Minutes:
Paula Wilkins, Chief Nurse and Executive lead of the vaccination programme, and Caroline Selkirk, Executive Director of Health Improvement, K&M CCG were in virtual attendance for this item.
1. Ms Wilkins introduced the agenda report and provided an updated on the number of vaccinations carried out in Kent and Medway, highlighting that 3.75m vaccines had been administered in total. She drew the Committee’s attention to an error in the report at section 1.2 – the wait between infection and vaccination for under 18s was 12 weeks. She affirmed that, in line with Government policy, the 3 February was the latest date by which frontline NHS staff required a vaccine before risking their employment. Vaccination inequalities were being focussed on, with work being undertaken to reach those groups that were typically hard to reach, had accessibility issues or had low confidence in the vaccine programme. She was keen to hear if Members could support or recommend any groups that needed tailored engagement.
2. Ms Selkirk explained that over the months of December and January, hospitals had been busy with covid-19, winter pressures and elective care. The number in hospital in covid was falling and the Nightingale hub set up at William Harvey Hospital (for use if Omicron had led to a high increase in cases) had not been required. She recognised the continued pressure on elective waiting lists and confirmed these would be the focus as covid pressures continued to decrease.
3. A Member questioned the apparent alignment between lower vaccine uptake and deprivation. Ms Wilkins acknowledged deprived areas tended to have a lower uptake but explained that was just one of many factors. There were more ways to book a vaccine that just online, and the CCG had been carrying out door to door visits accompanied by a vaccination bus. Lessons were continually being learnt, such as methods that worked for the 1st and 2nd dose did not always work for the booster.
4. In response to a question about vaccinations in the gypsy, roma and traveller community, Ms Wilkins confirmed that a lot of work had been carried out in this area.
5. Looking ahead, Ms Wilkins confirmed a fourth dose for the clinically vulnerable was being rolled out, and the CCG didn’t expect to use the mass vaccination centres going forward. It was being considered how the covid and flu vaccination programmes could be joined together to become more sustainable.
6. Asked about the national “no jab no job” policy, Ms Wilkins explained that vaccine hesitancy was the main reason for staff not getting vaccinated. This often stemmed from cultural and background factors. The CCG would be able to provide a clearer picture on numbers after the 3 February 2022 deadline. Impact assessments were being carried out on a service by service basis. They were not anticipating having to close General Practice surgeries or the number of beds available but that would be covered by the risk assessment if necessary.
7. A Member questioned the recording of covid on individual death certificates, asking about comorbidity data along with requesting a breakdown of covid case rates per hospital. Ms Wilkins explained that only the cause of death would be recorded on a death certificate, regardless of if the person had covid at the time. Ms Selkirk provided the web address https://coronavirus.data.gov.uk/ which contained hospital level data.
8. Answering a question about transfer of care from hospital to domiciliary care, Ms Selkirk agreed there were challenges due to the workforce shortage and short-term impact of covid isolation rules. The CCG worked with the hospitals to manage capacity and reduce the number of patients staying longer than necessary in acute care. Kent and Medway had not reached the NHS England South East target of discharging 30% of fit patients in acute hospitals by early January 2022 but neither had many others in the region.
9. Asked what support was in place for staff providing vaccines, Ms Wilkins explained that KCHFT had led the workforce during the early stages. They maintained a bank of staff which allowed for rotation. CCG and clinical staff had been released to work in that area also. Guidance had been shared with staff to assist with their response to “anti-vaxxers”, and the CCG had worked alongside NHS England and Borough Councils for extra security when needed.
10.Dr Jacobs from the Local Medical Committee spoke on GP pressures, explaining that the “no jab no job” policy would affect the 190 practices across Kent and Medway, he estimated around 2-3% of staff were affected but the granular detail was important. There needed to be clarity on what “frontline” meant, as many staff working in GP surgeries would come across patients during their day due to the nature of the job and layout of the buildings.
11.Members thanked the continued efforts of local NHS staff in delivering services and their work on the vaccination rollout.
12.RESOLVED that the Committee note the report.
Supporting documents: