Agenda item

To update the Health and Wellbeing Board on the COVID-19vaccination programme.

Jonathan Turner (Borough Lead Director – Brent, NWL CCG) introduced the vaccination programme update, highlighting that the positive working relationship with partners was in place, and he hoped this could be taken forward for other programmes. A weekly meeting took place with all partners involved in delivering the vaccination programme, with very close working between health and social care. Health colleagues had depended on the Council for the logistics and communications of organising the pop-up vaccination clinics and working with the voluntary sector. Jonathan Turner highlighted that the figures within the report presented to the Board were now around a week out of date from when the paper was submitted.

Vaccination had now moved to 18+ groups, in line with national programmes. The biggest challenge in relation to Covid-19 was thought to be the reopening and lifting of restrictions on 19 July 2021, and partners were being pressed to increase the rate of vaccination of people in 18+ ages to be ready for that. Nationally, cases of Covid-19 were rising, so there was a need to vaccinate many people as quickly as possible.

The Board were advised that the programme was focusing on the South of the Borough, as throughout the programme the rates of vaccination in the South of Brent had been lower, and there appeared to be more vaccination hesitancy in some parts of the borough. There was also work being done to host a mass vaccination event at Wembley stadium on 24 July 2021, but that was yet to be confirmed. A big communications push had been done with leaflets, social media campaigns and there was potential for celebrity endorsements.

The Board were informed that further information was coming out from NHS England about phase 3 of the national vaccination programme, where a booster campaign would start in September, most likely delivered by GPs. This would start with the higher risk groups, as the original programme had.

The Chair thanked Jonathan for the introduction and invited comments and questions from those present, with the following issues raised:

Vaccination figures and data:

·         In relation to the vaccination figures from the vaccination bus situated in Church End and Harlesden, the Board queried whether the figure of 44 vaccinations was for one week. Jonathan Turner confirmed it was a weekly figure that showed only vaccinations that had been done on the bus, and highlighted that the system was not dependent on just the bus for vaccinations as there were pop-up clinics, large vaccination sites and mass sites. The bus was only one way of reaching people. He added that to some extent the bus acted as an awareness raising piece.

·         The take-up for under 30s was moving, but Jonathan Turner highlighted there was some hesitancy within that cohort depending on the population. Some young people wanted to be vaccinated so that they could travel or go on holiday, but there was some complacency amongst other young people feeling that they were not affected by Covid-19. There were differing views but he advised of the need to continue to get the message out to emphasise the importance of getting vaccinated to protect yourself and the population.

·         The Board discussed the data which showed that Black communities were not taking the vaccination up in the way other communities in Brent were, and asked what was constructively being done to target and work with those communities. Jonathan Turner advised there had been specific pieces of work such as pop-up clinics, going into Churches with a high attendance from Black communities, a number of webinars, and through working with faith leaders. Robyn Doran added that there was a recognition that there needed to be more focused work with Black communities. It had been agreed that a Primary Care Clinical Director and Shazia Hussain (Assistant Chief Executive, Brent Council) would conduct a focused piece of work with 6 GPs, with some of the Community Leaders and members of Black communities to find out what more could be done to engage people, taking lessons learnt from other parts of London. Board members highlighted that intersectionality played a big part and not all members of Black communities were faith based, and felt those nuances were very important to understand.

·         Continuing the discussion around vaccination hesitancy, Dr M C Patel (NWL CCG) advised of the law of diminishing returns, where eventually the output on messaging would be larger than the outcomes. Conversations were happening at various levels, GPs were calling patients and the health inequalities team were calling people, and the return was around 5%. He advised that partners would continue to do the work to dispel the myths and inform people of the importance of vaccination, but acknowledged the need to be realistic with how far they could go with messaging before getting no return.

·         Board members noted the ethnicity data terminology may not best reflect British young people. It was highlighted that Brent had young people of Bangladeshi, Indian or Caribbean heritage who were also British which was not being reflected in the data currently. Jonathan Turner acknowledged the point and agreed to take away for future iterations.

·         Members of the Board queried whether there was any regular analysis, such as a postcode analysis, on who was coming in to vaccination centres, pop-ups and the bus. Jonathan Turner advised there was analysis of whether someone receiving the vaccination in Brent lived in Brent, North West London or outside of that, which was done centrally at NWL. The figures looked relatively good, with around 75% of vaccinations in Brent being given to those from Brent, which was better than many London boroughs particularly inner London. It was concluded that Brent was not vaccinating a disproportionate number from outside of the Borough.

·         Members requested that healthcare looked into whether it would be possible to compare data with the marked register, and whether there was a way of linking with social and private landlords as a way of reaching residents who may not be vaccinated. Phil Porter (Strategic Director Community Wellbeing, Brent Council) advised that there was work being done with housing associations.

Care providers:

·         Vaccination numbers in care homes and care home / home care staff were discussed. Phil Porter advised that care home and home care vaccinations were a central feature of the Care Provider Forum and there was variation in figures across homes. A range of support was available to make vaccination as accessible as possible, and the differential rates of vaccination in care home staff compared to home care staff was likely due to vaccination being easier to administer in institutional settings. The Workforce Fund had been distributed to care providers to ensure money was not acting as a barrier to vaccination, and commissioners were working hard with providers trying to find solutions to make it easier for staff to get vaccinated. He added that the leadership of providers and care homes may have a big impact on vaccination rates as the views of the leadership influenced staff. Work was now being done with individual providers to tackle individual barriers.

·         Basu Lamichaane (Brent Nursing and Residential Care Sector) added that there had been many incentives to encourage care home staff and residents to get vaccinated and the vaccination was now widely accessible. The feedback from staff was that they were still unsure on side effects and some were waiting to speak with their doctor, but he noted that media and news coverage had been pushing staff to come forward. The Care Provider Forum had discussed the potential for vaccinations to become compulsory for care staff and could see the benefits to that, with most registered provider managers feeling it would be a good thing. Most providers were of the view that staffing would not be an issue if vaccination became mandatory, as there was enough time to ensure contingency was in place.

·         In relation to the figures in individual care homes, the Board queried whether there were plans to publish that data on a regular basis so the public could see those figures. They considered that families of vulnerable people who may need to be placed in a care home may want to know the figures in care homes and levels of protection in each home. Phil Porter advised that there were no plans to make the data public but Adult Social Care had access to it to target the approach. He agreed that the big impact would be if mandatory vaccination was introduced. Sheik Auladin (NWL CCG) advised that there were ongoing discussions within Parliament on the issue of mandatory vaccination with plans in the pipeline for the vaccination to be mandated to care home staff from December 2021.

·         Regarding phase 3 of the vaccination programme, there was a planning session that week looking at how the booster Covid-19 vaccination might be administered together with the flu vaccination. Research was being undertaken but no decision had yet been made. An enhanced service had now been released to GPs to start running the booster campaign from September and, depending on the research and trials, the flu vaccination may also be given.

RESOLVED: to note the information provided in the paper.