In Scotland, we are modernising the delivery of vaccination services. In 2017, the Scottish Government and the Scottish General Practitioners Committee (SGPC) agreed vaccinations would move away from a model based on GP delivery to one based on NHS Board delivery through dedicated teams.
The Vaccination Transformation Programme (VTP) began on 1 April 2018. It is expected that Health and Social Care Partnerships (HSCPs) and NHS Boards will have all programmes transformed by the end of the 3 year transition period (April 2021). The order and rate at which HSCPs and NHS Boards make the transition will vary but progress is expected to be delivered in each of the 3 years.
The VTP is divided into different workstreams:
- pre-school programme
- school based programme
- travel vaccinations and travel health advice
- influenza programme
- at risk and age group programmes (shingles, pneumococcal, hepatitis B)
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IT is one of the most fundamental issues affecting the transformation. The Scottish Government VTP team are exploring a number of avenues to support immunisation delivery, both in the short to medium term, and beyond VTP. They are working closely with the team building the new CHI/Child Health replacement system: the Scottish Child Public Health & Wellbeing System (SCPHWS), to ensure that vaccination programmes in the years to come are underpinned by a robust, flexible IT system which can support a 21st century immunisation service. They are also exploring what can be done with existing NHS IT systems to see if these can be adapted to support transformation of services during VTP. In line with the VTP’s ethos of empowering local decision-making, it will be for each Health Board to decide which system(s) to use in their area and they are working closely with representatives from each Health Board to identify the optimum interim solution for them.
Communication resources to support the 2019/20 flu vaccination programme
To support communications with members of the public about vaccination service delivery change under VTP, NHS Health Scotland has developed tailored flu posters for pregnant women, 2-5 year olds, adults at risk and adults over 65 to reflect local service changes. There is also new online information on NHS Inform about how to arrange a flu vaccination.
Exploring public views of vaccination service delivery
Modernising vaccination services must include an understanding of patients’ views. To help inform how vaccination services are modernised under VTP, NHS Health Scotland commissioned focus group discussions with adults living in different areas of Scotland to find out their views of vaccination services. This study explored people’s current experience of vaccination services and views on what they consider to be the key elements of an effective vaccination service delivery model in the future.
Vaccination Transformation review
This rapid review looked for evidence on ways to improve uptake of influenza, shingles and pneumococcal immunisation programmes among adults aged 60 years and over.
Some adult populations may experience barriers to getting vaccinated so the review looked for interventions to engage:
- those in nursing homes, care homes, assisted living or sheltered housing
- those with reduced cognitive ability (for example, people with dementia and people with Alzheimer’s disease)
- those with reduced mobility or housebound individuals
- those living in remote/rural areas.
The review also looked for interventions to improve healthcare provider knowledge about vaccination to improve adult vaccination uptake as they play an important role in a patient’s decision to get vaccinated.
Interventions to improve engagement with immunisation programmes in selected underserved populations
Underserved populations experience inequalities in health and are often undervaccinated, being at greater risk of vaccine-preventable diseases. During the VTP transition, it is important that vaccination coverage is maintained or improved, and the inequalities gap closes further.
Underserved populations covered by this review were selected by business change managers for VTP within local health boards through a prioritisation process, and include:
- people from deprived areas
- people whose first language is not English
- Gypsy/Traveller communities
- people with learning disabilities.
Travel health service
Protecting individuals from the risk of infectious disease abroad is another key area of the VTP.
A Travel Health Best Practice Guide is being developed to outline nationally agreed standards for the provision of pre-travel health assessment and services.
Additionally, there is work underway to develop a model of delivery which will ensure a consistent, transparent, and readily accessible travel health service across Scotland.
Contacts for the VTP
Business Change Managers have been identified in each territorial NHS Health Board. They will work with their local Health and Social Care partners and Integration Boards to redesign vaccination service delivery models.
To discuss the VTP development in your area, please contact your local Health Board's Business Change Manager.
- NHS Ayrshire & Arran – Elvira Garcia; Clinical_VTP_Info_AA@aapct.scot.nhs.uk
- NHS Borders – Vaccination.TransformationProgramme@borders.scot.nhs.uk
- NHS Dumfries & Galloway – Dr David Breen; email@example.com
- NHS Fife – Fiona Duff; firstname.lastname@example.org
- NHS Forth Valley – Henry Prempeh; email@example.com
- NHS Grampian – Katrina Morrison; firstname.lastname@example.org
- NHS Greater Glasgow & Clyde – Jennifer Reid; email@example.com
- NHS Highland – Ken Oates or Lorraine McKee; firstname.lastname@example.org
- NHS Lanarkshire – David Cromie; email@example.com
- NHS Lothian – Lorna Willocks or Ruth Burns; firstname.lastname@example.org
- NHS Orkney – Sara Lewis; ork-HB.PublicHealth@nhs.net
- NHS Shetland – Susan Laidlaw; email@example.com
- NHS Tayside – Daniel Chandler; firstname.lastname@example.org
- NHS Western Isles – Christina Morrison; email@example.com