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NHS Manchester Strategic Plan for Improving Immunisation
Coverage, 2010-2012: ACTION PLAN
Contents
All text in tialics are recommendations from the DH feedback. The text regarding those recommendations given by
the DH feedback as priority actions is underlined.
Area Lead Updated?
1 Commissioning, coordination and urgent actions Kevin Perrett X
Rag status
2 Data issues Jeannette Beckett x
definitions
3 Immunisation Promotion Project Bev Yarwood x R Target date passed
4 Comms and engagement Val Bayliss-Brideaux x A In progress
5 Access and vulnerable groups Bev Yarwood x Pending Pending
Completed (some work
6 Training Helen Fabrizio x G
may be ongoing)
N/A Action no longer applies
Specific Vaccination programmes or settings
7 Vaccination of younger children (Primary Care) Karen O'Brien x
8 Neonatal Hep B vaccination Nicola Jepson x
9 Neonatal BCG Sally Webster X
10 Prison Health Erika Duffel x
Seasonal flu and pneumococcal vaccination for at-risk
11 Nicola Jepson x
groups
12 Seasonal flu vaccination - healthcare workers Nicola Jepson x
13 HPV vaccination Eleanor Roaf x
14 Teenage boosters Bernadette Dean x
Annex List of discarded recommendations
Strategic plan for Improving Immunisation Coverage 2010 - 1012 - Action Plan
1. Commissioning, coordination and urgent actions
Area Lead: Kevin Perrett
Overall Aim: overall coordination of the action plan, particularly the commissioning elements; to ensure progress on urgent actions and to
coordinate any actions not fitting clearly in to any other sections
Additional
resources
Person Target needed - if Evidence of RAG
Recommendation Action(s) needed Current situation (give dates)
responsible date resource issues completion status
are a significant
barrier
Strategic plan and accompanying action plan (this
spreadsheet) developed. Perf Indicators are, consistently, Monitoring
VS indicators, being monitored through new monitorinig spreadsheet,
Final plan should have a supported performance spreadsheet but also other routes (PM Framework, new IPT Vital Signs
Funding of IPT
framework with performance indicators for progress on data monitoriing system). Also imms highlighted in the monitoring,
1A Kevin Perrett Final sections of plan need completing by Bev Y and Berni D Jul-10 relevant, for G
actions by contributing organisations as well as outcome Director of Public Health’s Annual Report (2008), the Joint Failsafe data,
Section 3
measures. Strategic Needs Assessment (2008-13) and the most recent Manchester
PCT Annual Report (2010) and the 09/10 Operational Plan. standard, PM
2011 DPH report will focus on Health Protection and imms Framework
will be the lead chapter.
Imms issues are reflected in revised CSP. Board has
Each component of the final Immunisation Action Plan supported strategic plan as part of the PCTs' commissioning
Revisions of commissioning plans need to reflect imms strategic CSP. Strategic
1B should be explicit in all commissioning plans in line with Kevin Perrett Dec-10 None intentions and development of action plan. Action plan still A
planning and action plan
WCC needs one section completing (school leaver booster),
otherwise now completed.
(Commissioning arrangements should) include key service Manchester
Manchester standard, and related work, is taking forward this
specifications that set out key performance indicators, Detailed documentation being developed for IPT project, which Standard, MCH
agenda for GP. Clearer KPIs being included in MCH
1C quality standards for service delivery and access, Kevin Perrett should address these issues for IPT (the key part of this Oct-10 IPT funding contract, IPT R
contract. IPT documentation being developed (and this
performance management arrangements, frequency of recommendation). documentation
recommendation is mainly relevant to development of IPT).
reporting and an agreed data set. (Prince II).
Longstanding concerns about HV involvement in
TCS transition process involves detailed review of MCH
Relates to Limited capacity vaccination, particularly from GPs. HVs do have an
HEALTH childrens services, because the move to CMFT involves a Results of TCS
TCS of HVs because important role in advising parents on vaccination but no
1D VISITORS redesign. HV and SN issues will be part of that review and Bev Childrens A
transition of Safeguarding longer involved in imms DNA follow-ups. HVs also deliver
Bev Yarwood Y will feed in on the imms issues involved. The Childrens Board Services review
process pressures neonatal BCG vaccination. HV role being reviewed in
are involved in that review.
The NST identified a gap in relation to maternal and child relation to TCS process.
workforce capacity, e.g. health visiting and practice
nurses and training and midwife awareness of MMR
Results of TCS
schedules. NST recommend that NHS and Hospital Trust TCS transition process involves detailed review of MCH
Relates to Comments on action plan suggest useful to look at SNs role Childrens
review workforce requirements in relation to: 1. defining SCHOOL childrens services, because the move to CMFT involves a
TCS in vaccination, though not clear why. School nurse delivery Services
establishment, 2. levels of training needed and NURSES redesign. HV and SN issues will be part of that review and Bev Unclear at present A
transition of HPV and SLB vaccination is under review (see relevant review. See
professional development, 3. clarifying roles and Bev Yarwood Y will feed in on the imms issues involved. The Childrens Board
process sections). sections on
responsibilities, 4. ensuring sufficient capacity to improve are involved in that review.
HPV and SLB.
and sustain immunisation rates, and 5. service
specifications and key performance indicators for key
groups e.g. midwifery. NST were informed that health
visiting provide immunisation advice but don’t immunise
children so the NST recommend NHS Manchester explore
the role of nurses and other professionals in immunising
children and work with GPs and hard to reach families and
support these families to immunise their children.
nurses and training and midwife awareness of MMR
schedules. NST recommend that NHS and Hospital Trust
review workforce requirements in relation to: 1. defining
establishment, 2. levels of training needed and
professional development, 3. clarifying roles and
responsibilities, 4. ensuring sufficient capacity to improve
and sustain immunisation rates, and 5. service
specifications and key performance indicators for key
groups e.g. midwifery. NST were informed that health Considerable work undertaken by Primary Care
visiting provide immunisation advice but don’t immunise PRACTICE Yearly report
Commissioning in this area, led by Liz Slater, with approx 15
children so the NST recommend NHS Manchester explore NURSES Liz Specific support work undertaken with practices to encourage Aug-10 None of 20 PN vacancies now filled. About five vacancies
on PCC
G
the role of nurses and other professionals in immunising Slater employment of practice nurses. nursing team
remained unfilled but these are in practices with broader
children and work with GPs and hard to reach families and activity
problems that need to be tackled in a more general way.
support these families to immunise their children.
Information
regarding
MIDWIVES For discussion with midwifery leads to ascertain if current
Oct-10 None See row 1 I for further details. provision of G
Kevin Perrett situation satisfactory (contacts via Sam Bradbury)
MMR to rubella
neg women
V&I committee already has wide represenation and new
Imms Action Plan group adds to representation of key
groups/stakeholders. Action planning process is also
Revised Tof R
Review membership of Vac&Imm Committee. Also see Row widening stakeholder involvement eg presentation to
Kevin Perrett n/a n/a for V&I Pending
1H, which adds to this recommendation. Children's board. V&I group happy that all relevant
committee
Clarify the lines of communication between staff involved in stakeholders closely involved in strategic process and
immunisation, the infection control team and the therefore deferred updating V&I T of R, partly as a review will
Immunisation and Vaccination Committee. Consider be needed next year due to reorganisation.
1E
inviting key representatives (e.g. practice nurse lead,
specialist paediatricians, health visitor leads) to meetings Nick Gomm See Note that comms work - see Section 4 - also relevant to this
See Section 4 See Section 4 n/a N/A
and including them in the committee. and Sandra S Section 4 recommendation
Kevin Perrett See Row 1A n/a n/a See row 1A n/a N/A
The NST recommend that a designated Immunisation V&I Committee membership to be reviewed - see Row 1E. Also
The V&I Committee act as immunisation champions.
1F Champions with partners to facilitate the delivery of the Kevin Perrett nominated leads for general practices being considered - see n/a n/a n/a N/A
Additional issue is discussion of GP champions.
Action Plan eg GP champions Row 7D.
VS reporting arrangements are to V&I committee (monitoring
To ensure the vaccination programme forms part of the
Agreed to submit report to C&YP board (or possibly Exec) on spreadsheet) and to board (PM Framework). There is a
local child health strategy. Building on governance
imms situation and planning. To include issue of providing clear commitment towards improving MMR and Human
arrangements we recommend that two reporting streams: Report to C&YP
1G Kevin Perrett regular reports and also strengthening of imms planning in next Oct-10 n/a Papillomavirus (HPV) uptake in the Children and Young board (or exec). G
to NHS Manchester and Children Trust arrangements and
iteration of C&YP plan (though Coalition Government changes People’s Plan (CYPP) 2009-12 but stronger involvement of
the newly developed Manchester Standard could be used
mean that it is unclear if that plan will be revised??). Children's Trust is needed. Report presented to C&YP
to facilitate this.
board.
Build on Immunisation and Vaccination Management
Group. The NST recommended that we review members,
terms of reference and reporting lines, e.g.
- NHS Manchester Public Health Team
- Manchester Community Health
- Hospital Trusts
1H - Primary Care Kevin Perrett See Row 1E n/a n/a See Row 1E n/a N/A
- GM Health Protection Unit
- Child Health and school health departments
- Third sector groups
- Local people and service users (including Black minority
ethnic group representation)
Service provided by acute trusts to rubella negative is much
stronger than thought by NST visitors with all three trusts
now vaccinating post-partum women in hospital. Data from
Information
Ensure that eligible women who are rubella non immune Explore with midwifery services regarding details of current UHSM indicates a 100% rubella serology uptake and a 92%
1I Kevin Perrett Oct-10 None from midwifery G
when pregnant, receive 2 doses of MMR post delivery. service. vaccination rate for the 3.9% who are screen negative. Data
services
from CMFT suggests vaccination post-partum MMR uptake
is approaching 100%. PAT has only recently changed to
vaccination in hospital post-partum.
VESPA plan initiated. All practices aware of their VNN’s and
have confirmed to us. All practices contacted by phone and
NST made aware of the lack of clarity and ownership of NST Good Practice is available and DH launching VESPA are now aware/using ImmForm to order vaccines. CICT
the cold chain strategy. In order to develop a safe cold initiative this year, which will provide authoritative best practice monitoring the spreadsheet and updating if any practices
Results of
chain process we recommend that Manchester review and guidance, and to which PCT will need to implement. Approach have any queries. Practices informed of the DH protocol on
1J Helen Fabrizio Dec-10 None audits and A
clarify who has ultimate responsibility for this and a regular would be self-audits followed by targetted visits jointly management of vaccines, which is also available on DH web
VESPA process
system of audit is instituted. This needs communicating to developed between CICT and MM (perhaps combined with IPC site and ImmForm web site. Cold chain and management of
all partners. visits?). CICT need to work jointly with MM. vaccines is a module in every Immunisation training session.
Med Management emailed all practices with the cold chain
audit to complete.
DATIX (web-based software) reports are provided from
across organisation and monitored via MCH safety group.
Note that the new NW Imm Programme Standards A one-off report from Chris Garrett on recent incidents (MCH
Incident reporting (all incidents, not just SUIs) is a
recommend that local services ensure that "a robust only) for ~ last 12 months will be provided to V&I group (Chris to
organisational policy requirement and not just imms Reports
system is in place for the management of critical incidents liaise with Sally W). Report can also cover how imms incident
1K Chris Garrett Dec-10 None incidents. Applies to MCH primarily however. Primary care produced by G
and that information on incidents is reviewed, reports reporting may work in 2011/12 and onwards, and how V&I
reporting is a seperate mechanism (via Medical Directorate). Chirs Garrett.
produced, actions taken and that regular reports group might receive summary reports from whatever incident
CICT operational immunisation guidelines recommends all
disseminated to all immunisers. reporting system is put in place.
incidents are reported on DATIX and CICT support with
clinical advice as indicated for reported incidents.
2. Data issues
Area Lead: Jeannette Becket
Overall Aim: To promote accurate exchange and receipt of Information re childhood Immunisations and registrations
Additional resources needed
Person Target Evidence of RAG
Recommendation Action(s) needed - if resource issues are a Current Situation (Give dates)
responsible date completion status
significant barrier
1: Group set up - first meeting held July 21st includes
Need to recruit to 1 WTE to rep from GP Practice
work through the reconciliation
2: Ideas data checks 5th August for one
of the data comparing data Monitor progress
practice 3: Working on
from GP Practices and CHIS during 3rd quarter
electronic uploads 4:
to check any missing 10/11 to evidence
The NST supported the plans for data reconciliation that includes agreed 1: Prepare and implement a data improvement action plan M/cr choices team telephone plans will assist in
information and update by end of 4th
information exchange protocols and the development of an extensive data to check and clean data between GP systems and the following up DNAs
relevant systems - this quarter - year end -
reconciliation exercise, a Forward Plan on how this new data is to be Child Health System to improve and maintain childhood 5: Update report names on
additional resource is not demonstrate what
maintained and what action is to be taken in light of this data. The NST were immunisation records for Manchester children to enable reports to GP practice user friendly wording
currently available. The made the
made aware of issues identified surrounding data capture and data sharing best possible Vital Sign Submission and accurate data 6: Attend
current recruitment process difference
due to incomplete reconciliation of information systems across organisations. 2:Build on current relationship with Patient Data to Practice Managers forum to highlight CHIS system and
Jeannette Oct - Dec runs a significant risk of . Previous
2A Need unified approach to data collection and management to minimise exchange information and seek electronic upload data queries
Beckett 2010 delaying recruiting to this post lessons learnt
associated risks. NST stressed maintaining commitment to data quality and programme capability 7: Assist system suppliers in PDS compliance to
Partnership working with the result in assuring
regular data cleaning and linking to GP data with CHIS. Protocols should 3.Recommend to the project team that all children within improve GP Registration information flow-
Joint Health Unit hs led to Practices of all
be in place to ensure prompt sharing of information between Patient Data and the specified target group checked at GP practice are 8:Electronic exchange of GP registration details
admin support for two days per children registered
Child Health. Arrangements should be made between Practices, Child Health checked for immunisation history to protect and maintain from the Data Warehouse team has been requested -
week to assist in the project. with them and
and SHA to ensure the same data is collected by each, according to NICE Practice relationship and confidence between GP practices pending progress due to time restraints of Data
The person has been Child their immunistions
guidance and the Child health Department Warehouse Team
Health System trained to are acurately
9. The purchase of Business Objects has enabled a
retrieve Practice information recorded on both
more robust reporting mechanism to assist in the reports
from the Child Health system system
required for the project 10. The
prior to GP practice visits for
Data Warehouse is no longer utilised
Data checking
12.Child Health System developments planned for early
1:Established methods of reminders of children waiting to 2011 will support the project and improve data sharing
1:monthly flow of information to GP's
be immunised sent routinely to GP 's monthly- expand on 2: Arranging to join practice managers forum to
summaries to measure and evaluate each month on highlight and discuss issues TBA
progress made. 3: Rewriting routine
2: - all recorded on a daily letters to GP's with assistance from GP representative
As good practice we recommend that NHS Manchester establishes numbers 4. Attendance at the
turnaround from receipt in Child Health. - no significant Reduction in
of children waiting to be immunised in order to develop strategies to address Jeannette Practice Nurse Forum in North District allowed
2B problems apart from January 2010 during the severe Ongoing None children awaiting
this and regularly audits the time taken for data to be entered on CHIS and Beckett discussion on the flexibility of the Child Health
weather following closely on from the new year break - appointments
appropriate action is taken. Appointment system - attendance at future forums in
caught up inside two weeks
3:- establish Central and South districts are planned 5.. Child
new letter to GP's to accompany list of children awaiting HealthSystem upgrade due in January 2011 will enable
appointments - deliver monthly counts of outstanding electronic distribution of the immunisation schedule and
vaccines piloting of the return of results by spreadsheet is planned
with a GP practice
Encourage and enable private providers to give the relevant GP practice or 1:Determine who the private providers are to arrange letters to private providers to
Jeannette Oct - Dec Information flow
2D PCT details of all vaccinations administered to children and young people, so communication. 2: Send letters to ask private ask to provide CHIS with Not clear that this is a significant problem in Manchester
Beckett 2010 established
they can be recorded in the appropriate information system. providers to inform CHIS of any imms given to children details of any imms given
Check McKesson and IT
Advertise and promote the uptake of remote access to the Child Health Jeannette GP Access to
2E Set pilot site for access to the child health system Jul-10 Services can allow 2 GP practices currently using CHIS training completed
database in practices and clinics. Beckett CHIS
permissions through firewalls
Protocols in place at every practice to ensure Child Health is updated of any Jeannette
7F Data issues considered as part of Data Improvement Plan - see row 7 N/A
relevant changes of information. Beckett
There should be a level of minimum IT training for all practice staff involved in
data recording. Standardisation of Read Codes used for recoding Jeannette
7G Data issues considered as part of Data Improvement Plan - see row 7 N/A
immunisation will improve the quality of the data. Consider standardising data Beckett
coding if not already in place.
3. Immunisation Promotion Project
Area Lead: Bev Yarwood
Overall Aim:---To secure agreed improvements to uptake and, once increased levels of immunisation coverage are reached, to keep levels high.
Additional resources
needed - if resource
Recommendation Person responsible Action(s) needed Target date Current Situation (Give dates) Evidence of completion RAG status
issues are a significant
barrier
• This is very much new work that fits with making the role of the • Establishment of Failsafe
current (HPV and schools) immunisation team broader. Urgent Team. September 2010: Two
proposal needed (based on Salford system). members of staff now in post to
• An established project management method will guide this project pursue and consolidate 'failsafe'
through a controlled, well managed, visible set of activities to achieve action planning process
the desired results. This project will be managed using the principles • Immunisation Promotion
of the Prince 2 methodology Project lead with a strategic
Failsafe team'. A quarterly target list of children outstanding immunisation generated enabling
overview of the whole
contact with parents to clarify if they have been vaccinated, whether they have perhaps moved Resources are needed for a
programme, and Immunisation
away, or to encourage attendance at the GP for vaccination. Staff individually contact the new system to be
Promotion Nurse to focus on
parents of those children who have outstanding vaccination to encourage them to go to their GP. established. There is a • A restricted access information folder has been set up on the PCT
Partial impact operational management and
The very small proportion of patients who can’t be contacted or who are unable to attend their VaccImm reporting tool main server to ensure that all members of the project are able to
Q4 10/11 and delivery. Both staff members on
3A Bev Yarwood GP need to be visited at home and vaccinated by a domiciliary vaccination service. HoB and which has been created by access, save and update relevant information off site; and ensure that
full impact Q1 secondment from substantive
Salford experience suggest that team might consist of perhaps a band 6 project manager, two Central Lancashire PCT. all facts and data are easily and speedily accessible.
11/12 post until March 2011. To be
band 5 nurses and two band 2/3 admin. Funding may be required to • To improve vaccination coverage, our initial two key target groups reviewed and reconsidered as
further develop this tool to are for Vital Signs indicators One and Four.
Recommendations relating to access issues. Commission a ‘Failsafe Team’ necessary in response to other
suit our requirements. • Visits x two to Central Lancs for information sharing and gathering by
(which could be funded through non-recurrent budgets in year 1 and changes involved with the TCS
mainstreamed if successful). IPT agenda. Appropriate actions [
• For information sharing and gathering by IPT. see other sections of Action
• JHU support – another colleague x 3 day’s week allocated to IPT. Plan] as agreed; increase in
• See section 5 - Access and vulnerable group for further information. percentage uptake to be
Proposal to begin parental contact process; to clarify immunisation demonstrated by Quarter 4.
status of child, and reasons for same Quarter 3. Immunisation project plan
There is a need for a well functioning CHIS and regular and frequent information exchanges
between GPs, other information providers, and Child Health to ensure that data held is up to
Jeannette Beckett See Section 3
date and robust. This information, once available, will be used by and for the Immunisation
Promotion Team to manage and focus their activity.
Data on domiciliary immunisation
Domiciliary vaccinations to be offered only in specific circumstances, i.e. for
3B persistent non-attendees of appointments. The very specific use of this Bev Yarwood See comment in first column Q1 11/12? Via IPP No decision yet made on need for domiciliary immunisation
service must be made clear to all involved in immunisations
4. Comms and engagement
Area Lead: Val Bayliss-Brideaux
Overall Aim: The long term goal of this strategy is improve vaccination uptake across the city using a variety of communications methods
Additional
resources
Person Target needed - if RAG
Recommendation Action(s) needed Current Situation (Give dates) Evidence of completion
responsible date resource status
issues are a
significant
Need to strengthen communications across and between organisations and to communicate with communities. The NST endorse Related comms and
the planned development of an integrated internal and external communications strategy as part of the final action plan for engagement strategy and
Val Bayliss-
4A improving immunisation uptake. NST recommend we communicate changes in services, service configurations, policies and See communications and engagement strategy associated actions and A
Brideaux
pathways to professionals and the public. NST also recommended we adopt a cross agency organisational development approach resulting
to communications and increase the profile of immunisation uptake – the idea that this is ‘Everyone’s Business’. documents/papers etc
Related comms and
Regularly identify and target areas where uptakes of vaccinations are poor as 'places of concern'. Target these areas as priorities engagement strategy and
Val Bayliss-
4B to, for example, improve information available to patients, and work alongside community groups to ensure the importance. NST See communications and engagement strategy associated actions and A
Brideaux
recommends we develop deeper understanding of local population including the reasons for not immunising. resulting
documents/papers etc
Related comms and
engagement strategy and
Develop links with agencies that work with specific community groups. For example Connexions, Youth Offending Team, Asylum Val Bayliss-
4C See communications and engagement strategy associated actions and A
Seekers Centres, The Welcome Centre. Brideaux
resulting
documents/papers etc
Produce /provide and disseminate information for the public of Manchester – in line with national communications campaigns as
Related comms and
appropriate - in various media (e.g. leaflets, posters, newspaper adverts, radio adverts) about immunisations. The information
engagement strategy and
should be tailored to target audiences and also available on the NHS Manchester website. Provide information in a user friendly Val Bayliss-
4D See communications and engagement strategy associated actions and A
format for different audiences (particularly the seldom seen, seldom heard). Provide regular communications to local populations, Brideaux
resulting
especially families and service providers to increase awareness of the importance of immunisation and risks associated with the
documents/papers etc
failure / delay to an immunisation course.
Related comms and
engagement strategy and
Information should be easy to understand and to the point. Information should be available in all recognised languages when Val Bayliss-
4E See communications and engagement strategy associated actions and A
possible. NHS Manchester website to include links to information services on immunisations Brideaux
resulting
documents/papers etc
Related comms and
engagement strategy and
Carry out an awareness raising campaign (using results from social marketing campaigns carried out elsewhere) about Val Bayliss-
4F See communications and engagement strategy associated actions and A
immunisations, and promoting their importance. Brideaux
resulting
documents/papers etc
Related comms and
engagement strategy and
Work with the communication lead at NHS Manchester to develop communications campaigns when there are infectious disease Val Bayliss-
4G See communications and engagement strategy associated actions and A
outbreaks, government campaigns etc. Brideaux
resulting
documents/papers etc
Related comms and
engagement strategy and
Consider using pharmacies, retail outlets, libraries, and local community venues to promote and disseminate accurate, up-to-date Val Bayliss-
4H See communications and engagement strategy associated actions and A
information on childhood immunisation. Brideaux
resulting
documents/papers etc
Related comms and
Produce leaflets/posters for families who may consider taking their young children away for an extended period of time, advising engagement strategy and
Val Bayliss-
4I them to ensure that the child is fully immunised against the appropriate infections before they travel. These should be distributed to See communications and engagement strategy associated actions and A
Brideaux
key locations within local communities, to reach the target group. resulting
documents/papers etc
5. Access and Vulnerable Groups
Area Lead: Bev Yarwood
To review care pathways from a vulnerable group perspective; to ensure that barriers and blocks to access are identified and removed.
Additional resources
Person Target needed - if resource Evidence of RAG
Recommendation Action(s) needed Current Situation (Give dates)
responsible date issues are a completion status
significant barrier
The action plan needs a supported clear, integrated pathway, which identifies Bev Yarwood. Partnership working Ongoing. n/a Involvement of Communications Team - Scoping exercises in progress Imms Project Plan /
and describes the entry points and routes through services depending on the Comms Team. Work to Strategic Plan/Action Plan Plus Imms Action Plan.
needs of individuals and population groups longer
term
developm
ent
Ongoing. n/a MCH Homeless Families Team contact made 8.9.10 - Crude count IMMS Action Plan /
Plus made of Immunisation status of C & Y P. Consideration as marginal Imms Project Plan
longer group
term
developm
ent
5A
Ongoing. n/a Liaising with Voluntary Sector (BOAZ) 1.12.10 re asylum seekers - IMMS Action Plan
Plus Consideration given as marginal group
longer
term
developm
ent
Ongoing. n/a Information requested from Manchester CC re travelling families -
Plus Consideration given as marginal group.
longer Full engagement via Public Health co-ordinators. Meeting held to
term discuss Sure Start commission. 15/11/10.
developm
ent
Ensure enough immunisation appointments are available so that all local PCC IPT Child Strategic Action Plan/Action Plan – • Letter sent to all practice managers and nurses explaining ethos of Strategic Plan/ Action
children and young people can receive the recommended vaccinations on time. Health Engagement and pilot work with targeted GP practices. IPT Plan
McNesson Full engagement with and co-operation of Child Health Department. • Work ongoing re targeted GP practices
• Contact made by IPT/Child Health/Liz Slater
• Appointments made and data cleanse in progress
• Practice visits by IPT to view perceived operational difficulties to
IMMS delivery
5B n/a Bev Yarwood – IPT lead not engaged as accredited clinician with Immunisation Project
McNesson care plus system. Plan
Data cleanse between systems and reports to ensure accuracy.
Training with connecting for Health 17th-18th November 2010 –
Warwick (McNesson) for clinical safety workshop.
IPT Child Health Proposal for Opportunity. IMMS in n/a • Meeting arranged with GP Surgery 22/12/10
GP Surgery • Paediatric Out-Patient Department. • Meeting arranged with Community Paediatricians December 2010
• City Centre Medical Pratice.
Develop a protocol agreed across all agencies working with asylum seekers MCC JHU Liaison with MCC and voluntary sector. Ongoing n/a Not current vital signs requirement considered in more detail at later
whereby their immunisation history is gathered as accurately as possible and Comms date as marginal group.
ensuring appropriate appointments are made and given for outstanding
immunisations to be administered
5C
Health care professionals who work closely with asylum seekers and refugees IPT, ICT, MCC Liaison with MCC/ Voluntarty Sector Ongoing n/a
to improve services in relation to immunisations, and facilitate communication
between all groups involved in their care (with support from the infection control
5D
team).
(Identify areas of) low immunisation uptake to inform redesign routes into PCC, IPT, Child Scope capacity/necessity for drop-in clinic Meeting arranged with City Centre Practice to discuss 22.12.10 Action Plan /
services – e.g. appropriate flexible hours, use of a wider range of settings – Health McKesson • Consider pilot with City Centre GP Practice Drop in clinics require a risk assessment and availability of accurate Immunisation Project
use of children’s centres . Set up a number of drop-in clinics across the city, to • IMMS and delivery is a primary care responsibility and real time data. Paln
which patients can be referred to by any health care professional. Consider • Consider pilot with Paediatric community clinicians
locations which will suit the local needs such as in Sure Start centres, or
Meeting held with KP /HV / IPT / Public HealthCo-ordinator's to Action Plan /
5E discuss Sure Start involment/engagement. Immunisation Project
Plan
n/a Child Health colleagues involved re compliance with data management
McKesson – Business objects work in progress
(NST recommend as good practice the) opportunistic childhood vaccinations Royal Free Hampstead NHS Trust – opportunistic childhood vaccinations in its n/a Meeting arranged with Acute / Primary Care colleageues to scope.
paediatric outpatients department from February – March 09 See 5E
5F See 5E
Note that the new NW Imm Programme Standards recommend that Strategic Plan / Action Plan n/a Child Health - Data group - Section 2. Cover data regularly. Received IMMS Action Plan /
"Immunisation uptake by those at risk of not being fully immunised is reported treatment centre queries information received. IMMS Project Plan
and closely scrutinised on regular basis, and that immunisation uptake rates of
those at risk of not being fully immunised are fed back to all immunisation
services and discussed with the view to improving access and overcome
5G
barriers".
n/a Care Plus / McKesson Planning
n/a Working with Liz Slater and Commissioning
Health visitors to become more involved with immunising in the community and Bev Yarwood Revisiting the debate about HVs delivering vaccination is unlikely to be productive - By end Advising parents on IPT involved in HV S=standards / structure re-design. Evidence that review
targeting the non -attendees. The role of the HV in the immunisation agenda given capacity of HVs in the city - but their role in encouraging vaccination with new 2010 benefits of vaccination HVs already advising parents at new parent visit has taken place.
needs reviewing. parents should be reviewed is already part of HV Scoping exercise due with Public Health co-ordinators (Justine IMMS Action Plan IPT
role Baines) to establish what training is received by Sure Start Centre Project Plan Proforma
5H staff in regard to IMMS delivery for paeds admissions.
Results of a pilot
project.
Check the immunisation status of children and young people at every Lisa Redfern / Lisa Redfern to explore options, particularly for developing a proforma for paeds Oct-10 None Imms status of children is currently checked when admitted, but not in Proforma for paeds
appropriate opportunity including hospital in – or outpatient and accident and Kevin Perrett admissions. Will discuss with Rosemary McCann, who has an interest in this issue. particular detail. Issue is whether to vaccinate in acute setting, which admissions. Results
emergency departments, walk-in centres or minor injuries units. The NST Possibly a pilot project to vaccinate in an acute setting can be developed? is difficult as requires access to CHIS data, vaccine supply, and of a pilot project.
recommend that NHS Manchester use all opportunities to review children and considerable training and organisation. Alternative to that
young people’s immunisation history and fully utilise every opportunity to considerable undertaking is to improve the discussion with parents
immunise in the following situations: attendances at A&E and Walk In centres, about missing imms by raising awareness amongst paeds staff and
outstanding immunisation in schools, statutory reviews for children in care, improving their attempts to encourage GP attendance for vaccination.
5I children known to child and adolescent Mental Health services, children who Providing vaccination in A&E and similar settings seems very
are hospitalised ambitious for the likely benefits. Provision of vaccination in one WIC
is being pursued (but provision in all WICs also seems overly
ambitious). Audit of IMMS stands in progress - Crude numbers by
Health Care assistants (working for MCH, but placed in A&E at
CMMC). Will be discussed as progressive initiative as above.
Ensure all locations providing immunisations are recording any identified Giving out general information, perhaps n/a Work up IPT / Child Health contact / liaison / database management As in 5H
reason for non vaccination e.g. parental concerns, contraindications, needle Around the launch of a campaign with practice ongoing.
5J phobia etc. Results to be audited and findings to be used to improve service. Team brief (monthly information given HPV Spreadsheet (work in progress)
out by team managers) To capture identified reasons for default can be utilised for delivery to
under 5’s once accredited.
The Healthy Child Team, led by a health visitor working with other practitioners, Representation at LMC – Essential that n/a Healthy Child HV role does not exist in Manchester. Different roles IMMS Project Plan /
should check the immunisation record (including the personal child health Lead attends and gets support and responsibilities considered as part of re-design work with HV IMMS Action Plan
record) of each child up to 5 years. They should carry out this check when the perhaps on specific campaign, or standard group. IPT involved.
5K child joins a day nursery, nursery school, playgroup, Sure Start children’s certain area of communication e.g.
centre or when they start primary school. The check should be carried out in checking vaccination status if at the
conjunction with childcare or education staff and the parents. doctors for something else/or writing
to parents to remind them
Offer vaccinations in locations that are more tailored to the needs of looked NST Good Practice is available – Leeds – Children in Care Immunisation increased n/a Meeting held with LAC team. Progress further with Child Health / LAC
7A after children, such as drop in centres at local clinics (see recommendation 5). from 51% in 06/07 to 84% 08/09 through opportunistic immunisation at regular health team.
(moved assessments.
from
Section
7)
6. Training
Area Lead: Helen Fabrizio
Overall Aim: To provide accountable, targeted and inclusive multi-disciplinery immunisation training which conforms to Health Protection Agency standards
Additional
resources
Person Target needed - if RAG
Recommendation Action(s) needed Current Situation (Give dates) Evidence of completion
responsible date resource issues status
are a significant
barrier
All immunisation training and updates to be properly audited and 06.05.10 Meeting held with Maura Moss. Maura confirms that
evaluated. Attendance on training to be fed back to managers. Meeting arranged with Maura Moss, cancelled by all Imms training is evaluated, the attendance is fed back to
6A Maura Moss n/a Further meeting to be arranged G
Note that the new NW Imm Programme Standards recommend Maura, new date to be arranged. manager and a data base of immunisation training attended is
that "An up-to-date immunisation training database available". maintained.
Meeting at Wythenshawe offices 25.03.10 with Sally Webster, Leasa Benson, Liz
01.07.10 Training has been commenced as outlined. 1.
Slater, Helen Fabrizio. Cate Riley and Muara Moss unable to attend. Training to use
Introduction and Update to Immunisation to cover all age
HPA curriculum. To be for all immunisations, not just Childhood Imms. Training to be 1
groups, for all professional groups (excluding HCA's and other
day Introduction to Immunisation and a half day Update for Immunisers, four times a
support staff) 2. A 3 hr course for non-immunising support staff
If the PCT is year each course. To be available to all immunisers ( inc Prison Staff, HCA's giving flu
has been introduced and the first session is 16.07.10. (we are
required to provide vaccines). Flu and Pneumococcal training to be part Intro and Update courses, rather
currently awaiting HPA guidance regarding the structure of
Provide tailored training for non-immunising staff, particularly 3 day training for than separate. Separate training for support staff giving advice on imms e.g Sure Start
courses needed for HCA's giving Influenza and Pneumococcal
6B GPs, practice reception and admin staff, carers, nursery staff, Helen Fabrizio Meeting arranged 25.03.10 n/a HCA's this will / Social Services. ?Three times yearly half-day depending on demand (will need to be Pending
vaccinations. The current proposal is a 2/3 day course).
midwives, social workers. impact on staff monitored and evaluated when started). New training programmes to be developed
04.01.11 No further information has yet been received regarding
resource, and by end of April. Intro Imms and Update already completed. Further flyers to be sent
training proposals. The Immunisation traning packages have
training costs. out with changed course titles and content etc. Agreed actions needed to increase
each evaluated well throughout 2010 . At present there is only
course uptake among Practice Nurses, Liz Slater to discuss Imms training being part
one further training course for non -immunisers planned in Feb
of QOF with Jane Jackson. Infection Control to add Imms training to Infection Control
20111 due to changes to L&D with PCT re-organisation. No
audit form for General Practice. Liz to review training records she has of PN's and
further Imms traning is planned for 2011
promote course to them.
06.05.10 Meeting with Maura Moss Head of Learning and
Meeting arranged with Maura Moss 19.04.10 -
Development, Sally Webster, Head of Health Protection, and
6C Maura Moss unfortunately this has been cancelled by Maura. n/a None Further meeting to be arranged G
Leasa Benson, Clinical Lead Health Protection. NHS
New date to be arranged
Manchester has robust training evaluation protocol.
Carry out a review of the NHS Manchester/Manchester
01.07.10 All staff who immunise have to attend an Introductory
Community Health training evaluation protocol. Note that the
PCT recognised course. This may be provided by the local
new NW Imm Programme Standards recommend that "all
Universities, or by Dr David Baxter at Stockport, or through the
current immunisers have received core-training (basic training)
PCT Introduction to Immunisation Course. The corporate
followed by an annual update as set out in the HPA national
position regarding annual updates is still 3 yearly attendance at
minimum standards for immunisation training" If the PCT is
a recognised immunisation update course. Change regarding
required to provide
A proposal document of the relevant leads/ key this will be approached via a proposal document of the relevant
annual updates
Helen Fabrizio stakeholders regaring whether PCT has to provide Sep-10 See next cell leads/ key stakeholders in the next few months planned for @ A
this will impact on
yearly updates. Sept. 2010. Ideally an E-learning package would have been one
staff resource, and
solution but all e-learning is currently on hold with the re-
training costs.
organisation process in place. Staff can attend an Update
annually if they feel they need this or a need is identified by a
manager. A further option is to use the PCT /HPA competency
framework annually. 04.01.11 The HPA are planning to release
an immunisation e-learning package in Jan 2011.
Vaccine Update newsletter supplied by the DH. Email contact
All immunising staff should be signed up to receive Vaccine address for Vaccine Update has been circulated at Imms
Update, which provides general updates on the immunisation Vaccine update – detailed and specific information training events, to Practice Nurses/ Practice Manager's and
programme, including Green book changes. These staff must regarding vaccines. GP's via Elizabeth Slater, the PN Lead (Commisssioning). The
6D Helen Fabrizio n/a None See next cell G
make time to make sure they are up to date with changes and if GP update – monthly newsletter sent by Primary link is also on the Infection Control web site, Immunisation
training is required, that they attend training. Details on links to Care Commissioning to all GP’s Section. Immunisation information can also be added as needed
update etc to be advertised on NHS Manchester intranet site. to the Practice Nurse Newsletter sent by Liz Slater or the
Practice manager newsletter circulated by Joyce Thorley.
01.07.10 The infection control team have access to contribute to
newsletters provided by the HPA to care homes, co-ordinated
The infection control team to produce and disseminate regular NHS Manchester needs to ensure they are targeting
by the CICT Administrators. This would enable any current
newsletters to all involved in immunisations, and beyond. Helen and communicating the right people in the correct
relelvant advice on immunisation to be added as needed. The
6E Consider having a role for a surveillance and communication Fabrizio / area when we are running campaigns or generally n/a None See next cell G
General practices and Provider services have access to the
person within the infection control team to produce the Fiona Smith promoting vaccination.
vaccine update newsletter from the DH. There is access, links
newsletter.
and information on the Infection Control web site regarding
immunisations for all staff and the public.
7. Vaccination of younger children (Primary Care)
Area Lead: Karen O'Brien
Overall Aim: To improve delivery of vaccination through primary care in Manchester
Additional resources
needed - if resource Evidence of
Recommendation Person responsible Action(s) needed Target date Current situation (Give dates) RAG status
issues are a significant completion
barrier
Improving the performance of general practices,
particularly those performing less well, via
No new resources needed,
Manchester Standard. This work involves engaging
this is primarily a
with practices and negotiating better performance Quarterly Key
contractual issue being Manchester Standard launched 23rd June 2010. Practices will
against a series of indicators, including for Performance
Karen O'Brien Jun-10 taken forward through receive quarterly updates on the key performance indicators
immunisation. Being overseen by the PC indicators in the
Manchester Standard relating to childhood imms & vac, etc - starting with October 2010
programme board. Communication with general Manchester Standard
practice visits that begin in
practices on increasing uptake including the quality
January 2011
and accuracy of data and solid working
Those not meeting minimum standards should have their contracts reviewed,
7C relationships, e.g. GP champions.
with the possibility of remedial action.
Payment data already available from finance and COVER data
requested from Jeannett B. Payment data and COVER data to be
Analysis of data by practice, from both COVER data analaysed to identify mis-matches. Then practices will be Spreadsheet
Kevin Perrett and from payment data. To inform targetting of May-10 n/a approached to explain discrepancies. Decided not to undertake analysing uptake by N/A
further work analysis as discrepancies in COVER reporting to be investigated practice
by other means (and difficulties in underaking this work,
particularly validity).
Strengthen and formalise work with individual
Work already underway with practices, this is a more formal
practices, led by Primary Care Commissioning, and
approach to current work with practices as part of Manchester
supported by Community Infection Control Team as
From within current PCC Standard work. Manchester Standard data for 09/10 baseline is
Karen O'Brien specailist advisors. Agree process to select 2010//11 ?
and CICT resources already with practices who have been banded A, B or C
practices that require visits, based on performance
depending on achievement. PCC will work with the Band C
against Manchester standard, and to develop action
practices as a priority.
plans for individual practices that are monitored
Have a team in place to target poorly performing practices and assist them in
making steps towards improving performance in immunisation services. This
7D will result in jointly producing an action plan for the practice (based on guidance
and best practice from elsewhere) against which they can be assessed. All All practices should be asked to identify a lead for
practices should be encouraged to identify a lead for immunisations. immunisations with whom the CICT can make
Contact to be made with practices, focusing on those with low
contact regarding immunisation issues. Note that
immunisation coverage. Contact already made with all practice
the new NW Imm Programme Standards From within current CICT Listing of
Kevin Perrett By end 2010 to provide information. Discussed at Manchester standard group - N/A
recommends that "all immunisation services (GP resources immunisation leads
not clear that an identified lead is needed for all practices - many
practices / immunisation clinics) to have a named
are performing well without having such link persons.
individual for cold chain". Could this be the same
person?
See above, row 6 in particular. Focus is on working with all
That commissioners provide regular feedback of performance in relation to
practices but focusing on poor performers (no plan for 'GP
immunisations to the providers (GP practices), including targets and
No new resources needed, champions' as different methodology being used) Process for Manchester Standard
comparisons between practices and localities. This should be made publicly See row 6 above - The key performance indicators
this is primarily a working with under-performing has been developed. Quarterly process for working
available and use data held on the Child Health database. DH endorsed NHS in the Manchester Standard will be reported back to
7E Karen O'Brien Feb-11 contractual issue being notification of under-performance is being under-taken. Cluster with under-performing
Manchester’s proposed development of Manchester Standards and GP Cluster practice quarterly. Those Banded C will be priority
taken forward through managers idea is more to do with acute services, not primary practices. Practice
Managers to identify and target support to practices of concern. practices.
Manchester Standard care performance. Action plans will be developed as part of visit programme.
Communication with general practices on increasing uptake including the
practice visiting process - starts in February 2011 - and that will
quality and accuracy of data and solid working relationships, e.g. GP champions.
include imms.
Protocols in place at every practice to ensure Child Health is updated of any
7F Jeannette Beckett Data issues considered as part of Data Improvement Plan in Section 2 N/A
relevant changes of information.
There should be a level of minimum IT training for all practice staff involved in
data recording. Standardisation of Read Codes used for recoding immunisation
7G Jeannette Beckett Data issues considered as part of Data Improvement Plan in Section 2 N/A
will improve the quality of the data. Consider standardising data coding if not
already in place.
8. Neonatal Hep B vaccination
Area Lead: Nicola Jepson
Overall Aim: To improve uptake of local neonatal hepatitis B vaccination and screening to reduce transmission of hepatitis B in Manchester
Additional
resources
needed - if
Person Target Evidence of RAG
Recommendation Action(s) needed resource Current Situation (Give dates)
responsible date completion status
issues are a
significant
barrier
PCTs should have an identified person responsible for coordinating
Operational
the local Hepatitis B vaccination programme for babies at risk of
procedures and
Hepatitis B infection. The person should also be responsible for Joint co-ordination by Nicola Jepson (CICT) and Amanda Allocated coordination hours located in Community Infection
8A NJ/AW Jul-10 None database kept G
scheduling and follow-up to ensure babies at risk are vaccinated at Wynne (CHS). Clinical overview by LB/SW Control Team
in infection
the right time. This may involve working within and across several
control folder
PCT areas.
Draft revised operational procedure and database developed.
Develop joint CICT/CHS operational procedures and
Jul-10 None Current guidelines include movement out section on who and G
database to monitor procedure with assurance measures.
what to inform
A clear process for the local infant Hepatitis B vaccination
Operational
programme should be developed and implemented. Antenatal,
procedures and
postnatal, neonatal, paediatric, primary care and community
NJ/AW list kept in
support teams should communicate effectively and share
infection control
information so that the children and families affected can be
folder
contacted and followed up. Work in progress to ensure a contact list of out of area
immunisation co-ordinators and infection control nurses are
Need to strengthen communication links between virology,
kept by up to date. Visits to be planned by Hepatitis B Co-
8B trust screening co-ordinators, border PCT Hepb B co- Jul-10 None G
ordinators to meet with acute trusts to ensure communication
ordinator and CICT.
flows and that all relevant information is passed onto the
relevant bodies.
Babies born to Hepatitis B-positive mothers should be given the
Revised draft procedure includes 1st dose given by hospital, Operational
first dose of vaccine promptly, whether they are delivered in
Ensure neonatal hepatitis B schedule and serology follow up subsequent doses and blood tests arranged as per DH procedures and
hospital or at home. They should then receive all other
8C NJ/AW implemented as per national guidelines embedded within Jul-10 None guidance. Access database queries written to flag up any database kept G
recommended doses, a blood test to check for infection and, where
draft revised operational procedure and database outstanding vaccinations appointments, telephone calls to GP in infection
appropriate, Hepatitis B immunoglobulin, in line with the Green
or serology referrals control folder
book.
Health professionals should provide parents with information, Current draft procedure includes HPA Hepatitis B information
advice and support on how to prevent the transmission of Hepatitis leaflet sent to parents with reminder letter for 2nd, 3rd and 4th Operational
8D B. They should emphasise the importance of ensuring babies Review information sent to parent from PCT and acute trust. None immunisation. Visits arranged for Hepatitis B Co-ordinators to procedures and
complete the recommended vaccination course at the right time. In NJ/AW Sep-10 meet with acute trusts to check what advice/information is database kept A
addition, they should assess whether or not the baby’s siblings given to parents at hospital prior to admission. in infection
need to be immunised against Hepatitis B or tested for infection control folder
Infant Hepatitis B vaccine included in immunisation training
and should offer them vaccinations and blood tests if necessary. Ensure Hepatitis B included in staff training programme None
programme.
Health professionals should ensure administered doses of Hepatitis
Review instructions sent to GP who administer the Hep B Revised letter developed for HV and GP to ensure records are Copy of letter in
8E B vaccination are recorded in the patient records and the personal NJ/AW Jul-10 None G
vaccine of need to maintain patient records updated accordingly CICT folder
child health record.
Database and
All the above actions should be integrated into the local care Review and merge Child Health and Infection Control Operational
Joint Child Health/CICT Hep B database, procedures and
8F pathway for infant Hepatitis B. Disseminate recently developed antenatal hepatitis B database and procedures to develop a Jul-10 None procedures kept G
pathway developed.
neonatal hepatitis B care pathway and cycle of audit and review to NJ/AW Hep B pathway. in infection
ensure all eligible babies are fully immunised and serology is taken control folder
at year 1.
Draft audit pro forma in place. New process to be audited
Develop Hep B audit programme Oct-10 None Results of audit A
October 2010
9. Neonatal BCG
Area Lead: Sally Webster
Overall Aim: To increase BCG vaccine access and uptake to achieve the agreed KPI for neonatal BCG vaccination
Additional
resources
needed - if
Person Evidence of RAG
Recommendation Action(s) needed Target date resource Current Situation (Give dates)
responsible completion status
issues are a
significant
barrier
Copies of notes
from meetings
We recommend NHS Manchester builds on current work around Citywide review of BCG coordination complete. Formal review of service held on CICT
Service and chair ongoing citywide BCG provision meeting.
neonatal BCG uptake and endorse plans to do a city-wide review of delivery meeting in progress. This has identified need for following subgroups files. Final
9A Sally Webster Subgroups in place. Overall aim to aceive BCG KPI of 85% by age Mar-10 None A
this programme and where and who provides neonatal BCG in order - operational service/access issues and communications. Next citywide BCG working
one.
to plan a pan Manchester Service. review meeting to be arranged documents will
be uploaded as
available.
BCG model in place .BCG pathway and operational procedures in draft.
Develop routine BCG pathway with operational procedures that
South BCG coordinator piloting model in central area . BCG poster available
follow up those who DNA and improve service delivery. Need to
and for distribution. LAC pathway that encompassess BCG reviewed and for
9B review where services are provided from in relation to service need Aug-10 None As above A
distribution via LAC network. All developments excluding LAC pathway in
and recommendation to deliver services collaboratively from
Sally Webster. conjunction with comms and engagement team.Operational procedures will
childrens centres.
Ann need to be reviewed via PAG.
Review and develop pan Manchester care pathways for targeted McDermott.
immunisation programme including neonatal BCG Bev Yarwood.
Karen Moore. Need to develop BCG uptake monitoring for completion at 12 85% uptake of BCG by 2 years of age to be included in service specification
Sam Bradbury months of age against KPI target Mar-10 None from April 2011 for childrens services.statistics requested from child health to as above A
demonstrate BCG uptake according to the 2year COVER cohort.
10. Prison Health
Area Lead: Erika Duffell
Overall Aim: To improve vaccination status of all prisoners in line with DH guidance
Additional resources
Person Target needed - if resource Evidence of RAG
Recommendation Action(s) needed Current Situation (Give dates)
responsible date issues are a significant completion status
barrier
Awaiting employment of nurse immuniser.
Full implementation of Some progress made in terms of
Dedicated nurse Notes from
immunisation interim implementation improving
End of immuniser at HMP Health
plan and subsequent revision of this hepatitis B vaccination uptake through A
2010 HMP Manchester Protection
plan. training of prison staff, review and
Committee
awareness raising among prisoners
Interim plan actions: 1. Provide Hepatitis A, B, Diphtheria, Notes from
Additional funding Discussions held around lack of hepatitis
Tetanus, Polio boosters, MMR and Men C vaccines as per HPA, HMP Health
Jul-11 needed for hepatitis A A vaccine. No further work around this A
Schedule of Vaccination of Prisoners. Sept 2009 for new Protection
vaccine until resource improve.
receptions and long term prisoners. Committee
Notes from
Additional funding Discussions held around lack of hepatitis
Ensure appropriate equipment/vaccines available for each HMP Health
Jul-11 needed for hepatitis A A vaccine. No further work around this A
session. Protection
vaccine until resource improve.
Committee
Already being addressed but further work Notes from
Update medical records and provide around improving data quality including HMP Health
End 2010 None A
data to provide assurance. cross-referencing with vaccines Protection
dispensed. Meeting on 21.12.10 to discuss Committee
Notes from
HMP Develop plans to provide immunization Already being addressed through plans
Immunisation service provision in HMP Manchester needs to HMP Health
Manchester opportunistically and across remaining End 2010 None but should see further improvements once A
be increased such that all prisoners are checked for their Protection
10A Health wings and workplace. nurse immuniser in place.
immunisation needs upon first health assessments, and key Committee
Protection
vaccinations are offered, in accordance to DH guidance. Support induction of new nurse Current staff supported through training Notes from
Committee
immuniser until confident to provided through attendance on PCT HMP Health
End 2010 None A
undertake work plan unsupervised. courses and directly from ICT. New nurse Protection
immuniser will have to attend training. Committee
Monitor and review programme. Notes from
Analyze and provide data as HMP Health
End 2010 None Ongoing G
assurance. Report via HMP Protection
Health Protection Committee. Committee
Notes from
Training programme in place. Target of
Training of key prison staff to HMP Health
Jul-11 None 60% healthcare staff to be trained. New A
support role of new nurse immuniser. Protection
staff have been trained.
Committee
Notes from
Work with Health Promotion Work commenced further materials being HMP Health
End 2010 None A
Officer to promote vaccinations. developed. Protection
Committee
Notes from
Assessment around introduction
HMP Health
of prisoner vaccination cards. Jul-11 To be determined Link nurse undertaking assessment. A
Protection
Committee
11. Seasonal flu and pneumococcal vaccination for at-
risk groups
Area Lead: Nicola Jepson
Overall Aim: to meet national target(s) for seaonal flu
vaccination
Additional
resources
needed - if Evidence of
Recommendation Person responsible Action(s) needed Target date Current Stiuation (Give dates) RAG status
resource issues completion
are a significant
barrier
Nicola Jepson Meeting held 4 June 2010. Further meeting to be A
st
set up by NJ after 1 data collection to review data
Organise meetings and act as seasonal flu co-ordinator End April and measure progress by practice
Practices to order vaccine as necessary
Andrew Bidolak confirmed system in place for
A
supply and delivery of vaccine
Andrew Bidolak/Nicola Jepson/Judy Jones Supply and delivery of Pandemrix vaccine Ongoing
A
All practices should have by now ordered their
General Practice Supply of trivalent vaccine vaccine
Kevin Perrett
Uptake target set by WHO for over 65’s as 75% A
Chair planning group and oversee campaign and 60% for at risk groups
Letter, flowchart
Letter sent out to practices on 15 July 2010, and uptake table
11A n/a G
Write to all practices offering information and guidance – to included the NHS Dudley flowchart and uptake in flu folder in
General Practice cover various issues highlighted in this action plan chart by practice CICT office
Completed as part of swine flu debrief and at 4
June meeting
Seasonal Flu Vaccine Campaign 2009/10, data to
end December 2009 (1 Sep 09 to 31 Jan 2010) uptake on HPI
G
65 and over - 69.3% website
Under 65 (at-risk patients only) - 52.3%
Review 2009/10 practice uptake and compare to national
Nicola Jepson average uptake. Flu graphs End April
3 June 2010 NJ has commenced visiting and
contacting high uptake practices. Of the top 10
practices visited 4 practices, contact made with 1
over the phone. NJ and LS to meet w/c 9 August
to analyse good flu practice and arrange visits to A
the bottom 10 low uptake practices screening out
any new practices and for those who in previous
Targeting lower performers. Closer relationships with years had high uptake NJ will contact these by
Nicola Jepson/Liz Slater practices early to improve uptake May/June phone
Full listing required of:
• What system each practice are on
• Which primis facilitator covers which practice
A
• If there is an allocated flu person who can upload data
Training practice staff to upload their own data
Steven Norman/Bernie Ward During campaign
Suggested to have a dedicated flu page.
Highlighting top 10 high uptake practices. To
also congratulate highest practice as visited by
A
Autumn to NJ and it was clear this practice work together
Communications Action Plan to include promotion in areas coincide with as a team and very hard to achieve their
Fiona Smith where uptake is low. campaign uptake.
Email sent to Paul McGarry in April 2010 at JHU to
11B n/a put flu info in their leaflets/magazine. Further A
Nicola Jepson Liaison with final poverty/keep warm work contact made in August 2010
11B n/a
Provision of celvapan to those with contraindications Continuing from G
Kevin Perrett to investigate particularly those with severe egg allergy current provision
Payments for administration of the monovalent H1N1 Swine A
flu influenza vaccine should continue to be made in JT to check date on existing DES and feedback to
Joyce Thorley/Kevin Perrett accordance with the existing DES KP if DES expires before end March 2011
CICT NJ and CICT to continue to immunise poultry A
Identify and immunise all poultry workers During campaign workers as done in previous years
Kevin Perrett Mar-11 Meeting to be set up at the end of campaign A
Review campaign based on final data overall and by practice Feb/March
12. Seasonal flu vaccination - healthcare workers
Area Lead: Nicola Jepson
Overall Aim: to achieve higher seaonal flu vaccination coverage in HCWs than in
previous seasonal flu vaccination programmes
Additional
resources
needed - if Evidence of
Recommendation Person responsible Action(s) needed Target date Current Situation (Give dates) RAG status
resource issues completion
are a significant
barrier
Meeting held on 21 May 2010
Meeting held on 15 October
Nicola Jepson G
NJ to arrange final review meeting end of march to review 2010/11
and plan for 2011/12 campaign
Organise meetings and act as seasonal flu co-ordinator End April
Kevin Perrett Ongoing G
Chair planning group and oversee campaign
CMO letter has been sent out (twice, due to the error in the first version) and
there will also be the regional comms campaign to back that up. Employers also
Kevin Perrett Ongoing alerted through national guidance, but also specific letter sent to dentists and G
Contact relevant health and social care employers to inform of responsibilities and offering training support
pharmacists (in case not alerted through national channels).
Review best approach for vaccination of staff
HCW vaccination – feedback from National Conference on
what works
1. Flexibility and accessibility
2. Peer to peer vaccination
3. Training for vaccinators
At first meeting G
4. OOH access
5. Contact point for enquiries
6. Staff having to take conscious decision not to be vaccinated
7. Senior support
8. Creative comms campaigns Meeting accepted this feedback was helpful – to share as ‘best practice
At first meeting guidance’ with employers. Write to employers early for next year
12A n/a
North West Staff Seasonal Flu Vaccination Campaign have a range
of materials available to use at www.attishoo.com. Theme is
"Become a Flu Fighter" Suggested using local user friendly
12A n/a message for next year. Need to look at local comms ie new
Manchester message jointly with Acute trust and city council for
2011/12 campaign
Occupational Health are providing vaccination to MCH staff at
Wythenshawe Hospital and NMGH. The service has been
Comms At time of campaign advertised in Monday Messenger and will be repeated weekly and A
also promoted to staff at the imms training that CICT provide. Data
recorded by NJ and uploaded onto the DoH ImmForm Website
monthly.
Comms Tema have sent copies of staff flu magazines and
postcards have been sent to Health Centres and to the TCS event.
Also information in next Talking Health email bulletin and
information via our Facebook and Twitter pages and will continue to
To educate staff about staff benefits of flu vaccination. As send information out to voluntary sector newsletters
determined by communications
Categorisation problem, need to individually assess to be
completely robust but this is impractial.
Submit data to DoH as required
Data reporting
Nicola Jepson/ Managers At time of campaign New data reporting form designed and sent to all employers to be G
form in CICT folder
responsible for returned to NJ to upload data onto ImmForm wesbite
Occupational Health Curent Nov uptake is 19.2% KP to write again to independant
vaccination contactors
Training package complete, training arranged in Septemebr and
December Training material
Helen Fabrizio Sept Managers need to identify staff and book on training course, available on CICT G
advertised on L & D web page network drive
Immunisation Training
Managers responsible for Check previous immunisers are still able to immunise
Occupational Health N/A
and remain competent
vaccination Employer responsibility.
Judy Jones confirmed they
are currently storing 19 boxes of 50x10 dose vials of Pandemrix
Nicola
expiry date 9/2011. Agreed that swine flu specific vaccine supply a G
Jepson/Pharmacy/
relatively small issue.
Check vaccine supply re swine flu specific vaccines
MCH vaccine supply is taken from the Occupational Health supply.
Supply is based on demand for last year.
Issues regarding supply of new seasonal flu vaccine
Ann to update Bethan on vaccine and consumable supply and
N/A
Consumables will also need ordering especially delivery issues
anaphylaxis packs as they need ordering in advance
Also cover in employers letter.
Designated Leads / pharmacy
Identifying overall leads. Planning for provision of suitable G
vaccination service for: Access to vaccination is the key issue to be considered again next year.
12B n/a
12B n/a
Suggested the designated vaccine lead to be Bethan Abbott-Jones?
Two new staff groups will be targeted this year:
Consultants and HVs A
District Nurses
Due to operational capacity in MCH all MCH staff will be vaccinated via
Occupational Health in UHSM and PAT Trusts. HCW staff uptake is still
very low. Special clinics finished but staff can still have the vaccine by
appointment only at occ health. Acute trust staff have done peer to peer
Bethan Abbott-Jones MCH and have had a good response to this.
General Practices
Letter sent to empolyers in October, letter provides general briefing
information about seasonal flu vaccination and as NHS Manchester is Copy of data
required to inform the Department of Health of the number of seasonal flu reporting form in G
immunisations given to all healthcare workers employers are to provide CICT folder
the necessary data
GPs
HCS staff uptake also low, staff are vaccinated via occ health in the LA, G
Nathan Atkinson (Manchester City Council) Aug-10 not collecting data however (no requirement to do so)
13. HPV vaccination
Area Lead: Eleanor Roaf
Overall Aim: to meet Vital Signs target for HPV
vaccination
Additional resources
needed - if resource Current Situation
Recommendation Person responsible Action(s) needed Target date Evidence of completion RAG status
issues are a (Give dates)
significant barrier
Confirmed by Child
JM Send out and finalise school schedules Jul-10 None Confirmed G
Health
Confirmed by Child
JB Send out consents Aug-10 None Completed G
Health
Collate response and put together information for school Confirmed by Child
JB Aug-10 None Completed G
nurses Health
Confirmed by school
BY Commence immunisation programme Sep-10 None To start Sept G
nurses
n/a
BY Provide update on first dose uptake End Oct 10 None n/a First dose coverage data A
Consider uptake and make recommendations for any Action plan; minutes of
HPV group Early Nov 10 None n/a A
remedial actions HPV group
Second dose coverage
BY Provide update on second dose uptake End Nov 10 None n/a A
data
Consider uptake and make recommendations for any Action plan; minutes of
HPV group Early Dec 10 None n/a A
remedial actions HPV group
Futher actions to be described in the light of the December Progress against action
HPVgroup Unclear None n/a Pending
remedial actions required. plan; coverage data
14. Teenage booster
vaccination
Area Lead: Bernadette
Dean
Overall Aim: to meet Vital Signs target for school leaver booster vaccination
Additional resources needed
Person Evidence of RAG
Recommendation Action(s) needed Target date - if resource issues are a Current Situation
responsible completion status
significant barrier
School Planning
n/a BD Book dates for Year 10 vaccinations 17.12.10 (number) schools have dates booked A
data base
14A
Imms team N
n/a PW Development of "catch up" database Mid november Ongoing A
Drive
Ongoing
Confirmed by
n/a JB Send out consents dependant on Ongoing A
Child Health
date of session
Ongoing
Confirmed by
n/a JB Collate response and put together information for school nurses dependant on None Completed G
Child Health
date of session
Confirmed by
n/a BD Commence immunisation programme 18.11.10 Ongoing G
Immunsiation team
Ongoing
Admin support for Confirm by
14B n/a BD Inputting of uptake into "catch up" database to generate action plan dependant on Ongoing A
immunisation team immuniation team
date of session
Arrange meetings with appropriate School Personnel for Whalley Range High School and
Appointments
Withington Girls School regarding pilot of "pupil post" for delivery and return of consent
n/a BD to be organised Appointments made for 10th and 21st January G
forms for SLB sessions in order to encourage higher return of consent forms prior to
for new year
immunisation sessions.
n/a BD Arrange with 2 pilot schools dates for SLB End Jan 2011 Dates will be arranged at meetings A
Confirmed by
n/a BD Provide coverage data for those schools completed Mar-11 Not available as yet A
Child Health
Discarded recommendations
Recommendation HCNA or NICE or DH? Number of times chosen Number of times discarded Rationale for discarding
If children and young people are not up-to-date with their vaccinations,
school nursing teams, in conjunction with nurseries and schools, should
explain to parents why immunisation is important. Information should be
41. NICE 5 1 Already routine practice
provided in an appropriate format (for example, as part of a question
and answer session). School nursing teams should offer vaccinations to
help them catch up, or refer them to other immunisation services.
Monitor the age composition of the practice population so that there is This is work already undertaken by
39. NICE 2 5
enough capacity to provide timely immunisations. general practices.
Develop a Failsafe team modelled on the Failsafe team in the Heart of
Birmingham. The team will regularly identify specific groups who are
Considerable funding required which is
outstanding for a certain immunisation, and then seek to resolve their 11. HCNA 4 4
unlikely to be available.
status by data reconciliation, arranging appointments and possibly
domiciliary immunisation.
Health professionals should record the mother’s Hepatitis B status in
the personal child health record as soon as possible after the birth, Felt to be clinically inappropriate because
before the midwife hands over care of the baby to the health visitor. The 47. NICE 0 4 of issues regarding confidentiality of
mother’s Hepatitis B status should also be entered on the child’s record mothers' medical status.
in the local Child Health Information System.
Ensure young people fully understand what is involved in immunisation
This is already being undertaken by
so that those aged under 16, but considered sufficiently capable, can 36. NICE 0 4
school health.
give their consent to vaccinations, as advised in the ‘Green Book’.
