,200 qualified PAs in 2019 compared to around 350 now

Commenting on the workforce plans, Dr Taj Hassan, President, the Royal College of Emergency Medicine, said: “We are delighted to be launching this vision for emergency medicine which sets out to tackle the workforce challenges facing the service.  The additional resources are much needed and there are a large number of initiatives here which together will mean that emergency medicine can rebuild.”