Agenda item

Purpose of the item: To provide an update on the delivery of the Covid-19 Vaccination Programme in Surrey Heartlands to date and future plans for the continued roll out of the programme.

Witnesses:

Jane Chalmers, Covid Director, Surrey Heartlands

Ruth Hutchinson, Director of Public Health, Surrey County Council

Dr Sally Johnson, Clinical Lead for Covid Vaccinations, Surrey Heartlands

Giselle Rothwell, Associate Director of Communications and Engagement, Surrey Heartlands

Key points raised during the discussion:

1.    The Covid Director provided an update on the data since the report had been published. The total number of vaccinations to date within the Surrey Heartlands area stood at approximately 330,000. Approximately 320,000 of these were first doses. About 27% of the Surrey Heartlands population had received at least the first dose of the vaccine. The roving model of vaccination used by the programme included administering vaccinations to homeless people and hard-to-reach groups. An important part of the programme now was understanding why some of the people who had been offered the vaccine had chosen not to take it up.

2.    A Member asked what was being done to appeal to people who had been offered but declined the vaccination. The Director of Public Health emphasised that the programme was long-term. Whether people took up the vaccination when it was offered to them depended on the ‘three Cs’: confidence, convenience and complacency. The Director agreed to send a link to the Select Committee containing intelligence on vaccine hesitancy data. There was clear evidence on which population groups were less likely to take up the vaccine; these included black, Asian and minority ethnic (BAME), Gypsy, Roma and Traveller, and Pakistani and Bangladeshi communities, as well as people coming from certain economic backgrounds. As the vaccination cohorts were worked through and younger age groups came to be vaccinated, it was anticipated that patterns might also emerge of age groups that were less confident in taking the vaccine. Regarding the convenience of being vaccinated, it was important to understand the barriers to access and to work with affected groups to minimise barriers. This might involve making the vaccination experience accessible for people with disabilities, or ensuring vaccination sites were easy to reach by public transport. Regarding complacency, there was a need to understand complacency in some groups and develop solutions. Young people might be more likely to be complacent about taking up the vaccine. There was a comprehensive action plan and Equalities Impact Assessment (EIA) for the three Cs.

3.    The Associate Director of Communications and Engagement added that a video had been produced in Urdu with the help of the imam at a mosque in Woking, and it was hoped that a trusted, local leader would help encourage people to come forward for the vaccine. A vaccination site had also been set up at this mosque. There was a Gypsy, Roma and Traveller community service lead, who was working to develop a video of someone from within that community having their vaccine. Moreover, Surrey Heartlands was working with Surrey Care Association to dispel some common misconceptions and answer questions for care home staff. There were care homes that had vaccinated every member of staff, and those could be used as case studies to encourage other care home staff to take up the vaccination.

4.    A Member expressed concern that once people had received the first dose of the vaccine, many mistakenly thought that they could not contract Covid-19 or transmit the virus. The need to maintain social distancing and abide by lockdown rules, even after vaccination, was not always mentioned verbally at the point of vaccination. The Clinical Lead for Covid Vaccinations replied that Surrey Heartlands was asking all of its staff to verbally emphasise at all vaccination appointments the need to continue to socially distance and wear a mask post-vaccination. Nevertheless, this would be restated to staff, to ensure it happened in every case. There was also a Public Health England leaflet that emphasised the need to continue to abide by restrictions post-vaccination.

5.    A Member expressed concern that digital exclusion may lead to some people missing out on the vaccine, particularly elderly people or those who are not registered with a GP. The Clinical Lead for Covid Vaccinations stated that it could be difficult to contact people who were not registered with a GP. However, digital technology was not relied upon as the only method of contact for those who were registered with GPs; people were contacted about their appointment through landline phone calls and letters, and some GPs had even visited the houses of people they were particularly concerned about in order to ensure they could make an appointment to be vaccinated. Patients whose contact details were not in the system could be harder to contact, but it was key to remember that people did not have to have ever been registered with the NHS to be eligible for the vaccine. Anyone could phone the vaccination service or a GP and ask to be vaccinated, even if they were not registered. The Associate Director of Communications and Engagement added that the service was working with district and borough councils and local Covid champions to communicate information about the vaccine.

6.    A Member asked how it was decided whether a person would receive the Oxford/AstraZeneca or Pfizer/BioNTech vaccine. The Covid Director responded that the supply of each vaccine to vaccination sites depended entirely on the national supply. Both vaccines were equally effective. The Clinical Lead for Covid Vaccinations added that a small number of people would not receive the Pfizer vaccine due to their medical history; this could include conditions such as severe anaphylaxis.

7.    A Member asked for confirmation on whether the Epsom Downs Racecourse vaccination centre would close for the Epsom Derby in 2021 and whether it would reopen afterwards. The Covid Director stated that, while there would certainly be no closure of the vaccination centre in April 2021, it was possible that the centre might close temporarily in May 2021 for the Derby. If the centre was closed for the Derby, this would be communicated to residents, alongside alternative vaccination plans for this period.

8.    The Chair of the Independent Mental Health Network remarked that consumption of news media from traditional channels, such as television, was becoming less common, and many people now consumed news media through newer channels such as social media. He suggested that social media channels such as TikTok, which was popular amongst young people in particular, could be used to publicise and educate people on the vaccine. The Associate Director of Communications and Engagement agreed that using avenues such as TikTok should be looked into. Also, Surrey Heartlands had already made its own educational videos on the vaccine.

9.    A Member asked whether Surrey Heartlands was in contact with the universities in Surrey about communicating the importance of the vaccine. Communicating with university students could be an effective way of reaching multi-generational households. The Associate Director of Communications and Engagement replied that Surrey Heartlands worked with the Multi-Agency Information Group (MIG) across all stakeholders including universities, and agreed that this could be a useful way to reach multi-generational households.

10.  A Member expressed concern about a disconnect between the national and local vaccination systems, which could cause difficulty with booking appointments. The Covid Director stated that improvements had been made on this, although the system was not perfect.

11.  A Member enquired what help was available regarding transport to vaccination sites for people who had mobility issues, were isolated or lived in a rural location. Was transport available and was it offered automatically, or could people contact someone and ask for assistance? The Associate Director of Communications and Engagement said that there was no formal national service for transport to vaccination appointments, but that the national booking service for vaccination appointments did offer the closest available appointment, meaning the distance of travel to the appointment should be minimal. The Clinical Lead for Covid Vaccinations added that the community transport service was transporting patients to appointments with the help of volunteers.

12.  The Co-Chair of the Surrey Coalition of Disabled People asked how many people with protected characteristics had taken up the vaccine and requested more information on what the Equalities, Engagement and Inclusion Working Group had achieved since it had recently been set up and what actions from the stakeholder reference group for the EIA had been taken into account. The Associate Director of Communications and Engagement agreed to share the EIA and the initial findings of the Equalities, Engagement and Inclusion Working Group with the Select Committee.

13.  The Co-Chair of the Surrey Coalition remarked that there were often no hearing loops installed at vaccination sites; these should have been installed earlier to ensure the sites were accessible from the beginning. The Clinical Lead for Covid Vaccinations stated that a checklist of amendments that needed to be made at vaccination sites – including the installation of hearing loops – had now been put together. Staff had been working hard for some months and had not necessarily had the time to install hearing loops or other amendments so far.

14.  The Co-Chair of the Surrey Coalition commented that, when a person had two or more carers, only one of the carers would qualify for the vaccine. Why was this? He expressed concern that unpaid carers might be overlooked. The Clinical Lead for Covid Vaccinations replied that there had been some challenges in defining ‘carers’ according to the national guidance. The definition now was the sole or primary carer of a clinically extremely vulnerable adult. She acknowledged that whether or not a person received the vaccine was ultimately down to the discretion of their GP, which could lead to inconsistencies. It was important to comply with the order of cohorts for vaccination, particularly in the early stages of the vaccination programme.

15.  The Chief Executive of Healthwatch Surrey stated that the feedback Healthwatch Surrey had received about the vaccination programme was predominantly positive, particularly with regards to the experience at the vaccination centre itself. The clinical commissioning group (CCG) helpline had also been a useful place to refer residents.

16.  A Member remarked that some people who had been amongst the first cohort to be vaccinated had not been able to book their second dose. How was the booking of second dose appointments being managed? The Clinical Lead for Covid Vaccinations responded that people who had received their first dose through the national booking system had been able to book their second appointment at the appointment for the first dose. All others who had received their vaccine at a local site would be contacted within the next few weeks and receive details of their second dose.

17.  A Member asked who would contact residents about the second dose. The Clinical Lead for Covid Vaccinations stated that this depended on the vaccination site, but generally a text message would be sent by either the local vaccination site or the GP surgery, which worked closely together.

18.  A Member mentioned recent evidence showing that the Covid-19 vaccinations were highly effective after just one dose. He suggested that this could be included in communications, to help persuade people to take up the vaccine. The Associate Director of Communications and Engagement agreed to raise this with NHS England, from whom they took their lead on messaging.