1. The national flu immunisation programme Training for Receptionists 2015/2016

2. Aims of resource This training resource aims to: Update the knowledge base of receptionists regarding the seasonal flu vaccination programme Support staff involved in discussing flu vaccination with eligible patients by providing evidence based information Promote high uptake of flu vaccination by increasing the knowledge of receptionists around the eligible cohorts of people 2The national flu immunisation programme

3. Learning Outcomes On completion of this resource staff will be able to: Understand the evidence base for the administration of flu vaccination to those aged 65 years and over and those in clinical risk groups Understand the importance of their role in promoting flu vaccination to patients 3The national flu immunisation programme

4. What is flu? Flu is an acute viral infection of the respiratory tract (nose, mouth, throat, bronchial tubes and lungs) Highly infectious illness which spreads rapidly in closed communities Even people with mild or no symptoms can infect others Most cases in the UK occur during an 8-10 week period during the winter 4 The national flu immunisation programme 2014/15 The national flu immunisation programme

5. Features of flu Easily transmitted by large droplets, small-particle aerosols and by hand to mouth/eye contamination from an infected surface or respiratory secretions of infected person People with mild or no symptoms can still infect others Incubation period 1-5 days (average 2-3 days) though may be longer especially in people with immune deficiency Common symptoms include: Sudden onset of fever, chills, headache, myalgia & extreme fatigue Dry cough, sore throat and stuffy nose In young children gastrointestinal symptoms such as vomiting and diarrhoea may be seen 5The national flu immunisation programme

6. Possible complications of flu Common: Bronchitis Otitis media (children), sinusitis Secondary bacterial pneumonia Less common: Meningitis, encephalitis, meningoencephalitis Primary influenza pneumonia Risk of most serious illness higher in children under 6 months, pregnant women, older people and those with underlying health conditions such as respiratory disease, cardiac disease, chronic neurological conditions or immunosuppression Influenza during pregnancy may be associated with perinatal mortality, prematurity, smaller neonatal size and lower birth weight 6The national flu immunisation programme

7. Eligible Groups For Flu Vaccination People aged 65 and over People aged under 65 with specific clinical conditions All pregnant women All two, three and four-year-olds Extension of the programme for children ( school years 1 and 2) Healthcare workers with direct patient contact Carers 7Presentation title - edit in Header and Footer

8. Under 65s in Clinical Risk Groups prioritise chronic liver disease and neurological disease, including those with learning disabilities, Children in at-risk groups 8Presentation title - edit in Header and Footer

9. Vaccination of clinical risk groups Increasing flu vaccine uptake in clinical risk groups is important because of increased risk of death and serious illness if people in these groups catch flu For a number of years only around half of patients aged six months to under 65 in clinical risk groups have been vaccinated Despite those with liver disease and chronic neurological disease having some of the highest mortality rates, they have the lowest flu vaccine uptake rate amongst those in clinical risk groups 2015/16: prioritise the improvement of vaccine uptake in those with chronic liver and neurological disease, including those with learning disabilities 9The national flu immunisation programme

10. How do you promote the programme ? How could you extend your role ? 10Presentation title - edit in Header and Footer The Receptionist role in the Flu Programme

11. Top Tips for achieving high flu uptake 1.Patients recommended to receive the flu vaccine should be directly contacted inviting them to a flu vaccination clinic or to make an appointment. 2.The practice should follow-up patients who do not respond or fail to attend scheduled clinics or appointments 3.Reception staff play a role in reminding patients about flu from September to March 4.Receptionist who are fully briefed on flu and the eligible cohorts, and offer vaccinations when making appointments and booking patients in can make a difference 5.Use “ask me about flu signs” in reception. 6.Answerphone message …talk to the receptionist in surgery about flu vaccination 11The national flu immunisation programme

12. Top Tips Direct contact with the patient and can be via letter, phone, text, email, messages on prescriptions and opportunistically face to face To increase contact success rates, phone or text patients in the evenings as they are more likely to respond and have time to book in for their flu vaccine Receptionists can opportunistically discuss the flu vaccine during phone calls with any patients eligible when booking in other appointments Practices that have high uptake figures have indicated that persistence is key Remind parents that the flu vaccination for 2, 3 and 4 year olds is a nasal spray, not an injection 12 test

13. Top Tips 13 test Have a flu lead Have one person within the surgery to ‘run’ the programme as a project. The flu lead doesn’t have to be clinical, just someone responsible for the delivery of the programme for the season and who updates the whole practice on number delivered, reviews lists every few days and regularly distributes information on the flu programme.

14. Top Tips 14 test Display posters, leaflets and campaign material in waiting rooms and in reception areas etc. Put details of your flu clinics on the front page of your website Ask your PPG members to help spread the message to their networks Include details of flu clinics and how to book in practice newsletters Use your waiting room TV screen to remind patients of the importance of having the vaccination

15. Top Tips 15 test The admin team checks appointments for the day and looks at whether eligible patients have been immunised or not – if they haven’t, place a note on the patient’s record for opportunistic immunisation Make sure flu posters are on display in the room used by community midwives. Leaflets in the midwives rooms will enable them to give these out easily to pregnant women.

16. Top Tips A protocol could be developed for clinicians highlighting patients ‘at risk’ when opening the record and give them an option to give vaccination, decline or book an appointment. For administration staff, a protocol may be able to be developed to highlight patients ‘at risk’ – and serves as a reminder to discuss the flu vaccination with an option to book an appointment or to decline 16 test

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18. Scenarios 1.You offer a patient a flu vaccination. They decline stating there is no point as last years and it didn’t work. How might you respond? 2.You have ideas on how the practice could be more proactive in promoting the flu programme, who would you approach and how? 3.A patient asks for a flu vaccination but according to the list of eligible cohorts they are no eligible. What do you do? 4.A patient declines your offer of a flu vaccination stating they had it once before and still got flu? How might you respond? 18 The national flu immunisation programme

19. Key messages Flu immunisation is one of the most effective interventions immunisers can provide to reduce harm from flu and pressures on health and social care services during the winter Increasing flu vaccine uptake in clinical risk groups is important because of increased risk of death and serious illness if people in these groups catch flu For a number of years only around half of patients aged six months to under 65 years in clinical risk groups have been vaccinated Influenza during pregnancy may be associated with perinatal mortality, prematurity, smaller neonatal size, lower birth weight and increased risk of complications for mother Receptionists play an important role in offering vaccination and starting the clinical conversation 19The national flu immunisation programme