Dear colleagues,

After we passed our third major COVID-19 vaccination milestone on 19 July, I made a short video expressing my profound thanks to everyone who has contributed to protecting our population against this virus. I would like to take this opportunity to say some of that again here.

Many thanks to NHS staff, partners and volunteers for all your fantastic work on the COVID-19 vaccination programme.

We hit the national targets for 19 July, offering people aged 18+ a first dose and fully vaccinating more than two thirds of adults, ahead of the removal of legal restrictions on social contact, settings and life events.

And moving on from there, we have now delivered more than 8.9 million vaccinations across the North West: more than 4.8 million first doses, reaching 88% of adults, and 4 million second doses, reaching 72.5% of adults (ONS mid-2019 population estimates).

The offer of vaccination remains open to all those eligible. At this time, when the R rate is estimated to be 1.0 to 1.2 in the North West, we are renewing our efforts to encourage those at high risk from COVID-19 – people with a long-term health condition or a learning disability, family carers or who live with others who are immune suppressed – to get their vaccine.

We know that the most vulnerable people are almost six times more likely to become seriously ill from the virus than their peers so it is vital they are vaccinated to protect themselves as well as the people around them.

Following updated JCVI guidance on vaccinating children and young people, we are putting in place arrangements so 12 to 15-year-olds eligible for vaccination under the guidelines can be offered a first dose before they return to school in September. We are profoundly grateful for the assistance of our local government partners on this. Our joint aim is to promote access, minimise journey times, and take account of the complex needs of children identified as needing vaccination. We are also now vaccinating young people in the three months before their 18^th birthday.

Huge amounts of work are going on across the region to tailor the offer of vaccines to those who are yet to have their first or second dose. Many areas are providing walk-in clinics, making it easier for people to fit in having a Covid-19 vaccine around their work, family, and caring responsibilities. And we should all be proud of the creativity and innovation supporting the vaccination programme in the North West. More about this in this newsletter.

We have also been commended at national level for achieving significant increases in vaccine uptake by residents and staff of care homes. More about this below.

And we are featuring another vaccine hero this week – Pat Keeley whose work was fundamental to the hospital hub and vaccination centre in St Helens, which have given more than 200,000 vaccinations. Read more about her in the newsletter.

Our other major focus is preparing for the next phase of the COVID-19 vaccination programme in partnership with the seasonal flu vaccination programme, so we are able to work together to protect our population.

We will be ready to deliver booster jabs against COVID-19 from early September for everyone aged 50+, in line with guidance from the JCVI.  We still expect readouts from several clinical trials over the course of the summer and our plans will flex as new information becomes available.

We have learned a great deal about working in partnership to tackle health inequalities during the course of the COVID-19 vaccination programme, building on the work of our Community Risk Reduction framework. Running alongside this, we have established a broader health inequalities programme and the next phase involves a NW Regional health inequalities hub to consolidate expertise and provide ongoing support as we move from immediate and medium term work on health inequalities to longer term work across the region. More about this below.

I would like to thank everyone in the NHS and our partners and volunteers who are helping to deliver vaccinations to protect the people of the North West, and I hope you are able to get a break of some kind over the summer.

Do share your thoughts on this newsletter and let us know what else you would like it to contain. If you are a frontline health and care worker and not already a member of the North West Community of Practice, please see details at the end for how to join so you can access documents and other resources, and share your tips, challenges and experiences.

Yours
Linda

Dr Linda Charles – Ozuzu
Regional Director of Commissioning and Regional SRO – COVID Vaccination Programme
NHS England and NHS Improvement – North West

 

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Latest news

 

Tackling health inequalities

Focusing on cohort 6

We continue to focus intensively on increasing uptake in cohort 6, which comprises people aged 16 to 64 at risk including people with a learning disability or severe mental illness, household contacts of people with immunosuppression, and adult carers who are eligible for a carer’s allowance or who are the primary carer of a clinically vulnerable person.

As well as targeted communications encouraging people with specific health conditions and carers to come forward for their vaccination, each of our systems is continuing to put specific approaches in place.

Cheshire and Merseyside’s approach includes:

• using non-clinical call handlers to make contact with people in cohort 6 who haven’t yet been vaccinated to explore what might make the difference, supporting them with any practical issues or arranging for follow-up by a GP if appropriate
• making access easy for people who are very concerned about catching COVID-19 by offering drive-through vaccination centres, and home visits from the roving vaccination team
• liaising with cancer support groups to find out what extra support their members need
• offering transport assistance, including free bus services and travel vouchers, and help in securing an appointment via the COVID Isolation Helpline, overcoming IT and language barriers
• working with employers to offer pop-up clinics to which family members are also invited
• personal texts from GP practices and calls from GPs.

Greater Manchester’s approach includes:

• GPs calling vulnerable patients who have not been vaccinated, particularly in Oldham
• working with voluntary sector and specific groups such as Asthma UK to reach their members and encourage them to have the vaccine
• equipping people working in local businesses to have informed conversations with customers about the COVID-19 vaccine, as part of the VaccChat campaign
• working with trusted local health and community leaders, and having culturally specific conversations, to continue to reassure people about the safety and efficacy of the vaccine and encourage them to come forward
• providing vaccinations for carers in hospital hubs and pop-ups, including in China Town in Manchester, the Lowry in Salford, Moss Side, and Belle Vue
• providing buses and taxis for people to get to vaccination sites.

Lancashire and South Cumbria’s approach includes:

• personal texts from GP practices and calls from GPs
• detailed review of data to identify groups and geographical locations where cohort 6 uptake is low
• roving teams working collaboratively with local GPs and first responders to identify people not yet vaccinated who would like to be, including  socially isolated individuals and people with mobility issues
• working with local authorities to reach people in homeless hostels and on travellers’ sites, and to link to local employers
• working with community health champions and community connectors, door knocking to reach people

communications targeting friends and family of clinically vulnerable people and carers who have not yet been vaccinated, to encourage uptake.

 

Care homes – a continuing priority

People in our care homes are some of the most vulnerable people in our community. The social care working group of the Scientific Advisory Group for Emergencies (SAGE) has advised that 80% of staff in older adult care homes and 90% of residents need to be vaccinated to provide a minimum level of protection against outbreaks of COVID-19.

Work in the North West to systematically continue to improve vaccination uptake rates has been praised by the national team.

Thousands of additional vaccinations have already been given as the result of our approach which involves:

• line by line review of all North West care homes to identify ones with lower uptake and the reasons for this, with thematic analysis to enable targeting for highest impact
• contacting every individual care home not achieving the SAGE thresholds of 90% residents and 80% staff vaccinated to ensure action plans are in place.
• close partnership working with local authorities and place leads to maximise uptake and address hesitancy issues including those related to pregnancy, breastfeeding, fertility
• continued weekly monitoring with system partners, reviewing the 20 care homes with the lowest uptake or flagged by the latest response to the review each week with each system
• sharing good practice across the North West, and with the national team.

Vaccinating teams have been to all care homes in the North West to give first and second doses of the COVID-19 vaccine and mop-up visits continue – for instance, for people who may have missed out on earlier visits.

Examples of what has made a difference include:

• dedicated webinars for care home managers on how to promote vaccination uptake among staff
• NHS/directors of adult social care working together to monitor the reviews and action plans
• tailored, culturally sensitive services, for instance using female vaccinators to vaccinate female staff, and offering privacy during vaccinations
• engagement with staff to understand their thoughts and concerns, including a survey, peer to peer focus group, and one to one meetings
• support for staff with concerns about the vaccine, including FAQs, recordings of mock vaccination sessions answering people’s questions through role play, sharing of staff stories, and clinical conversations with specific care homes

capacity tracker champions working with care homes to encourage regular and accurate updates to data.

 

Expanding our work of health inequalties

Throughout the COVID-19 vaccine roll-out, we have focused strongly on ensuring everyone in our communities, irrespective of their life circumstances, ethnic background, health status, age and other characteristics is able to access the vaccinations, and on making it as easy as possible for them to do so.

From a broader perspective we have established a successful health inequalities programme across the North West in the aftermath of the first wave of the pandemic. The next step in the evolution of the programme is the development of the NW Regional health inequalities hub to consolidate expertise and provide ongoing support as we move from immediate and medium term work on health inequalities to longer term work across the region.

Examples of support to local systems include:

• data / analytics – supporting the translation of national and local data, understanding variation, identifying areas of focus across health inequalities
• programme evaluation – supporting systems to shape and implement programme evaluations so that demonstrable benefits can be shown
• PMO project and programme management support – helping to shape, develop and, where applicable, implement on the ground support including creating connections / coordinating key health inequalities activities that are region-wide and which require an interface with ICSs
• policy / best practice interpretation and application – utilising health resource to support systems with their health inequalities planning and mobilisation which includes access to health economist resource
• communications and engagement – supporting collation and publication of work across the region, connecting into ICSs to support showcasing their programmes of work.

The first phase of the hub is now live and the team is already working on two commissions!  Please email England.nwhealthinequalities@nhs.net  for further information.

 

Vaccine Hero

The latest COVID-19 vaccine hero in our occasional series is Pat Keeley (pictured), who set up vaccinations at both Whiston Hospital, part of St Helens and  Knowsley NHS Trust, and the St Helens rugby ground which have, between them, given more than 200,000 vaccinations to protect people against COVID-19.

On her watch, all local NHS and social care staff were offered the vaccine within three weeks of the St Helens hospital hub opening in mid-December 2020. And by 18 January, the vaccination centre at the Totally Wicked Stadium, the home of St Helens R.L.F.C. was up and running – the first mass vaccination site in Cheshire and Merseyside – which went on to deliver more than 2,000 vaccines a day at the height of demand.

Former matron Pat, 56, who went into NHS management 16 years ago, says: “I’m immensely proud of being part of a bigger story – we worked with the military, the fire service, St John Ambulance, local trusts and volunteers to build this from the ground up. Seeing lots of people from different backgrounds coming together with one goal, to get COVID dealt with quickly and efficiently, was a real career highlight. I’ve learned so much and I’m glad I’ve been able to support other sites locally and from across the country to build on our experience.”

Pat and her team work closely with GPs and PCNS and are now preparing for the hospital hub to re-open so it can administer booster jabs to staff and patients, when required.

Thank you, Pat, for everything you’ve done and continue to do to protect so many people against COVID-19! You are a real local hero!

 

Making reasonable adjustments

Much of our success in increasing uptake in communities which were initially hesitant about taking the vaccine is due to making reasonable adjustments to services to meet people’s needs.

Research shows that three key elements determine how likely people are to be vaccinated:

• confidence in the vaccine’s safety and effectiveness
• convenience – how easy it is for people to access
• complacency – how concerned people are about their risk of infection or serious illness, with those who are complacent being less likely to take up vaccination.

We are implementing learning for cohort 12 that draws on all of this, with tailored actions for specific groups including young people who are not in education or employment, young care leavers, students and young people with health needs. Actions include, for example:

• new social media content including live tweets and footage at vaccine sites
• specific messaging for university students and sports fans
• hyper local pop-ups
• linking with large employers
• linking with universities and colleges to get messages out to students
• freshers fair vaccinations agreed for when the new term begins
• working with Healthwatch and with young advisors to gain insights
• specific pop-ups for people from different ethnic groups, including the Roma community
• cricket-related communications and media for a pop-up at Old Trafford.

There are suggestions in our Menu of Reasonable Adjustments (MoRA) to help maximise vaccination uptake among under-served communities, including people from an ethnic minority background, people with a learning disability, people with serious mental illness, and inclusion health populations.

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Further information

Useful resources

A wide range of resources and case studies are available on the North West Community of Practice website.

People working in local, public, voluntary and NHS organisations can join the COVID-19 Vaccine Equalities Connect and Exchange Hub on the Future NHS platform, using this link.

Questions and feedback

If you have any questions or comments on this newsletter, please post them on the North West Community of Practice forum.

The North West Community of Practice is for everyone working in health and care in North West region. If you are working in this field and would like to become a member, please email england.pcn-development@nhs.net to request an invitation.