Tenth Report - Prevention in health and social care: vaccination

Vaccination is the one of the greatest success stories when it comes to preventing infection. Its impact is transformative. This makes it all the more concerning that England did not reach the 95% target for any routine childhood immunisations in 2021/22. The Government and NHS England should constantly strive to maximise the fantastic asset that vaccination represents and to ensure that nobody is excluded from the benefits that it can bring. It is unacceptable that there are people who are unable to take advantage of the important protection that vaccination offers due to practical challenges of time and location that can and must be addressed.

The incredible success of the Covid-19 vaccine rollout showed what can be achieved with a mission-based attitude from Government, which involved making it as easy as possible for everybody to receive the vaccine. Fundamental to that success was the wide range of people that were mobilised to deliver the vaccination, and this is a lesson that cannot be forgotten when considering routine immunisation programmes.

To ensure that nobody misses out on vital vaccine protection because of practical challenges such as convenient times or locations, a more flexible delivery model, that makes the most of the wide range of healthcare professionals, is needed. We recommend that the Government carries out a consultation on whether to amend the Human Medicines Regulations 2012 to give medical and nursing students, and recently retired staff, a greater role in routine immunisation delivery.

We agree that there is a need for national oversight of vaccination programmes and the value of this was clear during the Covid-19 pandemic. However, with routine immunisation programmes, the role of the Government and, in particular, NHS England must be limited to the more strategic, national level. Local ICS leaders, public health directors and health and care professionals have the best knowledge of the factors driving lower uptakes and the interventions needed to try and tackle that. As such, ICS leadership must step-up and take ownership of improving uptake in their area, and be supported to do so.

We welcome NHS England’s intention to set out an integrated vaccination and immunisation strategy. This strategy will be vital if England is to meet the 95% target for all childhood vaccinations and to address the variations in uptake across routine immunisation programmes. The strategy must receive the commitment and support from the Government that it will need to succeed. (Paragraph 27) 14 Prevention in health and social care: vaccination

The NHS England integrated vaccination and immunisation strategy must: a) have a strong focus on the action that is needed to tackle the practical challenges that limit access to vaccination; b) set out how to make best use of the wide range of healthcare professionals able to administer vaccinations; c) empower local leaders to pursue ways of addressing uptake in their own areas; and d) set out guidance and examples of best practice around how voices other than NHS England can be used to communicate important messaging about vaccination programmes.

We are deeply concerned to hear about the decline in clinical trial activity and the risk to the UK’s position as a global leader in this area. The challenges highlighted by witnesses, particularly around the administrative aspects of running a trial, are clearly fixable and it is vital that they are addressed if the UK is to make the most of its world-leading academic and research expertise.

We welcome Lord O’Shaughnessy’s review of commercial clinical trials, which chimed with a lot of the evidence that we heard in this part of our inquiry. The Government’s positive response to the recommendations is encouraging. We especially endorse the following recommendations and will be keeping a watching brief on the Government’s progress in implementing them, which we expect to be swift: a) Recommendations 2, 3 and 4 to address overly slow and bureaucratic clinical trial set-up and approval processes, in particular the goal for a 60-day turnaround for approvals b) Recommendations 14 - 17 to address the absence of conversation about research from interactions between clinicians and patients and increase the profile and awareness of research among disadvantaged or marginalised groups c) Recommendation 27 to develop an action plan outlining how the Government and delivery partners will implement the recommendations of the review.

Exciting innovations are on the horizon and have the potential to transform preventative healthcare. While the timeframe for such innovations, like a personalised cancer vaccine, is unknown, future planning must be done on the assumption that personalised therapeutics will become available. NHS England, and the MHRA and JCVI, need to be ready to play their part in ensuring these innovations can reach patients as quickly as possible, and the Department itself has a crucial role in ensuring this happens. It would be incredibly disappointing to reach a point where the vaccines themselves were ready but the infrastructure to approve and deliver them was still some time away. (Paragraph 41) Prevention in health and social care: vaccination 15

The Department of Health and Social Care and NHS England must lay before Parliament a plan for how they intend to ensure all relevant regulatory and delivery systems are ready to assess and deliver these new innovations to patients. As part of that plan, the JCVI and the MHRA must be adequately resourced and supported, focusing on modelling capability at the JCVI and, at the MHRA, on recruiting and retaining expertise relevant to new innovations, especially in personalised health. (Paragraph 42) 16 Prevention in health and social care: vaccination