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National Challenge; Local Considerations
Although invariably referred to as ‘the national flu immunisation programme’ the administration and delivery of flu vaccinations in the UK is done largely by GP practices. Our national, regional and commissioning bodies provide advice, incentives and, where they can, coordination. According to NHS England’s ‘Good-Practice Immunisation Invite Reminder Guide’, 68% of practices say the primary challenges they face in delivering flu vaccination invitation programmes are cost and lack of staff time.
By and large, general practices follow the same approach: first they pull out a list of the patients to be vaccinated by running a query against the patients held within their clinical systems. 60% of practices send a text message to those patients with a mobile number, provided the patient has consented to being contacted in this way, inviting them to book an appointment for their flu jab or to inform them of scheduled walk-in clinics. Where mobile numbers are not available, letters are sent by post, and as a last resort individual telephone calls are made by practice staff. The whole process is repeated until the patient is vaccinated, declines the vaccine, or has been contacted three times. A process which costs the practices both time and money at varying levels.
Of course, 2020 brings it owns challenges, several practices are investigating drive through clinics, however this can require additional insurance and a number of practices simply do not have appropriate facilities. Due to covid-19 there are many additional measures that need to be put in place to minimise patient-to-patient contact.
A significant number of patients decline the vaccination. Misinformation from the anti-vax movement is one of the many reasons why some patients opt not to have the flu vaccine.
To increase uptake and effectiveness we need to put the ‘national’ or at the very least ‘regional’ back into the approach of vaccination invitations. This means harnessing the strengths of general practice and executing at regional and ultimately national level to ensure an effective, consistent approach. Key requirements are:
- Patient engagement coordinated and executed at the regional level
- The ability to contact the patient in the patient’s preferred communication format including by text message, letter, and telephone
- A multi-language approach: communications sent in the patient’s first language
- Integration with general practice clinical systems to access the most accurate patient information, but using sophisticated and standardised queries to ensure all eligible patients are identified, including:
- The new COVID-19 50 to 64 age group who have not previously been invited for flu immunisation
- Households of those on the shielded patient list
- all school year groups up to year 7
- people aged over 65, pregnant women, and those with some pre-existing conditions including at-risk and under 3s
- Digital tools, such as Chatbots to engage and inform those patients hesitant in taking up the vaccine
- The use of patient barcodes to enable fast through-put of patients at vaccination centres
- The ability to track vaccine uptake cross communities and so indicate which communities have and have not achieved herd immunity.
Speaking on the 2020 influenza vaccination programme, Luke Wyatt, Engagement Hub manager at iPLATO commented ‘The 2020-21 flu season brings a unique challenge, the pandemic has increased the public’s awareness around the need for vaccination, however according to our own research approximately 10% of people will forgo their flu vaccination this year as they do not wish to be in a GP surgery. Consistent communication is key in ensuring as many of the eligible population are vaccinated as possible and we have been working hard to pivot our SMS solution to ensure it can work at scale to increase uptake of flu vaccinations this season.’
The myGP Engagement Hub offers the ability to centrally manage, distribute invites and provide advice to patients on behalf of practices, without taking up staff time. The service provides multi-language text messaging, letters, and agent callings.
In addition, myGP Engagement Hub can include several solutions which create efficiencies in the approach to the influenza vaccination invite programme. Solutions such as barcode scanning at walk-in clinics, the use of chatbots, online booking capability, and aggregated tracking and reporting.
The case for text message reminders
A study in the BMJ showed that using iPLATO text messaging software to send an SMS to invite patients for the flu vaccination increased uptake by 2.62%. Nationally, this would equate to an additional 513,575 patients having a flu vaccination, or 786,000 if you include patients aged 50-64yrs.
| Category | Patients registered (2019/20) | Increase in uptake by sending SMS |
| 65 years and over | 10,523,854 | 275,725 |
| 6 months to under 65 years at-risk | 7,086,331 | 185,662 |
| Pregnant women | 645,285 | 16,906 |
| 2-3 year olds | 1,346,654 | 35,282 |
| Total | 19,602,124 | 513,575 |
Source: Public Health England
To find out how iPLATO’s engagement hub can help manage your flu vaccination, sign up to attend a webinar on the topic here.
