Case Study: Hampshire and Isle of Wight’s vaccine programme
Hampshire and Isle of Wight’s vaccine programme was delivered across urban, rural and island geographies. Our partners helped deliver over 5 million vaccines through approximately 4,000 plus vaccinators (volunteers and staff, building lasting relationships which we can now capitalise on to transform how we deliver the health and wellbeing agenda, particularly for those who have traditionally been hard to reach.
On the back of a strong equalities programme, we now have a legacy within the ICS for developing a continued model of place-based partnerships, innovative communications, and integrated care planning, using innovative techniques to support personalised care for our diverse population.
Hampshire and Isle of Wight ICS serves a diverse population of 1.8million people, including rural, urban and island locations. The area includes multi-ethnic communities, areas of high deprivation, inequalities, and isolation due to extremely rural areas.
Particular barriers experienced for the vaccine programme included an island population which had a high level of vaccine hesitancy, as well as a rural population with limited access to transport. We also had a large young student population and a diverse Chinese community with vaccine hesitancy in the Southampton area.
In our planning process our guiding principle was that our offer must protect the most vulnerable and lead to equality of outcome in all communities. We conducted joint planning exercises with providers, Primary Care Networks, Acute Trusts and Local Government. We also worked with local communities and voluntary groups to understand needs and what was driving hesitancy.
Operationally, we were supported by volunteer drivers, the Fire and Rescue service and our growing workforce to distribute vaccines and ensure waste was minimised. We also worked jointly with all our partners to ensure consistent messaging and communications around vaccine supply and availability, to reassure the public.
We developed a PCN dashboard which identified the volume of vaccines needed across our places and allowed us to allocate supply as it became available to ensure the most vulnerable populations had access.
Workforce to deliver vaccines was clearly challenging for everybody but across Hampshire and Isle of Wight we built a workforce bureau of 1700 volunteers and contracted staff that could be deployed across a range of settings including our mass vaccination centres, primary care and hospital hubs.
Once we understood our coverage and had a proposed footprint our next planning priority was to stimulate demand. We built an equalities programme to engage, communicate and come up with the best approaches to ensure that everybody was coming forward for a vaccine.
This included looking at innovative ways to reach our most hesitant groups, such as taking vaccines as close to people as possible rather than relying on mass centres, on the Isle of Wight, and providing a Chinese-language app in Southampton.
In Hampshire and Isle of Wight we pivoted from a more conventional vaccine programme towards a population health management programme with a focus on local planning and tackling inequalities. This enabled us to achieve 98% uptake for first doses in our most vulnerable populations.
The Hampshire and Isle of Wight programme was innovative in its approach by using multiple community venues, places of worship as well as a roving service which targeted under vaccinated communities at places convenient to them, such as shopping centres.
A fantastic example of this is how we tailored our offering for the Chinese community. Our engagement with the community showed us that one of the main drivers of hesitancy was not concerns over safety but rather anxieties over how personal information would be used and shared.
Once we realised that this was the case, we worked with the Chinese association of Southampton to reach out to the community. A local GP spoke and promoted engagement at a community dinner. We outlined that only essential data would be taken, and it would not be shared. We then used the Chinese community centre as a vaccination centre and the first clinic we ran vaccinated 115 people. A follow up clinic vaccinated a further 140 people.
We also worked with mobile and roving vaccination centres on the Isle of Wight to support a very rural community with limited access to transport, ensuring people weren’t left without a vaccine due to their location.
Finally, we adapted existing school-aged immunisation services extremely effectively to deliver vaccines to young people in schools. This became a nationally recognised approach.
We worked collaboratively with multiple partners throughout the programme, but this was particularly demonstrated by our efforts to vaccinate people with learning disabilities. To deliver vaccinations to this cohort we worked with multiple providers, Southern and Solent Health, Primary Care, acute trusts, learning disability teams, as well as local authorities.
“This is such a powerful and rewarding programme to be involved with, and so much we have learnt that we need to share wider and embed within other health and care teams – the future is looking very exciting.” Provider Operational Director
“Very good service. Very approachable staff. Willing to allow children to access vaccine as part of drop-in. The nurse that administered the injection was very friendly and supportive of the children and their needs.” Patient.