Agenda item

The Chair introduced:

·         Mr Nicholas Ince, Deputy Director of Vaccination Transformation, North Central London Integrated Care Board (NCL ICB)

·         Dr Janet Djomba, Deputy Director, Public Health, LBB

·         Ms Khalida Aziz, Immunisation Commissioning Manager (North Central London), NHS England.

The Chair noted that measles is a topical issue, with many London Boroughs having some of the lowest Measles, Mumps and Rubella (MMR) vaccine uptake in the country. 

Dr Djomba spoke to the report which covers some of the roles and responsibilities for all immunisations across the lifespan of residents. She noted that the large migrant population and extensive areas of deprivation in London were some of the reasons for the lower take-up of vaccination compared to other parts of the country. Barnet’s figures were slightly better than NCL and London overall,  but vaccination take-up could be higher. 

Dr Djomba reported that there had been an increase in the number of measles cases in London over the past few weeks, but none so far in Barnet. A dedicated team is working on uptake of vaccines overall in Barnet but there are challenges due to the diverse population. In particular during the pandemic some groups had been identified has having reduced uptake. For example there is lower uptake and higher vaccine hesitance amongst eastern European communities and Somali groups. The Eastern European population in Barnet has been very hesitant towards childhood and Covid vaccinations.

Some useful information had been obtained in relation to these groups through the Community Vaccine Champions’ work which is presented in the report, for example that these groups would like to speak to health professionals with whom they can identify. Work with community leaders had helped to build trust and improve relationships with different groups, but behaviour change would take some time as it could be difficult to dispel myths around vaccination.

In addition overall it had been found that the population is suffering from ‘vaccine fatigue’ due to repeated messaging around vaccination, since the pandemic, so it was important to work with communities to continue to encourage vaccination.

Dr Djomba noted that increasing childhood immunisation is an ongoing task, with improvements seen following the pandemic, during which uptake had dropped. Access had also more difficult during the pandemic. The current focus is immunisation in school-age children, which so far is not improving. In particular the HPV vaccine uptake in boys is low across both Barnet and NCL. Adding to the problem was access to detailed, up-to-date data, which is needed to inform targeted interventions. Covid, ‘flu and childhood immunisation data were easy to access locally but school-age children’s data was more difficult, and the council is working with NHS England (NHSE) colleagues on how to tackle this.

Mr Ince reported that total uptake of seasonal booster vaccinations is included on page 9 of the report, showing a much higher uptake in the older population.

A Member enquired what actions are being taken in relation to measles and what improvements are expected in a year’s time. Dr Djomba responded that there is a focus on measles across London, including measles outbreak preparations. The council has ensured that access to the MMR vaccination is not an issue, with all Primary Care Networks (PCN) having availability and additional out-of-hours clinics having been held over autumn and winter 2023. There is also the possibility of deploying a mobile until depending on numbers in given populations being willing to take up the vaccine. Numbers being vaccinated had started to increase for the first time around a year ago, but it would take a year or two to see an increase across Barnet.

Mr Ince reported that it is difficult to quantify the scale of the impact of the measures being taken at this stage but incremental changes were being made. Currently the ICB is focusing on access to vaccination appointments, and work is ongoing with PCNs and the school-age immunisation provider. Over the next 3-6 months this would be closely tracked by the ICB, and updates would be provided to the borough partnerships.

Ms Omijie asked what is being done to employ people with similar backgrounds to the populations mentioned, into posts to try to encourage vaccination. Dr Djomba responded that the council is not able to directly employ into the posts but the council is working with ICB colleagues to build a pool of people. For example during the pandemic people were invited from specific backgrounds to a question and answer session on the Covid vaccine and for this health professionals from a Romanian background were sought to speak to people of Romanian origin. 

A Member asked what actions were being taken to meet the challenge of reaching out to the under-served communities as this poses a real problem in relation to the quality of the data being collected. Also what is being done to improve the governance and quality of the data being collected and linking the different systems that exist?

Dr Djomba responded that work is ongoing via the Community Vaccine Champions Programme and with voluntary, community and faith sector (VCFS) organisations covering the groups who are under-represented. This is not limited to ethnic or religious groups but also to asylum seekers, migrants, and the homeless population. For example a Health Ambassador for the migrant population had been employed and is visiting asylum seeker hotels and working with relevant organisations, and organising vaccine clinics for asylum seekers. Similar work is being undertaken for homeless people. This involves identifying people who can act as ‘broker’  between residents and the council, since it was identified during the pandemic that establishing communication with the council directly is less likely to be effective. This concept was also being used in other areas than health as it had been shown to be successful.

Ms Aziz reported that work was ongoing to try to improve the connection between the different computer systems, and this should be rectified within a few months. Mr Ince added that the errors were due to the coding system but tools had been added locally to help Practices to identify erroneous codes. The ICB is working with the digital platform and database HealtheIntent, which allows the ICB to see uptake in given areas, by ethnic subcategories and by language spoken and to respond in an agile way to trends.

A Member enquired about the figure in the report of the 95% of population vaccination target being missed, and how this compares to similar countries. Mr Ince responded that the team is currently carrying out international benchmarking, and England outperforms many countries in Europe but there are countries with similar healthcare economies where the uptake is higher.

A Member asked how value for money is monitored when grants are awarded to the voluntary sector for Community Vaccine Champions. Dr Djomba responded that a project management team monitors the activities of participating organisations, and end-of-project reports were provided by the organisations, outlining how they had spent the money, and the most successful projects were presented at an event. There is ongoing partnership with the Centre of Excellence to support MMR uptake improvements even though funding is no longer being provided. In addition the principles established through the programme are being used for screening programmes and health checks, where ambassadors are working to promote these programmes.  Mr Ince added that the VCFS provides a trusted voice for residents and is also a tool for the ICB to gather insight from populations to inform its actions.  

Cllr Chakraborty asked whether the vaccination uptake/ could be broken down by Ward. Dr Djomba responded that this can be done but the report would be lengthy, and advised that Cllr Chakraborty contact her following the meeting.

Action: Cllr Chakraborty

The Chair thanked Dr Djomba and NHS colleagues for the report.

RESOLVED that the committee noted the report.