Protecting and improving the nation’s health National Immunisation programme: Delivering a high quality accessible service in primary care Kent & Medway Screening & Immunisation Team Public Health England – South East (June 2018)

What do we do? PHE Screening & Immunisation Team Protecting and improving the nation’s health What do we do? PHE Screening & Immunisation Team

Your statistics are vital – using data Protecting and improving the nation’s health Your statistics are vital – using data Provides evidence for efficacy and cost-effectiveness of immunisations and monitors whether targets are being achieved Enables analysis, to ensure information is reliable and accurate Supports future planning including progress towards eradication/ elimination of disease Monitor trends and enables comparison of disease epidemiology Supports improving practice by monitoring issues and incidents Highlights areas of low immunisation uptake Essential role in managing and improving immunisation delivery . Evaluates the success of the National vaccination programme. Records Coverage measurement – those that have received a particular vaccine dose PHE Screening & Immunisation Team

Immunisation programmes and data COVER: data for vaccinations administered is sent by GP practices to Child Health Information System (CHIS) CHIS upload the data on to SystmOne (S1) Every quarter CHIS extract the data and submit to COVER for publication ImmForm: data for vaccinations administered is automatically extracted from the GP practice system The exception is health care worker flu vaccination data which is uploaded manually to ImmForm by the GP practice Additionally vaccination data for the school aged immunisation programmes is extracted from S1 and manually uploaded to ImmForm Please note: Published public health uptake data is reported from ImmForm and COVER. Open Exeter data is a separate data source used for payment calculations. PHE Screening & Immunisation Team

5 PHE Screening & Immunisation Team Protecting and improving the nation’s health 5 PHE Screening & Immunisation Team

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Measles outbreak 8 PHE Screening & Immunisation Team Protecting and improving the nation’s health Measles outbreak 8 PHE Screening & Immunisation Team

Season Influenza 2018/19: Vaccine ordering Protecting and improving the nation’s health Season Influenza 2018/19: Vaccine ordering The adjuvanted trivalent vaccine (aTIV) for all aged 65 years and over The quadrivalent vaccine (QIV) for patients aged 18 – under 65 years and IN a clinical risk group The live attenuated influenza vaccine (LAIV) for children aged 2 and over 9 PHE Screening & Immunisation Team

Protecting and improving the nation’s health Flu Clinic ideas: Staggered delivery of the adjuvanted trivalent vaccine Points to consider: Staggering invites to your patients aged 65 years and over and inviting patients aged 18 – under 65 years and IN a clinical risk group first and children aged 2 and over Keep a check of your aTIV stock to ensure your clinics are sufficiently covered, being more mindful of your delivery dates and fitting clinics around them 10 PHE Screening & Immunisation Team

Key points for 2018/19 Flu Season Protecting and improving the nation’s health Key points for 2018/19 Flu Season Aged under 65 in a clinical risk group including pregnant women At least 55% uptake in all clinical risk groups and maintaining higher rates where those have already been achieved. Ultimately the aim is to achieve at least a 75% uptake in these groups given their increased risk of morbidity and mortality from flu. Children’s programme Preschool children aged 2 and 3 years old At least 48% uptake with most practices aiming to achieve higher. School aged children (in reception class & years 1 to 5) An average of at least 65% uptake to be attained by every provider across all years. (These children are offered the vaccine by the school immunisation team) 11 PHE Screening & Immunisation Team

Seasonal Flu: aged under 65 IN a clinical risk group by CCG Protecting and improving the nation’s health Seasonal Flu: aged under 65 IN a clinical risk group by CCG 12 PHE Screening & Immunisation Team

2017/18 Seasonal Flu uptake by CRG in Kent and Medway Protecting and improving the nation’s health 2017/18 Seasonal Flu uptake by CRG in Kent and Medway 13 PHE Screening & Immunisation Team

2017/18 Seasonal Flu: CRG uptake in Kent and Medway Protecting and improving the nation’s health 2017/18 Seasonal Flu: CRG uptake in Kent and Medway 14 PHE Screening & Immunisation Team

Shingles vaccination From 1st April 2018: Protecting and improving the nation’s health Shingles vaccination From 1st April 2018: The shingles vaccine should be offered to: patients aged 70 years, on or after their 70th birthday patients aged 78 years, on or after their 78th birthday patients who were previously eligible, that is anyone in their 70s who was born on or after 2/9/1942 and 79 year olds (until their 80th birthday) A new checklist has been designed to help immunisation practitioners plan their shingles immunisation programme, this can be downloaded at: https://www.gov.uk/government/publications/shingles-vaccination-guidance-for-healthcare-professionals The shingles calculator has been updated and is available at: https://www.gov.uk/government/publications/shingles-vaccination-for-adults-aged-70-78-or-79-years-of-age-calculator Mention PGD

Vaccine incidents / Significant events Protecting and improving the nation’s health Vaccine incidents / Significant events Patient safety is paramount: practitioners should report all significant events/incidents and ‘near misses’ to their practice manager and to the SIT Following a significant event being identified, the practitioner should refer to the “Green Book” or contact the Health Protection team regarding any immediate clinical actions that need to be taken Practitioners should complete the SIT significant event reporting form which can be obtained by contacting the SIT by email phst@nhs.net or telephone 01233 658405 The purpose of reporting the event is to record actions and measures undertaken to prevent future events and for subsequent learning to be shared

Vaccine Stock loss 2017/18 17 PHE Screening & Immunisation Team Protecting and improving the nation’s health Vaccine Stock loss 2017/18 17 PHE Screening & Immunisation Team

Immunisation queries 18 PHE Screening & Immunisation Team Protecting and improving the nation’s health Immunisation queries 18 PHE Screening & Immunisation Team

School-Aged Immunisation Working together CCG CHIS Health Visiting School-Aged Immunisation Teams Midwives GPs/Practice Nurses PHE Screening & Immunisation Team

Summary and key points: Protecting and improving the nation’s health Summary and key points: Immunisation remains one of the most effective public health measures Ensure all the hard work you do for your patients is reflected and demonstrated by your data Ensure that you are using the correct READ codes Identify, invite and re-invite unvaccinated children for vaccination Work collaboratively with partners such as Health Visitors and Midwives Make Every Contact Count 20 PHE Screening & Immunisation Team

Contacts and further information Protecting and improving the nation’s health Contacts and further information SIT - phst@nhs.net or 01233 658405 ImmForm - www.immform.dh.gov.uk or 0844 376 0040 The Green Book - www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book PHE.gov.uk immunisations - https://www.gov.uk/government/collections/immunisation 21 PHE Screening & Immunisation Team

Workshop: How do we identify unvaccinated children and improve uptake? Protecting and improving the nation’s health Workshop: How do we identify unvaccinated children and improve uptake? 1st task 15 mins Identify the processes in place in your practice to identify unvaccinated children What actions do you undertake? How do you contact parents? How do you follow up children who DNA? Have you had an ‘eureka’ moment? 3rd task 20 mins What do you think the solutions to increase uptake are? What can you do as a practice? Who can help you and how? Throughout the workshop please consider: Your ‘take away’ actions What actions would you like the SIT team to consider What actions would you like the CCG teams to consider? 2nd task 15 mins What do you think are the barriers to increasing uptake? 22 PHE Screening & Immunisation Team

Feedback What are your key points from each section? Protecting and improving the nation’s health Feedback What are your key points from each section? 21 PHE Screening & Immunisation Team