To minimise the spread of influenza within the NHS, key organisations have launched a campaign to boost the uptake of staff vaccinations. Dean Royles reports.
Flu leads within NHS organisations, many of whom are occupational health professionals, are supporting England's first national NHS staff flu vaccination campaign called Flu Fighters. The involvement of occupational health practitioners is key to the success of this campaign, which this year provides more guides and promotional materials than in previous years.
The NHS Employers organisation was chosen to lead the campaign by the Social Partnership Forum, in partnership with the NHS trade unions and the Department of Health. This cooperation is expected to be a key factor in the success of the campaign.
Flu Fighters aims to increase vaccination rates by helping local trusts to explain how safe vaccinations are, provide encouragement and manage vaccinations locally.
Top tips: Getting the message out
Promote at team meetings/team briefs.
Give out flyers with receipts from the staff canteen. Promote at shift handovers.
Attach messages to payslips to encourage staff to get vaccinated.
Discuss at your staff forum/council.
Add messages to email footers, for example: "I've had my flu jab, have you?"
Work with local and regional media for features and editorial.
Send text messages to colleagues with work mobile phones.
Use social media (Facebook, Twitter, LinkedIn, YouTube, etc).
Keep your intranet page up to date with information about when and where to get vaccinated.
Use screensavers and pop-ups on all trust computers.
NHS Employers has been contacting senior NHS managers, flu leads and other key staff within the NHS to help them to achieve this in their local area.
The longer-term goal is for staff vaccinations to become as commonplace in the NHS as washing your hands or getting changed into clean clothes.
Department of Health figures show that only 34.7% of front-line health workers had seasonal flu vaccinations last year, up from just a quarter the previous year. This varies between staff groups, for example with nursing staff at 30%.
While there is no precise information about how much flu passes between staff and patients, there is more than enough evidence to support the need for vaccinations. Every 36 hours, one million patients pass through the NHS, many of whom will be vulnerable to flu. Last flu season, more than 600 deaths in the UK were directly caused by flu and many more were related to it. Sickness among NHS staff increases during the flu season, with more than 4% off sick at any one time.
Where to start
Deciding when and where to offer the vaccination is a key issue for many organisations. Evidence shows that a significantly higher uptake is likely to be achieved if the vaccine is taken to staff rather than asking them to attend set clinics.
However, there is not necessarily one approach that works best. The type of organisation, its culture, size, the number of sites on which it is based and where they are in relation to each other, as well as the staff groups employed and their shift patterns, are all key factors to consider when thinking about locations and the best time to offer vaccinations.
Many organisations struggle to find the capacity to provide vaccinations to all staff over such a short period of time and so train extra vaccinators to help deliver the programme. Trusts could train senior ward staff or representatives from each department and ask them to vaccinate everyone in their area. Staff who are keen could be trained and then asked to vaccinate out of hours, particularly if they normally work out of hours anyway.
These vaccinators will require training in line with all national and local policy. Skills council Skills for Health recently launched an immunisations and vaccinations e-learning programme, which has been developed with the Health Protection Agency and experts in the NHS. The programme is available free of charge to NHS organisations from Skills for Health.
Top tips: Leadership
Encourage immediate line managers to lead in persuading staff to take vaccines and arranging for them to get vaccinated.
Encourage managers to promote positive messages and encourage staff to attend clinics.
Have senior clinicians acting as champions.
Have a flu immunisation lead from the service.
Have more senior staff publicly immunised.
Use a working group with representatives from all areas to look at increasing uptake.
Have a nominated flu lead for each department.
Focus time on getting ward managers on board - encourage a positive attitude to the vaccine.
Stress the duty of care of healthcare workers to protect vulnerable patients who cannot protect themselves.
Make sure the campaign is added to your local joint negotiating committee agenda.
The Flu Fighters campaign will also be running a series of workshops and webinars throughout the coming months and will provide flu leads and others involved in local campaigns with an opportunity to share ideas, look at top tips and get the most out of their campaign.
Sending the message
Communicating the need for vaccinations to staff is a challenge but guidance that offers constructive help is available from NHS Employers.
Social media deserves particular attention because it is relatively new to many communicators and because it is also a great way to reach out to staff outside the hospital, as well as being a great way to reach staff outside of offices and those who may require particular assistance to get somewhere where vaccinations are available.
The campaign has a strong presence on Twitter and Facebook that can help trusts to promote the campaign locally. Staff using Twitter can follow @NHSflufighter and add a "twibbon" - a little pictorial badge - to their profile.
The campaign's Facebook page is interactive and allows staff to pledge that they are having their jab. Staff can submit details of their trust so that organisations can be ranked in a fun way to inject an element of competition into the campaign.
There is also information available on LinkedIn.
Text messaging to mobile phones is another option. A number of companies exist that will do this for a fee, including:
Please note that the campaign does not endorse any of these particular companies and there are other companies available.
The message encouraging staff to be vaccinated is a positive "call to action" and senior leaders in trusts can confidently get fully behind it, ideally making their support very visible to staff. Likewise, leaders from the partnership running the campaign are lining up to receive their vaccinations and put their face to it.
An organisation may or may not have one named person responsible for coordinating and running its campaign, but it is useful to draw upon a range of skills from across the business. Occupational health, immunisation, HR, communications and staff-side colleagues may be particularly helpful, but also consider involvement from infection control, nursing and training teams as they may be able to offer support with valuable expertise.
Top tips: Delivering the vaccine
Set up clinics in staff rooms or areas close to wards.
Set up in the staff canteen.
Hold drop-in clinics in main staff entrances, especially at times when staff are starting and finishing work, offering vaccinations out of hours.
Send vaccinators to wards and departments to catch staff who are traditionally difficult to access, for example A&E staff.
Run clinics and drop-in centres across other sites.
Run clinics at places you are likely to find community-based staff.
Offer a free cup of tea and biscuit to all staff who attend to get vaccinated.
Allow staff to "drop in" to a clinic at any time that suits them.
Use peer vaccinators to vaccinate colleagues.
Train ward managers to vaccinate their own staff (or, if this poses an issue, to swap with another manager and vaccinate their staff).
It might be a good idea to consider a working group of staff representatives from across the organisation to look at ways of increasing uptake. Organisations where senior leaders support and promote the vaccination tend to have higher uptake rates than those that do not. Many organisations take photographs of their directors and other senior staff, such as consultants, being vaccinated.
It can also be helpful for directors and senior managers to send clear messages that managers must give staff the time required to have their vaccination.
Voice of reason
The national campaign has been developed in partnership with staff-side organisations including Unison, Unite, the Royal College of Midwives and the Royal College of Nursing, which are keen to support organisations to deliver their campaigns.
Not only can staff-side colleagues provide valuable input into the planning of a campaign, they can also help to reach and communicate with many staff effectively and represent staff views. There are excellent case studies of effective partnership working available on the Social Partnership Forum. The leaders of the British Medical Association have also recently sent a letter to doctors encouraging take-up of flu vaccination.
Many staff have concerns about the flu vaccine that are grounded in myths. Clinical and non-clinical staff can often believe things that simply are not true, and OH practitioners may be the most important person in an organisation who can change this.
The campaign provides comprehensive summaries of the myths and the reality. Employers can use intranet pages, staff newsletters and magazines, emails and noticeboards, as well as team meetings and briefings, to pass these messages on. A trust could set up an email address for staff to submit their questions. Support for staff vaccinations is greatly appreciated and NHS Employers hopes its supporting material is able to provide everything required.
Dean Royles is director of the NHS Employers organisation.