Immunisation statistics for Tower Hamlets Luise Dawson and

Immunisation statistics for Tower Hamlets Luise Dawson and Sumaira Tayyab Tower Hamlets Public Health

How are we doing? • • • Decline in the 3 sets of childhood vaccinations over the past 2 years. There are concerns the NELCHIS Hub reporting on the childhood immunisation coverage levels for Tower Hamlets still does not equate with the figures being obtained from the CEG immunisation dash board. This is of concern because the data from NELCHIS Hub is published at a national level. As this programme is now commissioned by NHSE the level of targeted engagement with individual networks and practices has declined which did support to keep this programme high on the very busy primary care agenda

Data • Reaching herd immunity (95%) has not been continuous across the age groups • Data; unless you know your uptake you cannot effectively: üknow if you have a problem üidentify any target groups for additional sessions üsee any improvements to uptake üevaluate your strategy and learn lessons about what works to maximise uptake or improve outcomes

How we compare regionally/nationally? 3 rd DTa. P/IPV/Hib (12 months) 98 97 96. 5 96 95. 7 94 94. 9 94. 3 94. 6 94. 2 93. 6 93. 4 93. 1 92. 8 Axis Title 92 TH 91. 1 London 90. 6 England 90 89. 4 89. 2 88. 8 88. 6 88 86 84 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18

How we compare regionally/nationally? MMR 1 (2 years) 96 94 92. 3 93. 9 92. 7 93. 1 92. 3 91. 9 91. 2 91. 6 90 Axis Title 88 87. 1 87. 5 91 90. 2 TH 87. 3 London 86. 4 86 England 85. 1 84 83. 6 82 80 78 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18

How we compare regionally/nationally? MMR Booster (5 years) 100 95 94 93. 1 90. 6 90. 5 90 88. 9 Axis Title 93 88. 6 88. 2 87. 6 89. 98 87. 4 TH 85 London England 80 80. 8 80. 7 81. 1 81. 7 79. 5 77 75 70 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18

3 rd DTa. P/IPV/Hib (12 months) coverage 100% 95% 90% 85% 80% 2014/15 2015/16 2016/17 2017/18 NW 1 94. 3% 94. 2% 93. 5% 90% NW 2 95. 8% 95. 1% 93. 6% 93% NW 3 97. 6% 96. 5% 95. 7% 95% NW 4 95. 3% 93. 7% 92. 0% 95% NW 5 93. 7% 98. 0% 95. 2% 95% NW 6 93. 3% 96. 5% 92% NW 7 93. 3% 94. 5% 92. 7% 91% NW 8 92. 6% 97. 4% 95. 4% 89% TH 94. 3% 95. 3% 94. 3% 93%

MMR 1 (2 years) coverage 100% 95% 90% 85% 80% 2014/15 2015/16 2016/17 2017/18 NW 1 84. 3% 92. 6% 92. 7% 83. 11% NW 2 90. 5% 95. 5% 87. 2% 84. 18% NW 3 92. 0% 93. 7% 95. 3% 91. 60% NW 4 92. 8% 89. 6% 88. 89% NW 5 84. 9% 96. 9% 91. 5% 92. 75% NW 6 87. 3% 89. 4% 94. 4% 92. 18% NW 7 88. 5% 90. 1% 89. 1% 87. 55% NW 8 92. 5% 96. 1% 94. 0% 90. 67% TH 89. 4% 93. 1% 91. 6% 90. 20%

MMR Booster (5 years) coverage 100% 98% 96% 94% 92% 90% 88% 86% 84% 82% 2014/15 2015/16 2016/17 2017/18 NW 1 88. 4% 89. 5% 90. 6% 90. 4% NW 2 84. 6% 95. 9% 95. 5% 87. 4% NW 3 95. 2% 99. 1% 93. 3% 93. 4% NW 4 92. 7% 90. 2% 86. 2% 91. 1% NW 5 96. 7% 93. 1% 88. 6% 90. 1% NW 6 90. 3% 89. 4% 93. 4% 91. 2% NW 7 91. 8% 92. 8% 88. 3% 89. 1% NW 8 92. 2% 95. 1% 94. 4% 88. 5% TH 91. 4% 93. 0% 91. 4% 90. 0%

Small numbers…

Seasonal flu statistics for 2017 -18 Coverage for Tower Hamlets, London & England, 2017 -18 80% 72. 90% 70% 60% 52. 60% 50% 49. 00% 40% 30. 80% 30. 60% 30% 20% 10% 0% Tower Hamlets London England 65 and over 72. 90% 66. 90% 72. 60% 65 and under with LTCs 52. 60% 45. 40% 48. 90% All pregnant women 49. 00% 41. 10% 47. 20% All 2 year olds 30. 80% 32. 20% 42. 80% All 3 year olds 30. 60% 33. 30% 44. 20%

Flu coverage compared to neighbouring boroughs 80% Coverage in Tower Hamlets, Newham & City & Hackney 70% 60% 50% 40% 30% 20% 10% 0% Tower Hamlets Newham City & Hackney 65 and over 72. 90% 69. 30% 66. 00% 65 and under with LTCs 52. 60% 53. 00% 43. 90% All pregnant women 49. 00% 47. 60% 31. 60% All 2 year olds 30. 80% 30. 20% 24. 20% All 3 year olds 30. 60% 29. 50% 22. 60%

Comparison of coverage from 2015 to 2018 80% 74. 28% 74. 04% 72. 40% 70% 56. 44% 60% 52. 74% 51. 26% 48. 88% 50% 56. 74% 49. 70% 65 and over 40% Under 65 s at risk 30% All pregnant patients 20% 10% 0% 2017 -18 2016 -17 2015 -16

Seasonal flu network coverage 17 -18 over 65 yrs 80. 00% 78. 11% 78. 00% 75. 43% 76. 00% 74. 01% 74. 00% 72. 07% 72. 00% 72. 40% 71. 57% 71. 44% 69. 94% 69. 82% 70. 00% 68. 00% 66. 00% 64. 00% NW 1 NW 2 NW 3 NW 4 NW 5 NW 6 NW 7 NW 8 TH

Network Coverage 2017 -18 under 65 62. 00% 60. 46% 60. 00% 58. 00% 56. 00% 54. 44% 54. 00% 52. 00% 51. 45% 51. 43% 50. 43% 51. 00% 51. 65% 52. 26% 52. 74% 50. 00% 48. 00% 46. 00% 44. 00% NW 1 NW 2 NW 3 NW 4 NW 5 NW 6 NW 7 NW 8 TH

Network coverage 2017 -18 2 -3 yrs 40. 00% 36. 39% 35. 00% 34. 94% 34. 44% 31. 90% 30. 35% 30. 71% 28. 97% 30. 00% 25. 32% 24. 38% 25. 00% 20. 00% 15. 00% 10. 00% 5. 00% 0. 00% NW 1 NW 2 NW 3 NW 4 NW 5 NW 6 NW 7 NW 8 TH

Practice name Practice level 65 yr and over – practices 17 -18 84. 26% 82. 13% 82. 00% 79. 36% 78. 98% 78. 57% 77. 86% 77. 80% 77. 60% 77. 21% 75. 98% 75. 90% 75. 73% 75. 45% 74. 75% 74. 48% 73. 36% 72. 45% 72. 22% 72. 15% 72. 04% 71. 61% 70. 75% 70. 61% 70. 40% 69. 93% 69. 72% 69. 55% 69. 25% 68. 24% 67. 98% 67. 39% 65. 57% 61. 77% 58. 62% Whitechapel Health (Shah Jalal) St Katharine Docks Practice Brayford Square (Dr Varma) Globe Town Surgery Barkantine Practice Grove Road Surgery (Dr Shah) Ruston Street Clinic (Dr Amin) Blithehale Medical Centre Pollard Row Surgery Harley Grove Medical Centre Gough Walk (Dr Selvan) Stroudley Walk Centre Harford Health Centre St Stephens Health Centre Bromley-By-Bow Health Centre St Pauls Way Medical Centre Merchant Street (Dr Rana) City Wellbeing Practice (Tower Medical) Tower Hamlets St Andrews Health Centre Aberfeldy Practice Limehouse Practice (Gill Street) XX Place Surgery Spitalfields Practice Strouts Place Medical Centre East One Health Island Medical Centre Docklands Medical Centre Bethnal Green Health Centre Jubilee Street Practice The Mission Practice The Tredegar Practice Chrisp Street Health Centre Albion Health Centre Island Health Wapping Group Practice All Saints Practice Health E 1 10% 20% 30% 40% 50% 60% 70% 80% 90%

Under 65 yr with long-term conditions 17 -18 73. 76% 71. 98% 66. 88% 65. 71% 65. 11% 61. 89% 57. 53% 57. 29% 56. 63% 56. 07% 54. 63% 54. 43% 54. 05% 53. 87% 53. 62% 53. 14% 52. 93% 52. 29% 51. 91% 51. 90% 51. 77% 51. 76% 51. 21% 50. 65% 50. 55% 50. 47% 49. 67% 49. 20% 49. 04% 47. 95% 47. 87% 47. 28% 47. 14% 46. 62% 44. 54% 44. 33% 44. 04% 43. 36% St Katharine Docks Practice Whitechapel Health (Shah Jalal) Grove Road Surgery (Dr Shah) Barkantine Practice Strouts Place Medical Centre Brayford Square (Dr Varma) Pollard Row Surgery Albion Health Centre Blithehale Medical Centre Gough Walk (Dr Selvan) City Wellbeing Practice (Tower Medical) XX Place Surgery Stroudley Walk Centre Ruston Street Clinic (Dr Amin) Merchant Street (Dr Rana) Practice name Bromley-By-Bow Health Centre Chrisp Street Health Centre Tower Hamlets East One Health Limehouse Practice (Gill Street) Spitalfields Practice Harford Health Centre Globe Town Surgery Aberfeldy Practice St Stephens Health Centre St Pauls Way Medical Centre Wapping Group Practice Jubilee Street Practice Bethnal Green Health Centre Health E 1 St Andrews Health Centre The Tredegar Practice The Mission Practice Island Medical Centre Harley Grove Medical Centre Island Health Docklands Medical Centre All Saints Practice 10% 20% 30% 40% 50% 60% 70% 80% 90%

All Pregnant women 2017 -18 St Katharine Docks Practice Grove Road Surgery (Dr Shah) City Wellbeing Practice (Tower Medical) Strouts Place Medical Centre Whitechapel Health (Shah Jalal) Globe Town Surgery Bromley-By-Bow Health Centre Brayford Square (Dr Varma) Barkantine Practice Pollard Row Surgery St Andrews Health Centre Ruston Street Clinic (Dr Amin) Blithehale Medical Centre XX Place Surgery St Stephens Health Centre Practice name Stroudley Walk Centre Albion Health Centre Tower Hamlets Spitalfields Practice Merchant Street (Dr Rana) St Pauls Way Medical Centre Jubilee Street Practice Chrisp Street Health Centre The Tredegar Practice Island Health Bethnal Green Health Centre Wapping Group Practice Aberfeldy Practice Limehouse Practice (Gill Street) Gough Walk (Dr Selvan) Harley Grove Medical Centre East One Health Docklands Medical Centre The Mission Practice Harford Health Centre Island Medical Centre 23. 53% 22. 22% All Saints Practice Health E 1 0% 10% 20% 32. 50% 31. 03% 30% 61. 83% 61. 00% 59. 70% 58. 90% 56. 04% 55. 51% 53. 85% 52. 94% 51. 95% 50. 87% 50. 85% 49. 70% 48. 88% 47. 62% 46. 99% 46. 80% 46. 63% 45. 09% 44. 86% 44. 55% 43. 31% 42. 78% 42. 54% 42. 03% 41. 80% 41. 35% 41. 26% 40. 43% 39. 58% 40% 50% 60% 75. 00% 74. 16% 73. 81% 70. 59% 70% 85. 19% 90%

Practice name 2 – 3 years coverage 2017 -18 Stroudley Walk Centre St Katharine Docks Practice Blithehale Medical Centre Grove Road Surgery (Dr Shah) Island Medical Centre Pollard Row Surgery Albion Health Centre City Wellbeing Practice (Tower Medical) The Tredegar Practice Whitechapel Health (Shah Jalal) Docklands Medical Centre Limehouse Practice (Gill Street) Gough Walk (Dr Selvan) Aberfeldy Practice Strouts Place Medical Centre Barkantine Practice Harford Health Centre Tower Hamlets St Stephens Health Centre Bethnal Green Health Centre East One Health Island Health Globe Town Surgery The Mission Practice Harley Grove Medical Centre XX Place Surgery All Saints Practice Bromley-By-Bow Health Centre Spitalfields Practice Brayford Square (Dr Varma) Merchant Street (Dr Rana) Chrisp Street Health Centre Jubilee Street Practice Wapping Group Practice St Pauls Way Medical Centre Ruston Street Clinic (Dr Amin) St Andrews Health Centre 68. 47% 59. 09% 51. 74% 48. 33% 45. 09% 44. 94% 44. 75% 41. 50% 41. 38% 39. 45% 37. 68% 34. 85% 34. 80% 34. 03% 33. 33% 32. 63% 30. 82% 30. 71% 30. 69% 30. 61% 30. 60% 29. 26% 27. 75% 26. 46% 25. 95% 24. 76% 24. 73% 22. 60% 22. 56% 21. 95% 21. 43% 20. 82% 20. 36% 19. 22% 18. 87% 18. 25% 0% 10% 20% 30% 40% 50% 60% 70% 80%

Decliners recorded 2017 -18 for under 65 yrs 23. 90% XX Place Surgery Barkantine Practice 23. 06% Brayford Square (Dr Varma) 21. 71% Pollard Row Surgery 21. 13% 19. 86% St Pauls Way Medical Centre Ruston Street Clinic (Dr Amin) 19. 47% St Katharine Docks Practice 19. 31% Blithehale Medical Centre 18. 51% Bethnal Green Health Centre 18. 46% Whitechapel Health (Shah Jalal) 17. 11% Albion Health Centre 16. 65% Strouts Place Medical Centre 16. 38% Docklands Medical Centre 15. 93% Island Medical Centre 15. 65% St Andrews Health Centre 15. 40% East One Health 14. 81% Health E 1 14. 79% Bromley-By-Bow Health Centre 14. 69% Island Health 14. 32% Wapping Group Practice 13. 74% The Mission Practice 13. 17% Limehouse Practice (Gill Street) 12. 99% Harford Health Centre 12. 82% Jubilee Street Practice 12. 79% The Tredegar Practice 12. 50% 12. 10% Chrisp Street Health Centre Globe Town Surgery 11. 43% Gough Walk (Dr Selvan) 11. 16% Stroudley Walk Centre 11. 07% Grove Road Surgery (Dr Shah) 10. 06% City Wellbeing Practice (Tower Medical) 10. 00% Spitalfields Practice 9. 85% St Stephens Health Centre 9. 37% Aberfeldy Practice 9. 09% 7. 24% Merchant Street (Dr Rana) All Saints Practice Harley Grove Medical Centre 6. 64% 5. 78%

REMINDER : To increase the practice staff uptake of the seasonal flu vaccination ……….

Shingles vaccination programme Year 2013/14 2014/15 2015/16 2016/17 June 2018 (EOY : August 18) Age group Number eligible Coverage % coverage 70 yrs 758 386 50. 9% 79 yrs 592 333 56. 3% 70 yrs 769 384 49. 9% 78 yrs 565 265 46. 9% 70 yrs 676 312 46. 2% 78 yrs 551 262 47. 5% 70 yrs 761 319 41. 9% 78 yrs 601 266 44. 3% 70 yrs 901 292 32. 4% 78 yrs 584 199 34. 1%

Pertussis vaccination – June 2018 Merchant Street (Dr Rana) Stroudley Walk Centre Grove Road Surgery (Dr Shah) St Katharine Docks Practice Strouts Place Medical Centre Wapping Group Practice St Stephens Health Centre City Wellbeing Practice (Tower Medical) The Tredegar Practice Island Health Harley Grove Medical Centre Brayford Square (Dr Varma) XXP/BBB St Andrews Health Centre Aberfeldy Practice Albion Health Centre Harford Health Centre Tower Hamlets Blithehale Medical Centre East One Health Barkantine Practice Chrisp Street Health Centre The Mission Practice Whitechapel Health (Shah Jalal) Limehouse Practice (Gill Street) Globe Town Surgery St Pauls Way Medical Centre Spitalfields Practice Island Medical Centre Jubilee Street Practice Docklands Medical Centre Bethnal Green Health Centre Gough Walk (Dr Selvan) Pollard Row Surgery Ruston Street Clinic (Dr Amin) 100. 00% 90. 00% 88. 89% 83. 33% 80. 00% 76. 92% 75. 00% 72. 73% 70. 00% 66. 67% 64. 86% 63. 64% 62. 50% 62. 22% 61. 90% 61. 54% 60. 87% 60. 00% 56. 52% 53. 33% 50. 00% 44. 44% 38. 89% 36. 36% 33. 33% 0. 00% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Group work

How do we improve? Delivery of immunisation is simple however the process is multifaceted and complex requiring a range of different initiatives/support to make the improvements. Increase the numerator (getting as many patients immunised as possible) & decrease the denominator accurate lists via cleansing - 0 -5 yrs – by promptly putting vaccination information onto records when joining the practice / removing from the registers list when not longer in Tower Hamlets - Improves accuracy, reporting and will be a true uptake - Ensures you are not undertaking futile activity

Recommendations at practice level • Named immunisation champion at a practice and Network level to oversee the local programme (clinical or non-clinical staff) – • Seasonal flu vaccination – whole practice approach for the campaign period • Systematic call and recall system for all vaccinations (shingles 70 th birthday) • Start of the year (0 -5 yrs) – recall who will be 2 yrs or 5 yrs and have missed their vaccinations (at 1 yr or at 3 yrs 4 mths) • Children & adults who do not attend their immunisation appointment are followed up with a written recall invitation and a phone call or text message. • Opportunistically reviewing children /adults attending the practice for outstanding vaccinations • Support list cleaning – review data sent by the NEL CHIS (0 -5 yrs) to keep the registrations up to date • Children (0 -5 yrs) have their immunisation status checked at specific educational stages (mandated HV checks) • Networks NIS; encouraging practices to reach a target of 95% for which they will receive reimbursement • Reviewing the league tables/health competition – learning from other good performing networks and practices. • School aged children – sign up to Vaccination UK emails

Recommendations at community level I. Raise awareness through routine communication channels II. Identify a leads in the community ; champion guidelines, motivate others III. Engage with Children Centres