Based on the evidence, recommendations for vaccination and immunisation teams and staff for improving the uptake of the influenza vaccination fall under the following headings;

LEADERSHIP

  • Effective leadership
  • Clear responsibilities and named individuals for each part of the vaccination pathway across the healthcare system
  • Positive, motivated staff who are vaccinated themselves

ORGANISATION

  • Effective, comprehensive organisation of vaccine programmes supported by robust IT systems
  • Ordering vaccine stocks based on anticipated target uptake levels rather than previous year’s uptake

CLINICS

  • Offering vaccination in a variety of settings including dedicated clinics, ad hoc patient visits, domiciliary visits, mobile clinics and opportunistic appointments
  • Ensuring clinics are notified well ahead, with sufficient spaces and are welcoming, family friendly & not overbooked

IT

  • Local electronic data records, linked to national databases
  • Regular data cleansing to reconcile duplicate records and identify incomplete records
  • Use of adapted national IT search programmes, or in-house systems to identify eligible patients

TRAINING

  • Training for staff in information giving, data recording and use of the electronic records as well as delivery of vaccination programmes

INFORMATION FOR PATIENTS AND INVITATION FOR VACCINATIONS

  • Personal invitations for vaccination and delivery of vaccination that take into account people’s understanding, preferences (including language) and ability to access clinics
  • Patient information designed to increase knowledge and understanding of the programme, explaining the rationale, risks associated with the illness and the personal need for vaccination, appropriate for all levels of patient understanding
  • Telephone reminders are more effective than letters; multiple reminders are more effective; text message reminders are reportedly effective for some groupings, for example, younger age groups

COMMUNICATIONS

  • Consistent, positive recommendation and reminding of the need for flu vaccination by healthcare professionals in all contacts with relevant groups
  • A mixture of population and individual communications
  • Professional design of mass communications programmes
  • Use of credible and trusted ‘champions’
  • A positive, proactive attitude to vaccination in healthcare staff
  • Consistent messages at all levels, with front line staff aware of all communications being given

MONITORING AND FEEDBACK FOR ACTION

  • Real time monitoring and regular, timely feedback of information to managers and front line staff, during the programme, enabling remedial action to be taken
  • Inclusion of the flu vaccination monitoring in wider health monitoring (for example not considered in isolation)
  • Inclusion of immunisation data in needs assessment and equity audit

REGULAR FOLLOW UP AND REMEDIAL ACTION DURING THE PROGRAMME

  • Follow up of non-attendance and exploration of the causes so that low uptake in certain groups or individuals can be understood and vaccination or catch up programmes targeted accordingly