Abstract
Health care workers are a priority group for seasonal influenza vaccination, which is recommended by the World Health Organisation. There is a wide variation in uptake between and within countries. England has achieved 69.5% of health care workers vaccinated overall in 2017/18 across NHS acute and community health care settings, but it varies between Trusts from 50% to over 92.3%. While attitudinal factors have been well researched, there is limited evidence on organisational factors associated with high uptake. In England, most NHS Trusts are now implementing a similar range of interventions as part of their flu programme, and it remains unclear why performance remains so variable. This qualitative study is the first to explore reasons for this variation and provide recommendations for lower performing Trusts on how to improve. Fifty-seven interviews of managers and vaccinators were conducted in nine hospitals with flu vaccination uptake ranging from just over 55% to above 90%. Our study found that while Trusts deployed a wide range of both demand generating and supply interventions to increase uptake, there were marked differences in the organisational and delivery models utilised. Our study suggests that organisational culture was possibly the most important ingredient when trying to differentiate between high and low performing Trusts. We found that a positive culture aimed at fostering continuous improvement and favouring non-coercion on balance yielded more adherence from staff. Where influenza vaccination was embedded in the organisation wellbeing strategy, rather than executed as a siloed seasonal programme, this tended to foster good performance. Improving performance of influenza vaccination in health care workers will involve not only deploying the right interventions, and following “best practices”. It will require the adaptation of flu progamme delivery strategies to the organisation context, and embedding vaccination into the organisational culture, thus supporting the normalisation of yearly vaccination.
| Original language | English |
|---|---|
| Pages (from-to) | 3079-3085 |
| Number of pages | 7 |
| Journal | Vaccine |
| Volume | 38 |
| Issue number | 15 |
| DOIs | |
| Publication status | Published - 30 Mar 2020 |
Bibliographical note
Funding Information:We would like to thank our study participants for their valuable contributions, Louise Letley (Public Health England), and NHS Improvement for support in recruiting participants to the study. This work was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Immunisation at the London School of Hygiene & Tropical Medicine in partnership with Public Health England (PHE) [Award letter refs: HPRU-2012-10096 dated 11th Dec 2013]. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health, Public Health England or of the London School of Hygiene & Tropical Medicine.
Funding Information:
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Tracey Chantler, Sadie Bell, Pauline Paterson and Sandra Mounier-Jack report that they were in receipt of funding from the National Institute of Health Research while conducting this research. Pauline Paterson has received research funding from GlaxoSmithKline, and has received honorariums from Sanofi Pasteur and Pfizer. Angela Edwards and Joanne Yarwood worked for Public Health England for the duration of this research. Douglas Gilbert worked at NHS England and NHS Improvement during the duration of the study.]
Funding Information:
This work was funded by the National Institute for Health Research Health Protection Research Unit ( NIHR HPRU ) in Immunisation at the London School of Hygiene & Tropical Medicine in partnership with Public Health England (PHE) [Award letter refs: HPRU-2012-10096 dated 11th Dec 2013].
Publisher Copyright:
© 2020 The Author(s)
Keywords
- Health personal
- Health policy
- Health workers
- Healthcare
- Influenza
- Operational research
- Public health
- Vaccination rates
- Vaccine
