The Panel received the Immunisation Update Report presented by NHS England Officers; Dr Catherine Heffernan, Principal Advisor for Commissioning Immunisations and Vaccination Services and Bernadette Johnson - Immunisation Commissioning Manager NHS England

The Panel noted additional information from Fiona White -Nurse Consultant in Primary Care and Lead for Maternity & Transforming Primary Care Nursing Merton CCG, and from Hilina Assress Principal in Public Health LBM.

Dr Heffernan explained that London had struggled with immunisation levels both historically and currently. This was down to a number of complex issues. There is a high population turnover, which is reflected in GP patient lists, the system cannot always keep up with the intake. Many Children in London are vaccinated abroad, and this may not be recorded on the Child’s records. Staffing for vaccinating and administration is under pressure in London.

She continued that there is much work being done by NHS Digital to make childhood records more portable  and therefore more accurate. The best way to increase uptake is to invite parents to bring their children for vaccination. However many GP practices have to do this manually. Work is being done to improve and automate this system. We have to make sure that people are informed – there is a lot of misinformation available. Merton is neither the top or bottom performing London Borough

Fiona Wright detailed the work her Practise does to ensure children are recalled for immunisation. She also explained that some countries have different vaccination schedules and this can affect children arriving from those countries.  There are quarterly meetings with NHS England to look at data and scheduled training for nurses. Her practice will also encourage adults and children to get missed MMR vaccinations.

Bernadette Johnson highlighted current programmes in different areas of London to promote immunisation, including incentivising GPs to check the vaccination status of their patients.

The Public Health Principal explained that immunisation was embedded into Merton’s commissioning of services, with the School Nursing and Health Visiting services having roles in promoting and recording immunisations. Immunisation is promoted through the My Merton magazine.

In answer to Panel Member questions Dr Heffernan replied:

·         Despite London’s percentage uptake being lower than the regions, London does vaccinate almost twice as many 0-5 year olds than any other region.

·         London is more complex and has more GP practices than other UK city

·         Some communities choose to vaccinate later in childhood

·         As a country our situation is good and stable and our systems are better than other parts of Europe

·         There are shrinking resources both for actually vaccinating and for administration of the service ie manual call/recall

·         Work is underway to safeguard services in the event of a no deal Brexit

·         Data collection has been simplified but further work is needed to simplify and improve. NHS Digital is working on a system that will reduce data input demands, making it easier for GP practices and will create records that will follow a child.

·         There is an ambition to create an electronic Red Book System

Fiona White described the call/recall scheme in Merton, that after a family has defaulted on an immunisation there should be a phone call, text or letter to remind them

Dr Heffernan was asked which reason was most important in increasing uptake, she replied that when the Data Collection and call/recall systems are improved the figures should improve. She also said that it is important to have pro-vaccine champions to counter the mis-information on social media. It is important to remember just how serious childhood illnesses were in the past.

Members expressed concern about Merton’s position, and that it has lower vaccination figures than its neighbouring boroughs. Dr Heffernan accepted their concerns and said that a mapping process had just started to try to understand what was really happening in London. She said that a ward by ward breakdown of the figures was not available. Members noted that Merton’s figures for 12 month vaccinations  show good engagement, but that they drop at 24 months and 5 years, and she believed that solving the problems with data and with call/recall would improve these figures. 

A panel member reminded the Panel about the Immunisation Task Group from 2016/17 and said that this did have a local affect and that this had put forward a number of recommendations.

Dr Heffernan suggested that Councillors could lobby locally for improvements such as Pharmacists giving vaccines, and evening appointments for working parents.

Bernadette Johnson asked Members to note the good work being done in Schools to check the immunisation status of teenagers and offer vaccinations not previously received. She continued that Merton met or exceeded the figures for School Age Programmes. Dr Heffernan explained that when children are offered vaccinations via their School uptake can double.

Members noted that there is a Healthy London Partnership that looks at research on all areas of public health in London, including Asthma and immunisation.

A panel Member commented that she was concerned that there were not enough Health Visitor visits after 12 months and that this was contributing to the lower uptake of vaccinations after this age, she suggested that this was monitored more closely.

The Panel noted that the Health and Wellbeing Board would keep immunisation as priority.

The Chair concluded by saying  that she could see that there were a lot of systems in place to try to improve the uptake figures, but she asked if there was a regular update that could be sent to the Panel. Dr Heffernan said the she could send through an update to the figures in 6 months and that there were plans that could be shared.