Source · Select Committees · Public Accounts Committee
Recommendation 2
2
Accepted
Comparatively low vaccination uptake persists in many vulnerable groups and, after the first booster campaign,...
Recommendation
Comparatively low vaccination uptake persists in many vulnerable groups and, after the first booster campaign, has even dropped further for some. Overall uptake of COVID-vaccination has been high, reaching 90% of adults by the end of May 2022 (based on 2 doses). But some groups have seen much lower uptake. For example, by the same point, only 55% of young people aged 16 and 17 had received 2 doses, and only 38% of 12- to 15-year-olds. There has been particularly low uptake among pregnant women: as of February 2022, only 58% had received 2 doses. Some gaps widen when acceptance of booster doses is taken into account: for example, compared to people of White British origin, people of Black, Black British and Pakistani origins were less than half as likely to have had their boosters. Local and national bodies have taken a variety of approaches to encourage uptake, but it is not clear which of these has really been most effective, and for which groups. There are particular challenges when it comes to vaccinating people with learning disabilities, including identifying who is eligible, making communications accessible, and tackling needle phobia: these have not always been consistently or adequately addressed. Recommendation: Recognising that reasons for lower uptake will vary, NHS England and UKHSA should urgently evaluate which approaches are most effective for increasing uptake, communicate again with local areas about what works, and provide support to them to deploy the most effective approaches. This should include fresh approaches to tackling the persistent low uptake observed in some ethnic groups.
Government Response Summary
NHS England, supported by UKHSA, will evaluate approaches to vaccine delivery and work with local systems to continue evaluating different approaches to vaccine delivery, especially for communities where uptake and confidence may be lower. NHS England intends to continue offering vaccinations through a range of flexible delivery models, supported by culturally tailored and targeted campaigns.
Government Response
Accepted
HM Government
Accepted
The government agrees with the Committee’s recommendation. and conducted evaluation about which approaches work most effectively in reducing vaccine inequalities. For the 2022 autumn/winter campaign, NHSE will work in partnership and support local systems to continue evaluating different approaches to vaccine delivery. Supported by the UK Health Security Agency (UKHSA) vaccination evaluation framework, this will provide better understanding of the most effective ways to offer vaccination, especially for communities where uptake and confidence may be lower. Continuous engagement at a local, regional and national level with partners and organisations, as well as greater understanding through insight and community conversations, allow NHSE to continue to build trust and confidence with communities, maximise convenience and minimise complacency in a way that works locally. NHSE intends to continue offering vaccinations through a range of flexible delivery models, supported by culturally tailored and community-led activity. 3: PAC conclusion: NHS England has started planning for a reduction in vaccine sites and staffing for the rest of 2022 in anticipation of lower overall demand, but it is not yet clear how its strategy will strike the right balance between maintaining high levels of vaccination uptake and ensuring that demands on healthcare staff are sustainable. 3a: PAC recommendation: By the end of October 2022, NHS England should write to the Committee with the results of its assurance of local plans – particularly with regard to whether these provide an efficient and effective basis for the programme to achieve its aims, while safeguarding staff welfare and aligning with other demands on the NHS. It should also set out any further central actions it will take to address areas of deficiency in the plans. 3.1 The government agrees with the Committee’s recommendation. 3.2 NHSE working through its regional and system teams will review and assure local COVID-19 vaccination plans throughout the summer and autumn of 2022 against optimal delivery as outlined by the Joint Committee on Vaccination and Immunisation (JCVI). 3.3 NHSE with regional and system partners is working to develop plans for the remainder of 2022 that determine the appropriate site and provider model composition. This will ensure appropriate capacity and service provision are in place aligned with JCVI advice, whilst recognising the wider demands on healthcare staff. 3.4 NHSE wrote to the Committee on 31 October 2022 to provide an update to the Committee on the outcome of assurance of local plans. 3b: PAC recommendation: During 2022–23, NHS England working with others should develop clear, costed options for how the programme will ensure both value for money and accessibility in its future approach to COVID-19 vaccination, including who it expects will primarily administer vaccinations and in what locations. 3.5 The government agrees with the Committee’s recommendation. 3.6 These have also been key considerations throughout the lifespan of the programme and in the initial approach that was taken to vaccine deployment. The considerations outlined have been utilised in planning for the remainder of 2022 and for the future vaccination strategy. 3.7 During 2022-23, NHSE is transitioning to more standard financial mechanisms to pay for services; this is stimulating further development and expansion of delivery models which provide best value for money, with a clear focus on maintaining accessibility with specific funding to support. The learning from this work will form part of the long-term strategy development, to ensure that NHSE continues to build on and improve the value it is able to achieve in delivery of vaccination services. 4: PAC conclusion: There is considerable learning from the COVID-19 vaccine programme that might apply elsewhere, both in the health sector, such as screening programmes and routine vaccinations, and across wider government. 4: PAC recommendation: The Department should carry out a systematic exercise to identify successes and other lessons from the programme and, within six months of this report, communicate to the Committee the main improvements it will make as a result in other health programmes, as well as any wider applications to emergency response planning or other government programmes. 4.1 The government agrees with the Committee’s recommendation. 4.2 There are many important lessons to be learned from the COVID-19 vaccine roll-out which will have application across other public health programmes and beyond. 4.3 In practice, lessons learned to date are already influencing work across the health system. NHSE is leading development of an integrated immunisations strategy, aiming to align vaccination and immunisation services over the longer-term, drawing on the successes and lessons from the COVID-19 vaccine rollout, and with a focus on uptake and addressing health inequalities, data and technology, vaccine deliver