Effective planning for winter flu
The winter flu vaccination season is about to start, and good planning and preparedness will ensure that practice staff do not become overwhelmed by the extra workload
Although last year saw some of the lowest levels of flu on record the Department of Health (DH) is expecting practices to achieve higher uptake rates in all at-risk groups during the 2012/13 vaccination programme than ever before.
There is pressure this year to focus extra efforts on pregnant women and patients in clinical risk groups. There will also be a drive to ensure that practice nurses and other staff with direct patient contact get themselves vaccinated.
'Flu remains highly unpredictable. We must therefore guard against complacency,' says the annual flu letter from chief medical officer, Professor Dame Sally Davies, director of nursing Viv Bennett and chief pharmaceutical officer Dr Keith Ridge.1
Last year, the overall vaccine uptake for people aged under 65 years in clinical risk groups failed to reach the recommended 60% target. This target had been set as a first step to achieving an uptake of 75% by 2013/14.
Only just over half (52%) of people under 65 eligible for a flu vaccination and only a quarter (25%) of pregnant women took up the offer of a jab last year, according to Health Protection Agency figures.2
The proportion of people aged 65 and over who received the seasonal flu vaccine in 2011/12 was much better, at 74% - a slight increase from the previous year when 73% were vaccinated.
The DH has set practices a target for 2012/13 of a 75% uptake for people aged 65 years and over and a 70% uptake for people under 65 years in clinical risk groups, including pregnant women.1
It will also be running a national campaign to emphasise the importance of practice nurses and other healthcare professionals themselves vaccinated against flu. Last year vaccine uptake among health care professionals increased to 45% - up from 35% the previous year - but this figure was still considered disappointingly low. 'Vaccinating staff against flu is an important infection control measure as part of the annual winter planning process to ensure the NHS and social care are as resilient as possible,' says the DH.1
VACCINATING CHILDREN
In July the government announced that the UK flu vaccination programme will be extended to all children aged from two to 17 years from the autumn of 2014.
The nasal spray Fluenz has been named by the Joint Committee on Vaccination and Immunisation, the expert committee which advises the DH, as the vaccine of choice. The committee has suggested that the extended programme should be delivered through schools but it is possible that immunisation of pre-school children from two years of age may be delivered via general practice. A DH spokesman says no final decision has yet been made on this. Fluenz is available for healthcare professionals to order as part of the existing 2012/13 flu immunisation programme.
FORWARD PLANNING
Tina Bishop, editor-in-chief of Practice Nurse, practice nurse lead and freelance primary care adviser, says at this stage in the year nurses should be downloading and reading the updated chapter on influenza from the Green Book and saving it on their lap top so that it is easily available to refer to.
They should make sure they have their patient group directions in place - and that they have signed them - and they should be liaising with the practice manager to plan extra clinics and be discussing with other practice staff their availability to deliver the vaccination programme.
'The seasonal flu season is a stressful time and does put extra pressure on nurses because the "day job" still has to be done. So it is important that practice nurses take time to organise themselves, make sure they have completed their annual flu update course and most importantly of all, have taken the time to plan ahead,' she says.
ANNUAL CYCLE
Helen Batchelor, practice nurse manager at The GP Centre in Cheam, advocates year round planning for flu.
During January and February she reviews feedback from the previous flu season then during March and April she starts planning for the next season by estimating demand and ordering vaccine supplies.
During May and June she audits did not attend rates, and puts on some education for the practice nurse team. In July and August she checks which patients need to be included in the call and recall registers and agrees plans with district nurses for vaccinating the housebound.
In September in preparation for the pending flu season Mrs Batchelor checks the nurse rota, the fridge capacity, advertises the campaign locally and ensures all practice staff are vaccinated.
During October when the vaccination season is in full swing she makes regular progress reports. In November and December she checks stock control, sends reminder letters to any patients who failed to attend and makes further progress reports.
She says: 'I look forward to the flu season every year and always carefully plan for it. We have our first Saturday morning flu clinic planned already and I can feel the buzz starting already.'
REFERENCES
1. Annual letter from the chief medical officer, the director of nursing and chief pharmaceutical officer. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_133963.pdf
2. Surveillance of influenza and other respiratory pathogens in the UK: October 2011 - April 2012. Health Protection Agency. June 2012. http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317134705939
3. Seasonal flu plan winter 2012/13. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_133964.pdf
