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Delivery of the HINI Vaccination Programme within the Southern Health and Social Care Trust A reflection. Glynis Henry Assistant Director of Nursing for workforce Development and Training. Contents. Context Background Working structure and arrangements Activity
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Delivery of the HINI Vaccination Programme within the Southern Health and Social Care Trust A reflection Glynis Henry Assistant Director of Nursing for workforce Development and Training
Contents • Context • Background • Working structure and arrangements • Activity • Learning through reflection
Context • Late April 2009 – WHO announced emergence of a novel influenza virus • From a health and social care system perspective spring 2009 was characterised by planning to prepare for a potential pandemic influenza • 11th June 2009 the World Health Organisation had announced a move to pandemic alert 6, the intensity of preparedness planning intensified. • Vaccination development was underway
Pandemic Influenza (H1N1) Vaccination Programme • 1st July 2009 HSS (MD) 28/2009: Vaccine availability, timeframe, licensing, number of doses, storage and presentation, initial priority groups, resources, training, information materials and data collection • 14th August 2009 HSS (MD)37/2009 Increased clarity re supply, prioritisation and that the seasonal influenza programme would continue as normal
Pandemic Influenza (H1N1) Vaccination Programme • 6th October HSS (MD) 44/2009 Covered specific issues including vaccines, supply, distribution, storage, priority groups, Trust arrangements, primary care arrangements, university health service, monitoring uptake and information. • 15th October HSS (MD) 47/2009 Provision of final details of the programme and Launch date for programme
Pandemic Influenza (H1N1) Vaccination Programme • Further updates followed including HSS (MD)49/2009, HSS (MD)58/2009 24th November which announced phase two of the programme, through to end of the financial year and beyond, HSS (MD) 9/2010.
Structure and arrangements • Regional Pandemic Vaccination work-stream Comprising a number of stakeholders including for example, PHA, BSO, HSCB, DHSSPS HSC Trusts and universities and was multidisciplinary in make up. Met frequently and communication was via a range of modes. • SHSCT pandemic vaccination work-stream Included PHA, HSCB and Trust staff. Multidisciplinary initially with a relatively small membership which expanded as information about the programme increased. Meetings scheduled to follow regional meetings.
SHSCT pandemic vaccination work-stream • Purpose: Prepare plan to deliver pandemic vaccination programme and deliver that plan • Plan included a number of elements: Model, supplies of vaccine(s), workforce, training, information and communication, system for data collection, monitoring and reporting
Programme streams • All pregnant women • Those within clinical risk groups 6 months - 65 years • Household contacts of immunocompromised individuals • People aged 65 and over in the current seasonal flu vaccine clinical at risk groups • Frontline health and social care workers (extended to all)
Pandemic Influenza (H1N1) Vaccination Programme • Special schools • Inpatients within clinical risk groups with hospital stay of more than 7 days • Egg and constituent allergy vaccination clinic • Domiciliary/housebound community (supporting primary care) • Children 6 months – 5 years The Trust had to ensure arrangements were in place for it deliver vaccination to all these streams
Gibbs reflective cycle Description: what happened Fluid dynamic situation Feeling: what we were thinking and feeling Dynamic, changing, trying to keep pace, communication Evaluation: what was good and bad Good-Regional and local groups, team work, support, commitment of staff, training, responsiveness of all involved, expertise of colleagues. Regional group approach to learning the lessons Challenge- Trying to keep everyone informed in a fluid situation
Gibbs reflective cycle Analysis: What sense we could make of it Recognise need to strike the right balance between regional direction and local delivery model. The approach based on prioritisation worked well. Sound decision making at critical points. Support the creative thinking of staff. Conclusion: what else could we have done Encouraged more engagement with areas where public health is not as embedded. Continued focus through the ongoing programme Action plan: If it arose again what would we do Feel better prepared in light of the experience We think the focus on priority groups encouraged uptake and lessened the impact of surge on the acute hospital system
Conclusion Don’t judge each day by the harvest you reap, but by the seeds you plant. (Robert L Stevenson)
A final word: Thank you, colleagues from Regional Agencies and Education Providers who supported us. Thanks to the Trust’s Vaccination Group, the vaccinators and to all those staff and managers who contributed and supported this work. Thank you all for listening. Glynis Henry