How can we design an integrated vaccine programme?
With rumours circling of the launch of a national vaccine service and a letter published yesterday revealing NHS plans for administering Flu and COVID vaccines simultaneously – Hassan Majeed looks at how we can best deliver an integrated vaccine programme.
On 8th December 2020, 90-year-old Margaret Keenan received the first COVID-19 vaccine at University Hospital in Coventry. Since then, more than 142 million vaccines have been administered in the UK, preventing millions of infections, and saving hundreds and thousands of lives.
While much of the focus has naturally been on the COVID-19 vaccine, the NHS also delivered a variety of other immunisations, most notably, flu. As we move forward to the endemic phase of the pandemic and begin to merge COVID-19 and Flu vaccine delivery, healthcare systems will have to maintain a relentless focus on vaccine delivery to continue to protect the population.
A successfully integrated vaccine programme can accelerate delivery, provide huge benefits for patients, the healthcare workforce and at system level. But it’s much easier said than done – here are some approaches to design teams for success.
How can we bring together Vaccine teams to accelerate delivery?
Vaccine programmes are complex - a single vaccine will require multiple teams engaging and co-ordinating supply chains, cold storage requirements, estates, workforce, delivery channels, communications and much more. This picture is reflected both nationally as well as in local delivery systems. Despite the complexity inherent in delivering vaccines, it makes sense for patients and systems to integrate vaccine delivery to improve clinical outcomes, value for money and efficiency.
A successful merger of different vaccine programmes will rely on staff buy-in at all levels, clear roles and responsibilities, transparent governance, integrated technology offering and a continued focus on the needs of the population.
The below operating model demonstrates how future vaccine programmes can widen their scope to deliver more types of vaccines while also focusing on patients and giving the workforce clear direction:
Our key principles to design teams for future success:
Define what’s important. The right operating model should make it clear what the strategic priorities are. The great strength of the COVID-19 programme has been the clarity of objectives, giving rise to a singular focus extending from Whitehall to local GP practices. By defining what mattered the most, staff were empowered and had a clear goal to work towards. Priorities do not have to be as simple as ‘offering a vaccine to everybody’ either, the COVID-19 programme made great headway in vaccinating hard to reach populations due to clear strategic focus.
Ensure governance acts as an enabler. Important clinical, operational and strategic decisions should be made quickly, transparently and communicated with speed. Governance should be designed to make high priority, high impact decisions while ensuring that decisions regarding local execution are highly devolved.
Align your products to improve vaccination uptake. By bringing immunisations together in one product portfolio it will enhance collaboration, maximise use of resources and enable a singular focus across all vaccines.
Focus on the needs of our Population. Services should be designed with the needs of the population in mind. The COVID-19 programme, utilising different data sets across public sector organisations, built a sophisticated picture of who our populations are, where they are located and what their health needs are. A focus on population allows communications, vaccination sites and workforce to be designed and deployed in a manner tailored to local contexts.
Emphasise delivery channels to enhance partnership working. Delivery channels are the linchpin of vaccination delivery. The COVID-19 programme worked with Primary Care, Acute Trusts, Local Government, Public and Private providers to great effect to deliver more than 142 million vaccines. A team dedicated to fostering and building relationships with these stakeholders should be the cornerstone of any future vaccination service.
Create an effective operations centre. Bringing together key operating functions can help guide and strengthen the foundation of an organisation. A single operating centre will ensure that the programme runs smoothly providing skills, expertise, and lasting resilience across systems.
Technology should enable delivery teams and provide patients with a seamless experience. It is vital that a new organisational design should facilitate communication between teams, from accessing the same communication platforms to easy data sharing. From the patient’s perspective, the National Booking System was extremely popular due to its simple design. Going forward, overcomplexity in the technology offering should be avoided both externally and internally.
As the NHS builds on the COVID-19 vaccination programme and merges other vaccines programmes with it, it is vital that strong design principles underpin vaccine delivery systems across the country.
The PSC has helped deliver over 4.1m COVID-19 vaccines in one of the largest integrated care systems in the country. If you would like to discuss anything in this article or vaccine related please get in touch with Hassan at Hassan.firstname.lastname@example.org.
Author: Hassan Majeed, The PSC Transformation Team
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