Vaccination board moved to Manx Care- request for minutes

Summary

The requester sought the new name, Terms of Reference, minutes, and evidence for the vaccination board transferred to Manx Care. The authority disclosed the Terms of Reference for the 'Immunisation Committee' and minutes from an initial meeting in October 2022, resulting in a partial upholding of the request.

Key Facts

• The vaccination board was renamed the 'Immunisation Committee' under Manx Care.
• The committee reports to the Health Protection Committee.
• Membership includes representatives from Primary Care Network, Manx Care Executive, Community Pharmacy Services, Public Health, School Nursing, and DHSC.
• An initial meeting was held on 6th October 2022 to review the Terms of Reference.
• Concerns were raised regarding operational resources, data assurance, and the need for a permanent service budget for clinical advice.

Data Disclosed

• 2023-07-10
• 2024-12-04
• 22/03/22
• 1st April
• 6th October 2022
• 14:00
• 2023-4
• 1 day a week
• 4 meetings
• 49 pages
• 3 documents

Original Request

Hello, Further to FOI 2939093 request to the DHSC, it states on Vaccination board minutes 22/03/22 in the 'Continuation Meeting' that 'it will be moving to Manx Care from 1st April, meaning a slightly reviewed ToR and membership'. Please provide the following: 1. the new name of the board/committee that continued from DHSC under Manx Care 2. the new ToR's, goals and objectives 3. all meeting minutes to current date 4. all evidence reviewed that was considered in making decisions on the vaccination programme: data/studies/reports Thank you

Data Tables (1)

Data Tables (reformatted)

Full Response Text

P a g e 1 | 2

Terms of Reference – Immunisation Committee

1. Aim, Scope and Objectives

1.1 Aim

A forum to provide system ownership of immunisation activity so that assurance of immunisation outcomes and quality can be given to the DPH via the Health Protection Committee.

1.2 Scope

Matters pertaining to immunisation activity throughout all life stages in all settings on the Island

1.3 Objectives

• To oversee the development of an island wide immunisation strategy and subsequent implementation • To review and receive data reports on immunisation activity to include uptake of vaccinations at a schedule to be decided by the committee. • To identify and address health inequalities in immunisation activity. • To receive a summary report of reported incidents pertaining to immunisation activity to help identify persistent quality issues. • To identify and through the committee to take action to remedy any omissions, gaps, weakness of process, or other quality issues in immunisation activity through an agreed action plan. • To review and agree Communications strategy pertaining to immunisations. • The Board/Committee/Group may appoint a subcommittee/task and finish group to carry out elements of its objectives and make recommendations to Board/Committee/Group

1. Membership

• Chair – will rotate but will start with Public Health for the first few months. • Representatives from
• Primary Care Network
• Manx Care Executive • Community Pharmacy Services • Public Health
• School Nursing • DHSC
• Public Health Communications • Other members may be invited as decided by the committee

P a g e 2 | 2

1. Frequency

The committee will meet every …….. months – to be determined at initial meeting

1. Reporting

• Action points will be recorded • The group reports to the Health Protection Committee

1. Accountability

Health Protection Committee

1. Review date

These Terms of Reference will be reviewed after 4 meetings.

Initial Immunisation meeting 6th October 2022 @ 14:00 via MS Teams

Attendees:

TOR reviewed by the Group and initial thoughts were they were good. However, invite comments after meeting, including additional necessary representation.

Concerns appear to be: 1. Operational issues – resources including hardware to staffing and clinical queries, i.e., how we as an immunisation network deal with queries at a vaccination site dose not have capacity, should a person have or not a vaccination 2. Assurance – who has the data,
3. Longer term comms strategy re immunisations on island, i.e., we don’t know where the gaps are 4. Comms – continued quality of improvement, packing inequalities, antivac, misinformation filling the void of lack of comms 5. Broad areas are concern which are not covered above? : 6. Plan for Year 9 offered via GP routinely, but others need to be requested.
7. Future of the vaccination progammes for 2023-4 and who is to take on what functions – we need DHSC representation, i.e., in order to assist with this issue in order to steer.
can brief with the notes from today’s meeting

How do we work?

Strategy for both the immediate and long term. In the first instance could be a small group to take away with input from DHSC for scoping as to what this looks like. Theme to be stabilised and consolidate what we already have, rather than look for new initiatives until 2023-4.

Routine scheduled imbedded imunisations programme, with the exception of Covid which is an ever- changing programme. We also don’t know about Monkey Pox and Polio. Where will Covid sit in the future?

MDT to manage governance and safety to help support clinical queries in order to reduce risks and respond promptly to issues as they arise. It is not in anyone’s role and the team is seeking some to assist.
A point of escalation as to non-routine queries, i.e., operational steers above the licence of clinical staff.
is available but when she is not, who can assist.
Lack of understanding as to costs relating to clinical costs.
provided overview of 1 day a week for a pharmacist. But what about a GP? Budget for Covid has been bid every ¼ and covered by contingency and this cannot continue – need to make a decision as to a permanent service.
There are 2 points:
1. Day to day individual clinical advice, i.e., allergies, blood clots, etc. should be done via GP – currently not within the current contract and would need to be recourse.
provided explanation as to GP contract 2. Wider policy/SOP advice and seeking interpretation, i.e., to changes in Green Book or PGDs or something that would affect a wider group of patients.– would need separate resource within DHSC. Set up a Clinical Group aimed at this? Who would this be – representation of a pharmacist, Medic Clinician, Public Health, Comms, Logistics, invite specific representation – to allow a consensus opinion. Question shared via MS Team prior to allow consideration and then a commitment to attend in order to gain a consensus and make a decision. Discussed examples of urgent cases that need support, i.e., cancer patients who need vaccination treatment – the biggest challenge is patient information. Meeting to be arranged between in the first instance, perhaps inviting . Then set up a working stream to deal with logistics support – perhaps create a report of issues being experienced re logistical challenges. Mapping out what we need, identify gaps – to map this and pass to in order to gain her thoughts. Discussed funding and strategies around this. Do we look at what the UK and/or other jurisdictions are doing?
Who is surveying new information and disseminates this. Is this a public Health role? suggested the creation of an MS Teams channel in order to share information. Who is going to what meeting – is it appropriate? Whole host of process issues to which a sub-group needs to be created in order to develop logistics and map out the issues … ideas to who will provide a summary and seek representation in order to start building work streams We need a Comms strategy Primary Care Network are happy to assist with bridging the gap, however we need to gain a greater understanding as to the work behind giving an informed clinical decision. How do we move forward? Next meeting in 2 weeks – to send invites to request attendee information
Initial Immunisation meeting 24th October 2022 @ 10:30 via MS Teams

Attendees:

Apologies:

As the meeting was not quorate, it was therefore decided a new date would be sought.
Action:
to send our new invite. – DONE 24/10/22 Action:
to attached draft TOR to be circulated along with new meeting invite. Also ask for progress regarding sub group set ups and leads agreed. – DONE 24/10/22

did mention concerns over the Hub and this needing a deep clean due to rising cases of Covid.
Action:
to flag with

Action:
to circulate POFF spreadsheet to , , ,

and asking fir the numbers they are seeing is correct. – DONE 24/10/22

New meeting date: 10th November 2022 @ 13:00 via MS Teams

Immunisation meeting

11th November 2022 @ 13:00 via MS Teams

Attendees:

Apologies:

1. TERMS OF REFERRENCE

Agreed: Accepted the current TOR which will run for six months – review May 2023.

1. 0-19 PHNS HPV SERIOUS INCIDENT

provided an update regarding this SI and, and logistic problems around HPV preparations, fridges’ locations and the deliveries process, plus the governance around these. Discussed the difficulties being experienced and the need to centralise fridge storage, however many areas are not appropriate and stores are full, hence the use of Ramsey.

Modelling to be undertaken to identify staff capacity needed to accommodate HPV vaccination periods. 6 week period (September/October) plus 2 weeks in May. Need coordination in order to apply and review nursing rotas in order to create capacity.

1. UPDATE ON INDIVIDUAL PROGRAMMES

a) HPV:

to provide a service wide HPV debrief next Thursday @ Crookall House.

Action:
to invite

Action:
to provide this meeting with a summary of the briefing

b) Covid 19 and Flu:

provided data on the autumn programme take up from the public which has been good. However, there has been a low take up from care staff. Co-administration has been working well to provide the Flu vaccination. Staff have been struggling with the logistics and it is very administration heavy.

Discussed the flu data and the collation process.

The consent processes is very labour intensive and this is being developed including online consent forms being completed pre-vaccine and could be utilised by various vaccination programmes.

Agreed: Add Consent process to an agenda

Action:
to provide younger age group flu data would be useful Action:
to look into OH data Action:
to provide OH contacts to

1. SUBGROUPS

a) Strategy (lead:
)

and met with yesterday to understand the proposals for Covid/Flu, where the future intention is for the Covid programme to move to primary care, however nothing is formal as yet.

express two specific concerns: 1. we should be planning for this now so we are ready for the Spring programme, and
2. how will the GPs apply the programme within surge periods

Currently the vaccination programmes are very fragmented. There is a need to retain a centralised vaccination team to lead and have oversight of the whole programme, however this has not yet been formalised. A delivery model needs to be decided very soon.

confirmed has not yet seen the locally enhanced service document. It was acknowledged there is a great deal of planning to be done before GPs can provide these services.

In the past GPs did not provide any delivery plans as to them providing historical vaccination programmes within 2021, and there were challenges experienced during that period.

Agreed: There is a degree of risk, but this could be mitigated by good planning. There needs to be assurance around the planning milestones around this transfer, but also commissioning and de-commissioning.

Action:
to contact to discuss and gain a copy of the plan.

b) Clinical (lead: tbc)

• Cold Chain policy reviews and audits
• Process around patients being unable to consent • Allergies

c) Logistics (lead:
)

Agreed:
would be happy to lead and will scope need.

There is a need to have a basic understanding of the vaccination timetable in order to develop a surge planning programme.

Year 9 booster programme and the apparent inequity around this was discussed.
shared PHOF summary data, and the group discussed the disparity of current comms from GP surgeries.

Action:
to arrange a meeting in order to discuss the above. With representation from persons who are proficient in each vaccine and its General Practice systems, i.e., GP representation, someone from ’s team, ,

, Manx Care BI .

provided an update regarding the positive conversation with the Estates team who provide support at the Ramsey Hub. It appears we will not be loosing this support and topics discussed were around training and SOPs.

reported there needs to be multidisciplinary support to provide advice/interpretation regarding vaccine treatment.
confirmed she has been invited to CAG.

Agreed: We need a Clinical Group meeting to find potential solutions and present these in order to gain movement.

1. Formal meeting in January 2023

to report on this Group’s progress to the Health Protection Committee

Agreed: agenda items

Action:
to send the draft Plan on a Page: Immunisation Committee, and

to reformat into a Manx Care document – DONE (see below)

1. Date of Next meeting … Thursday 15th December 2022 @ 13:00

This is currently a full meeting, but may be minimise to a subgroup if deemed necessary.

Action:
to arrange Outlook Teams invite – DONE invite sent (see above date)

Immunisation meeting

23rd January 2023 @ 13:00 via MS Teams

Attendees: Apologies:

Introductions and Welcomes made

Minutes of the last meet were review and agreed as accurate

Sub Groups Updates:

asked for everyone to complete the Plan on a Page reports as these would be very helpful. Action: Plans on a Page to be sent to for collation and inclusion to these notes

a) Strategy

confirmed they have not met for a while, although discussions have taken place as to the wider plan for the delivery in the next financial year.
asked for an update from as to next year’s plans.

confirmed the GPs no longer want to do the Covid Programme which does not give much time to plan. The plan is to substantiate a permanent service to deliver the Covid programme, and create capacity for the team to provide a dual joined up approach of both delivery and support. This new team will deliver other vaccine services which will give a full yearly programme, including a wider public health programme accommodating more than vaccine and 111.
is meeting with later today and seek agreement asap to ensure staff contracts are set up and substantiated. He did confirm the plan for delivery out of Primary Care will be more expensive, however the trade-off will be a more centralised and organised, given the capacity of primary care currently, this is the more pragmatic approach. It will also enable patient data to be more centralised.

r confirmed Covid will be the main work, although picking up the smaller vaccination programmes within GP practices and centralising these instead of them having to train staff. Flu will be staying with GPs, as well as anything linked with school nursing.

It was confirmed the service will be launched in March 2023, however there is still a lot of development work to be done with GTS as to the existing booking and recording system. It will be expanded to various repositories of information and the reduction of re-inputting of data. It is the hope there will be interfacing with EMIS at some point.
confirmed Primary Care Services were consulted on the above.

Discussion took place as to the fact that a lot of data is having to be pulled manually as the BI is unable to do this, which is an additional challenge.

b) Communications

Work has taken place with Manx Care Comms to update the webpage. The next updates will be Flu within certain age groups. Regarding the long term work, as to who is doing what is yet to be confirmed, however initially currently existing information is to be updated, and then the focus will be on new developments.

c) Data

The meeting reviewed the Plan on a Page (to be attached), and provide an overv

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