1. Delivery of the HINI Vaccination Programme within the Southern Health and Social Care Trust A reflection Glynis Henry Assistant Director of Nursing for workforce Development and Training Glynis Henry Assistant Director of Nursing for workforce Development and Training

2. Contents Context Background Working structure and arrangements Activity Learning through reflection

3. Context Late April 2009 – WHO announced emergence of a novel influenza virus From a health and social care system perspective spring 2009 was characterised by planning to prepare for a potential pandemic influenza 11 th June 2009 the World Health Organisation had announced a move to pandemic alert 6, the intensity of preparedness planning intensified. Vaccination development was underway

4. Pandemic Influenza (H1N1) Vaccination Programme 1 st July 2009 HSS (MD) 28/2009: Vaccine availability, timeframe, licensing, number of doses, storage and presentation, initial priority groups, resources, training, information materials and data collection 14 th August 2009 HSS (MD)37/2009 Increased clarity re supply, prioritisation and that the seasonal influenza programme would continue as normal

5. Pandemic Influenza (H1N1) Vaccination Programme 6 th October HSS (MD) 44/2009 Covered specific issues including vaccines, supply, distribution, storage, priority groups, Trust arrangements, primary care arrangements, university health service, monitoring uptake and information. 15 th October HSS (MD) 47/2009 Provision of final details of the programme and Launch date for programme

6. Pandemic Influenza (H1N1) Vaccination Programme Further updates followed including HSS (MD)49/2009, HSS (MD)58/2009 24 th November which announced phase two of the programme, through to end of the financial year and beyond, HSS (MD) 9/2010.

7. Structure and arrangements Regional Pandemic Vaccination work-stream Comprising a number of stakeholders including for example, PHA, BSO, HSCB, DHSSPS HSC Trusts and universities and was multidisciplinary in make up. Met frequently and communication was via a range of modes. SHSCT pandemic vaccination work-stream Included PHA, HSCB and Trust staff. Multidisciplinary initially with a relatively small membership which expanded as information about the programme increased. Meetings scheduled to follow regional meetings.

8. SHSCT pandemic vaccination work-stream Purpose: Prepare plan to deliver pandemic vaccination programme and deliver that plan Plan included a number of elements: Model, supplies of vaccine(s), workforce, training, information and communication, system for data collection, monitoring and reporting

9. Programme streams All pregnant women Those within clinical risk groups 6 months - 65 years Household contacts of immunocompromised individuals People aged 65 and over in the current seasonal flu vaccine clinical at risk groups Frontline health and social care workers (extended to all)

10. Pandemic Influenza (H1N1) Vaccination Programme Special schools Inpatients within clinical risk groups with hospital stay of more than 7 days Egg and constituent allergy vaccination clinic Domiciliary/housebound community (supporting primary care) Children 6 months – 5 years The Trust had to ensure arrangements were in place for it deliver vaccination to all these streams

11. Activity

15. Gibbs reflective cycle Description: what happened Fluid dynamic situation Feeling: what we were thinking and feeling Dynamic, changing, trying to keep pace, communication Evaluation: what was good and bad Good-Regional and local groups, team work, support, commitment of staff, training, responsiveness of all involved, expertise of colleagues. Regional group approach to learning the lessons Challenge- Trying to keep everyone informed in a fluid situation

16. Gibbs reflective cycle Analysis: What sense we could make of it Recognise need to strike the right balance between regional direction and local delivery model. The approach based on prioritisation worked well. Sound decision making at critical points. Support the creative thinking of staff. Conclusion: what else could we have done Encouraged more engagement with areas where public health is not as embedded. Continued focus through the ongoing programme Action plan: If it arose again what would we do Feel better prepared in light of the experience We think the focus on priority groups encouraged uptake and lessened the impact of surge on the acute hospital system

17. Conclusion Dont judge each day by the harvest you reap, but by the seeds you plant. (Robert L Stevenson)

18. A final word: Thank you, colleagues from Regional Agencies and Education Providers who supported us. Thanks to the Trusts Vaccination Group, the vaccinators and to all those staff and managers who contributed and supported this work. Thank you all for listening. Glynis Henry