Agenda item

The Panel received a presentation from Olivia Falgayrac-Jones, Director of Commissioning, Paula Jackson and Nisha Jayatilleke, Consultants in Public Health – Screening & Immunisations from NHS England on NHS Immunisation and Screening programmes in Slough.

The presentation set out the operating model for the delivery of the immunisation programmes; the key objectives and priorities for 2018/19; the actions designed to drive quality improvement; performance data; and the approach towards collaborative working with partners.  Two of the charts in the appendix had not reproduced correctly in the agenda pack and it was agreed they would circulated to Members as part of the presentation slides. 

(Councillor Matloob joined the meeting)

During the course of the presentation is was noted that:

·  Slough had a historically low uptake on immunisation and screening programmes.  The first annual report sought to benchmark against progress.

·  NHS England was responsible for commissioning screening and immunisation programmes with GP practices being the main providers of childhood immunisation for children under 5 years of age and NHS Trusts the main providers of NHS screening programmes.

·  The programmes included a wide range of activities including cancer screening, maternity screening, childhood and adult immunisation programmes as set out in Tables 1, 2 and 3 of the appendix.

·  There were variations in the uptake of immunisations and the work to improve the rates of childhood immunisations in Berkshire was summarised.  This included improving data collection, sharing good practice and ensuring timely reminders through the Child Health Information System.

·  There had been increased uptake in Slough on all but one childhood immunisation programme in the past year, however, uptake in Slough remained below the England averages.

·  Priorities for the future included improving links between practices and health visitors and outreach clinics in places where immunisations couldn’t be delivered in the school setting.

·  The main adult programme was for seasonal flu vaccination which was also targeted at eligible groups of children and at risk groups.  49,000 children in Berkshire had been vaccinated and the national target had been exceeded, however, take up in Slough was below the national average and national ambition.

·  For example, only 26% of 2 year olds were vaccinated in Slough last year compared to the national average of 43%.  Two-year-olds were considered to be “super-spreaders” and proactive work had taken place to increase uptake this year.  Early indications were that this had been effective.

·  A number of developments and improvements to screening programmes were explained, including a new test for bowel cancer.  Targeted work took place in communities to increase awareness of screening programmes and local action was taken to maximise the impact of national campaigns such as the upcoming “Be Clear on Cancer” campaign.

The Panel had a wide ranging discussion about performance issues; collaboration with partners including local authorities and communities; and the importance of effective and regular promotional campaigns to raise awareness.  NHS England sought to work with local partners to promote campaigns and there was regular press and social media activity.  Members offered to use their connections with local residents to support future campaigns, for example, through involvement in photo opportunities or using their social media feeds to communicate key messages.

A Member queried the performance indicator for DTaP/IPV booster for children aged 5 and asked whether it should be ‘red’ rated due to the deterioration in performance in the past year and the fact it was significantly below the England average.  The dip in performance was explained and action had been taken to increase the timeliness of vaccinations.  Uptake of MMR 1^st and 2^nd dose for age 5 was 81% in Slough in 2017-18 and Members were concerned that this implied 19% of children were not immunised.  It was noted that the indicator was specifically for those aged 5 and that some children would be immunised when they were slightly older.  A detailed explanation was provided about the meningitis vaccination process in young adults.  NHS England worked with schools, colleges and universities.  It was suggested that Slough Youth Parliament be engaged.

Prostate cancer screening was not included on the list of screening programmes in Table 9 of the report.  A Member expressed concern that it appeared it wasn’t a priority, however, it was explained that it was not included in the table as prostate cancer was not part of the nationally commissioned programme.  There was a discussion about the process of selecting those included in nationally mandated programme, which was done by the National Screening Committee.  The Panel agreed that preventative action to reduce the risks of such cancers was vital.  Ethnicity was a factor in the prevalence of prostate cancer and early detection was key to patient outcomes.

The figures in the report were Slough wide and the Panel asked whether any data was available which showed any variations by ward, age, ethnicity or other demographic factors.  It was responded that practice level data was available and there were variations.  There were groups less likely to take up screening such as younger people, men and those from vulnerable groups.  The services needed to work with communities to raise awareness and accessibility to address such variations including by ‘normalising’ immunisation and making it feel a routine part of what people did to protect themselves and their families.  The role of community leaders in spreading this message was recognised and Members expressed an interest in playing an active role in supporting campaigns and contributing to the working group to promote engagement and awareness.

It was recognised that vaccinations carried risk and a Member question how negative reactions were recorded and lessons learned.  Assurance was provided that vaccinations were thoroughly tested and negative impacts were reported, monitored and taken into account in future programmes.  Members asked for further information on the prevalence of such risks and it was agreed this would be provided.

At the conclusion of the discussion, the Panel welcomed the presentation and thanked colleagues from NHS England, Public Health and East Berkshire CCG for their contributions.  A Local Action Plan was being developed and it was agreed that the Panel would receive a report on this later in 2019.  Members offered to contribute to the working group on the communication and awareness raising activity of the programmes.

Resolved –

(a)  That the action being taken to deliver the national programmes for immunisation and screening and their progress is tackling health inequalities in Slough be noted.

(b)  That the proposed Local Action Plan be reviewed in 3-6 months to ensure had the action tailored to the needs of Slough and relevant partners were addressing the relatively lower update and health inequalities in both immunisation and screening.

(c)  That the Panel receive an Annual Report on Immunisation and Screening from NHS England every year.

(d)  That members of Panel be involved in supporting communications and campaigns activity to promote the take up of immunisation programmes.