Agenda item

For this item, the Chairman invited Catherine Heffernan - Principal Advisor Public Health England, Amanda Goulden - Population Health Practitioner Manager NHS England and Natalia Clifford - Senior Consultant in Public Health to the table.

Following discussions at the Board meetings in May and July, the Chairman welcomed the update report on Childhood Immunisations which has been a matter of concern to the Board and an area of particular importance - as set out in the JHWB Strategy - due to continual reporting of low immunisation rates.

Dr Debbie Frost welcomed the update and informed the Board that significant work has been carried out by GP practices to input data. She requested that assurances are provided that the updated information will be incorporated into the data system. Ms Heffernan noted the contributions made to the data system. She also stated that in partnership with practices, reminders will be escalated to parents about immunisation.

Dr Clare Stephens raised a query about reminders for immunisation for teenagers and adolescents. Ms Heffernan stated that similar technique is adopted as that for children and that the 3-in-1 teenage booster vaccine is utilised.

The Commissioning Director for Children and Young People, Mr Chris Munday asked why the immunisation rates for Barnet were lower than national average rates and stated that this puts Barnet at risk if levels required for herd immunity are not being met.

Ms Heffernan noted that immunisation rates as a percentage would be difficult to influence on a short term basis due to the large population in Barnet. Ms Heffernan stated that it was difficult to say if Barnet was below the herd immunity. This was due to the denominator showing that there were more children to vaccinate than the number of children actually living in Barnet. Ms Heffernan also noted that children move in from other areas. Ms Heffernan stated that if Barnet was under herd immunity there would be more outbreaks. She further stated that going forward, utilising NHS Digital platform could provide a more accurate overview in terms of immunisation rates.

The targets in the action plan were brought to the attention of the Board by Mr Munday who requested that these be updated following visits to GP practices. Ms Heffernan welcomed the comment and noted that the action will be updated. Dr Charlotte Benjamin briefed the Board about the community team who provide other vaccination services from a community base - she also queried whether data from other settings was taken into account.

Ms Dawn Wakeling, Commissioning Director for Adults and Health, expressed serious concerns over the lack of clear evidenced assurances over immunisation rates and noted that the lack of an outbreak would not constitute sufficient assurance. Ms Wakeling raised a query about the timeline to resolving the data reporting issues and complexities that have been on going.

Ms Heffernan noted that the technology used for data reporting is outdated and that it is gradually but slowly being updated to reflect a full picture of actual rates. She also noted that work is on-going to remind and encourage parents to come back at certain stages for vaccinations.

In relation to a query from the Chairman about reminders - Ms Heffernan stated that in order to address this issue various streams of work will be carried out through partnership working with NHSE regional and Public Health, London Councils and other partners.

Dr Stephens highlighted the importance of utilising communication channels such as smart phones and digital communication technology.

Councillor Reuben Thompstone noted the need for a further update on the matter to be brought to the Board’s attention in due course. Ms Amanda Gouldon noted that sourcing the root problems of the data reporting issues may take time and that going forward there will be a great deal of focus on updating and implementing the action plan.

The Chairman welcomed the comments and highlighted the need for accurate data on actual immunisation uptake and importance of communicating reminders to parents.

It was RESOLVED:

1.    That the Health and Wellbeing Board had noted the work done by NHS England, since the HWBB in July on childhood immunisation in Barnet.

2.    That the HWBB had noted that the levels of coverage of childhood immunisations in Barnet are comparable to London although noting that this is below the threshold for herd immunity and requests a further action plan from NHS England in six months.