London seasonal influenza bulletin
27 February 2014
The pan-London seasonal influenza implementation steering group aims to ensure that all
relevant organisations are kept up-to-date with developments around seasonal flu in London.
This bulletin is jointly produced by Public Health England and NHS England (London) to
ensure that key messages and communications are aligned across all boroughs and that we
are taking a joined-up approach to delivering the seasonal flu programme. It provides
summary information on the incidence of flu, supply of flu vaccine, levels of vaccine uptake,
and other matters of interest.
Please share this bulletin with your teams.
Key points:
We are continuing to offer seasonal flu vaccine to at risk groups through GP practices
and community pharmacies in London.
No excess in all-cause mortality was seen across the UK overall, by age group or by
region.
We are planning for next year’s seasonal flu programme and the year after’s If you have
any lessons learnt to help inform our planning, please email immunisationsubmissions.london@nhs.net.
1.
2.
3.
4.
Flu activity - rates of Influenza-Like Illness (ILI)
Vaccine supply
Vaccine uptake (including HCWs national report published today)
Innovation
New research by Siriwardena, A.N., Asghar, Z and Coupland, C (2014). Influenza and
pneumococcal vaccination and risk of stroke or transient ischaemic attack—Matched case
control study. Vaccine. Volume 32 (12), Pages 1354–1361 has shown that Influenza
vaccination was associated with a 24% reduction in risk of stroke but not TIA. Pneumococcal
vaccination was not associated with reduced risk of stroke or TIA. This has important
implications for potential benefits of influenza vaccine.
5. Commissioning
6. Winter pressures and ILI in Acute Trusts
7. National children’s flu pilots for primary school-aged children
8.
9.
10. Further information and web links
Contacts
NHS England (London): Thara Raj Seasonal Influenza Lead: immunisation-submissions.london@nhs.net
PHE (London): Viv Cleary Influenza Lead: Vivien.Cleary@PHE.gov.uk
1. Flu activity - rates of Influenza-Like Illness (ILI)
According to the PHE GP In Hours Syndromic Surveillance System, influenza-like
illness (ILI) GP consultations rates in England decreased in the past week; 9.9 per
100,000 in week 7 to 9.2 in week 8. ILI consultation rates in London decreased in the
past week; 14.9 per 100,000 in week 7 to 13.3 in week 8.
Contacts
NHS England (London): Thara Raj Seasonal Influenza Lead: immunisation-submissions.london@nhs.net
PHE (London): Viv Cleary Influenza Lead: Vivien.Cleary@PHE.gov.uk
National influenza like illness and uptake rates by risk groups are published weekly
and the latest can be found at:
http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/12871479
13271
2. Vaccine supply
There are currently no supply issues that we are aware of and therefore no established
reason for GP practices in London to access the Public Health England national reserve. If
this situation changes we will let you know in this weekly London seasonal flu bulletin. A list
of manufacturers with stocks available can be found on page 20 in the national seasonal flu
letter:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207008/13061
3_Flu_Letter_v_29_Gateway_GW_signed.pdf
Fluenz® is no longer available to order, due to it expiring on 15 January 2014.
Fluenz has a limited shelf-life and, like all vaccines, needs to be used before it exceeds its
expiry date.
3. Vaccine uptake
Seasonal Flu vaccination uptake (At risk groups)
We will not be able to update this information until the data is available because
ImmForm/Public Health England does not monitor seasonal flu uptake beyond the end of
January.
Provisional monthly seasonal flu vaccine uptake data for frontline healthcare workers
(HCWs), covering cumulative flu vaccinations administered from 1 September 2013 to end of
December 2013. The data is shown at National and Area Team (on behalf of primary care
and Independent sector healthcare providers) level.
https://www.gov.uk/government/publications/seasonal-flu-vaccine-uptake-inhealthcare-workers-1-september-2013-to-31-december-2013
ImmForm data returns (a mandatory public health surveillance system)
All GP practices are asked to log on to ImmForm and check that the data entered against
their practice is correct. Some practices rely on automatic data extraction or manual entry. It
is the responsibility of the GP practice to make sure this data is accurate and change it if
incorrect.
Please find attached the ImmForm survey user guide which is accessible from the PHE
GOV.UK website at the following link; www.gov.uk/government/publications/seasonalinfluenza-vaccine-uptake-data-collection-guidance-gp-patients-all-practices-survey-england2013-to-2014
Contacts
NHS England (London): Thara Raj Seasonal Influenza Lead: immunisation-submissions.london@nhs.net
PHE (London): Viv Cleary Influenza Lead: Vivien.Cleary@PHE.gov.uk
Requests for passwords to access the ImmForm website or changes to organisation codes,
contacts etc. or technical issues concerning the ImmForm website should be emailed to
helpdesk@immform.org.uk
4. Sharing good practice
Two of the five 2014 NHS Employers flu fighter awards went to London NHS Trusts:
Most innovative campaign: London Ambulance Service NHS TrustThe London
Ambulance Service West area team decided to change the way they delivered their flu
vaccinations to staff this year, by taking the flu jabs to staff while on duty. James Johnson,
Staff Officer, led in the creation of a 'flu bus' in the West area.
Dean Royles, chief executive of NHS Employers said "The winning nomination used a truly
innovative approach, which was developed so staff on the move could still have the
opportunity to have their flu vaccinations. Due to flexibility and increased mobility their flu
campaign has resulted in a significant increase in uptake. This is a real example of a trust
adapting their flu fighter campaign to meet the needs of staff."
#flufighter digital and social media: Barnet and Chase Farm Hospitals NHS Trust
With the help of over eighty staff members, patients and visitors, Barnet and Chase Farm
Hospitals produced a cover version of Mariah Carey’s Christmas classic ‘All I Want For
Christmas Is You’ to generate publicity for their annual staff flu vaccination campaign. The
video amassed over 20,000 YouTube hits with almost half of these coming from overseas.
Judge Teresa Chinn from #WeNurses said it was "an inspired use of social media".
5. Innovation
New research by Siriwardena, A.N., Asghar, Z and Coupland, C (2014). Influenza and
pneumococcal vaccination and risk of stroke or transient ischaemic attack—Matched case
control study. Vaccine. Volume 32 (12), Pages 1354–1361 has shown that Influenza
vaccination was associated with a 24% reduction in risk of stroke but not TIA. Pneumococcal
vaccination was not associated with reduced risk of stroke or TIA. This has important
implications for potential benefits of influenza vaccine.
6. Commissioning
NHS England has commissioned services to offer the following at risk groups the seasonal
flu jab:
•
those aged 65 and over
•
children and adults in clinical ‘at risk’ groups (see Green Book
•
pregnant women including those in ‘at risk’ groups
•
carers
The NHS England (London region) immunisation commissioning team is continuing to
contact ‘outliers’ (those providers whose vaccine uptake data is very low or very high) to find
out why and to either discuss recovery plans or to learn from good practice so this can be
shared with others.
7. Winter pressures including Acute Trusts
Contacts
NHS England (London): Thara Raj Seasonal Influenza Lead: immunisation-submissions.london@nhs.net
PHE (London): Viv Cleary Influenza Lead: Vivien.Cleary@PHE.gov.uk
NHS England has published its weekly update on how the NHS is handling winter pressures,
giving the public better information than has previously been available.
Advice on how the public can help themselves keep well will be given throughout the winter.
See NHS England’s winter health check for the latest position on A&E, winter pressures
and influenza.
Also see Winter Pressures releases and PHE Winter Health Watch
8. National children’s flu pilots for primary school-aged children
The two geographical pilot sites based in London are in Newham and Havering. Both sites
have delivered flu vaccinations in primary schools situated in their boroughs as well as
providing community clinic options. Evaluation reports from the pilot sites will inform the
future roll-out of the national extension to the flu vaccination programme.
9. Further information and web links
Public Health England publishes its detailed weekly flu report every Thursday
afternoon. It can be viewed at:
http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/SeasonalInfluenza/Epidemiol
ogicalData/03influsweeklyreportpdfonly/
The list of community pharmacies that are part of this year’s NHS seasonal flu
scheme in London is available here:
https://www.myhealth.london.nhs.uk/sites/default/files/u1217/List%20of%20pharmacies%20l
ondon%20flu%2003%20Oct%202013.pdf
Copies of the NHS England (London) authorised Patient Group Directions (PGDs) for
seasonal flu and Fluenz® can be found here:
http://www.lmc.org.uk/article.php?group_id=9586
CAS alert on 27 January 2013 advising GPs to offer antivirals to eligible patients with
influenza flu like illnesses can be found here:
https://www.cas.dh.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=102108
Guidance on how to improve seasonal flu vaccine uptake amongst frontline health
and social care workers:
https://www.gov.uk/government/publications/flu-vaccination-increasing-uptake-by-healthand-social-care-workers
NHS Employers ‘flu fighter’ campaign:
http://www.nhsemployers.org/HealthyWorkplaces/StaffFluVaccination/Pages/seasonal-flucampaign.aspx
Contacts
NHS England (London): Thara Raj Seasonal Influenza Lead: immunisation-submissions.london@nhs.net
PHE (London): Viv Cleary Influenza Lead: Vivien.Cleary@PHE.gov.uk
Seasonal flu vaccine uptake amongst frontline health care workers in London in
2012/13:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/245605/Seaso
nal_Influenza_Vaccine_Uptake_HCWs_2012_13.pdf
Joint letter from DH, NHS England, and Public Health England asking that the NHS and
local authorities work to improve flu vaccination uptake rates amongst health and social care
workers in order to protect their patients/ clients, themselves and their colleagues from flu:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/244941/13_09
_25_-_Seasonal_flu_letter_on_HCW_FINAL.pdf
Clinical evidence and rationale for seasonal flu vaccine amongst frontline workers
can be found here:
http://www.nhsemployers.org/SiteCollectionDocuments/Flu_clinicalevidence2013.pdf
Q&As for Health Professionals on flu vaccine and porcine gelatine can be found here:
Q&A.pdf
The Green Book chapter online:
https://www.gov.uk/government/publications/influenza-the-green-book-chapter-19
Fluenz® online video:
A video for health professionals on how to administer the vaccine produced by NHS
Education for Scotland is also available.
Excess Winter Mortality in England and Wales, (provisional) 2012/13 and 2011/12
(final)
www.ons.gov.uk/ons/rel/subnational-health2/excess-winter-mortality-in-england-andwales/2012-13--provisional--and-2011-12--final-/stb-ewm-12-13.html
View the latest copy of Vaccine update.
The Cold Weather Plan for England
https://www.gov.uk/government/publications/cold-weather-plan-for-england-2013
Excess Winter Mortality 2012/13
https://www.gov.uk/government/publications/excess-winter-mortality-2012-to-2013
Keep Warm Keep Well booklet
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/254859/Keep_
Warm_Keep_Well_2013_WEB_FINAL.pdf
Contacts
NHS England (London): Thara Raj Seasonal Influenza Lead: immunisation-submissions.london@nhs.net
PHE (London): Viv Cleary Influenza Lead: Vivien.Cleary@PHE.gov.uk