Immunisation Leadership in Practice

Immunisation Leads: Key to delivering effective vaccination programmes

Busy day? Here’s a quick summary:

• Immunisation Leads play a key leadership role in delivering effective vaccine programmes, including coordinating, training, and overseeing members of the immunisation team, delivering vaccinations, keeping themselves up to date with immunisation information, and providing vital information to patients and healthcare bodies^1,2
• Any organisation that either commissions, manages, or provides vaccinations is required to have a named vaccination lead to ensure efficient and effective delivery of vaccinations¹
• Not all practices will use the specific ‘Immunisation Lead’ job title for this role, but it is critical to have someone who is responsible for ensuring that services meet core standards and that every contact opportunity for vaccinations are maximised within the practice^1,2
• It is typically a practice nurse who takes on the role of an Immunisation Lead; however, it can be other members of the practice team, such as the practice manager
• Working in collaboration with the broader immunisation team, the Immunisation Leads are crucial in safeguarding public health and promoting community wellbeing and engagement^1,2
• It’s important to explain the purpose of the vaccination to your patients. Starting the conversation prior to them reaching eligibility status ensures they are aware, informed, and ready to accept the vaccine once they do become eligible
• A top tip from Stacy Evans, an experienced immunisation nurse, is to make sure every patient contact counts. Read on to find out how

Why do we need an Immunisation Lead?

Immunisation is vital to help protect people from preventable diseases, like shingles. But what does it take to deliver a successful vaccination programme that maximises uptake? Who is involved and what does best practice look like?

There are a number of factors that need to be considered when implementing a successful vaccination programme. These include:

• Ordering and storing vaccines
• Administering vaccinations and monitoring patient safety
• Coordinating the identification of eligible people for vaccine invitation and course completion
• Delivering education to team members and patients
• Evaluating the success of programmes
• Scheduling dedicated clinics and the proactive call and recall of all eligible patients

There can be many different individuals in a practice involved in these processes. However, as you can see from the figure above, having a central person to coordinate both the team and vaccination activities is critical.

This is where the Immunisation Lead steps into the spotlight. Every practice is required to have an Immunisation Lead, although they may not be given that specific job title.^1,2 It is often a practice nurse who takes on the role of an Immunisation Lead, but it is not required for the lead to be a clinician. If they are not a clinician, then they are required to work with and be supported by a clinician to ensure that the core standards are met.¹

Immunisation Leads play a key role in ensuring vaccinations and routine immunisation schedules are delivered effectively, helping to protect more people in their community. Practices that have a designated Immunisation Lead leading the charge often see a higher vaccine uptake as a result.

Does your practice have a lead? If not, could this be you?

In this article, we explore their various responsibilities, highlighting the importance of immunisation leadership to coordinate, inform, and train members of the team to effectively deliver immunisation programmes.

What does an Immunisation Lead do?

Immunisation Leads ensure the effective and efficient delivery of immunisation services in their community. They are responsible for overseeing immunisation programmes within a healthcare setting, such as a GP practice, as well as coordinating activities relating to immunisation, including setting up vaccination clinics.

Any organisations that either commission, manage, or provide vaccinations are required to have an Immunisation Lead to ensure efficient and effective delivery of vaccinations,² with their responsibility varying depending on practice requirements. This individual should have access to information and facilities as required to carry out their role safely and effectively.²

Not all practices will use the specific ‘Immunisation Lead’ job title for this role, but it is critical to have someone who is responsible for ensuring that services meet core standards and that opportunities for vaccination are maximised for their patient population.¹

Below we show some of the varied responsibilities that Immunisation Leads may need to carry out as part of their role.

Coordination²

• Planning, working, and liaising with other members of their team; sharing and coordinating tasks to ensure the efficient delivery of the programme
• Identifying all people who are eligible for the vaccination, including those who are more difficult to access; like those who are housebound for example
• Working with staff in supported living settings and care homes to ensure they have a policy in place regarding vaccinations
• Communicating with staff in secondary and tertiary care providers who do not provide vaccines to ensure that people eligible for vaccinations are identified and are signposted to relevant services
• Liaising with community services such as health visitors, school nurses, and district nurses within the locality
• Working with voluntary agencies, faith leaders, and Gypsy and Roma communities for example, to identify and meet the needs of eligible hard-to-reach populations

Vaccine management^2,3

• Overseeing procurement, storage, and distribution of vaccines within the healthcare facility to make sure that there is an appropriate stock of vaccines, particularly seasonal vaccines, and that all vaccines are stored according to manufacturer’s instructions
• Ensuring recommended guidelines, policies, and procedures are followed to maintain vaccine potency and prevent avoidable wastage

Vaccine administration^2,4

• Ensuring appropriate staff are trained, skilled, knowledgeable, and competent in administering vaccines, and provide training and support where necessary
• Developing and implementing standardised procedures for vaccine administration, and monitoring adherence to best practices in accordance with national guidance

Vaccine safety monitoring²

• Monitoring and reporting any adverse events following immunisation
• Following appropriate measures when addressing adverse events

Quality assurance²

• Certifying the quality and accuracy of immunisation records
• Generating and following processes to verify and document vaccine doses administered, maintaining accurate immunisation records and reconciling any discrepancies

The following codes for the SHINGRIX® (herpes zoster vaccine, recombinant, adjuvanted) vaccine can be used:⁸

Immunocompromised & Immunocompetent

First dose: 39756611000001109, 39655511000001105, 38737511000001105 or 38736811000001106

Second dose: 1326111000000107

Education and training²

• Providing education and training to healthcare providers across a range of topics, including vaccine-preventable diseases, immunisation schedules, vaccine safety, correct vaccine administration techniques, consent, communication, and governance
• Staying updated on the latest research and recommendations – find out more at illuminate’s Shingles National Immunisation Programme page
• Disseminating the latest information and updates to guidelines with all clinical staff who will advise or signpost patients in relation to the immunisation schedule and eligibility
• Ensuring immunisation is on the agenda and prioritised at practice meetings, on practice social media channels and digital messaging, and at wider team meetings

Programme evaluation^2,9

• Monitoring and evaluating the performance of immunisation programmes within their clinical setting
• Assessing vaccine coverage rates for their area, identifying approaches for improvement and implementing strategies to enhance immunisation uptake and compliance

Collaboration and networking

• Collaborating with stakeholders within primary care networks, and with external bodies such as public health departments, immunisation coalitions, and community organisations
• Participating in immunisation-related meetings, conferences, and committees to stay informed about best practice
• Sharing best practice experience and potentially even contributing to the development of immunisation guidelines

Patient communication²

• Addressing vaccine hesitancy and multi-dose compliance by increasing awareness and providing evidence-based information about vaccines to patients, families, and healthcare providers
• Making patients aware that they are eligible for the vaccination and invite them for an appointment through their preferred communication channel (phone call, SMS, etc.)
• Handling concerns and misconceptions around vaccinations
• Promoting vaccine acceptance through effective communication strategies

The specific responsibilities of an Immunisation Lead may vary according to practice due to the size and complexity of the practice, or the overall population of its patients, for example.

In some practices, Immunisation Leads may be responsible for vaccine procurement, inventory management, and compliance with cold chain requirements. In others, these tasks may be delegated to specific personnel or departments, allowing the Immunisation Lead to focus more on the clinical aspects of vaccine delivery, such as vaccine safety and monitoring, adverse event reporting, and staff training, reviewing uptakes and assessing the rationales for declining the offer.

Overall, the role of an Immunisation Lead and immunisation team is crucial in safeguarding public health and promoting community well-being.

By overseeing vaccine distribution, educating the public, monitoring immunisation coverage, and collaborating with other healthcare professionals, Immunisation Leads play a pivotal role in helping prevent the spread of infectious diseases and helping protect individuals from vaccine-preventable illnesses.

To find out more about how you can optimise your vaccine practice and increase uptake levels in your community, check out Stacy’s top tip below.

Stacy's top tip: Every patient contact matters

For me, it’s all about being open and transparent with your patients when communicating with them about vaccinations. Explain the purpose of the vaccination and what it is protecting against prior to their eligibility, in addition to when they are eligible. It is also essential you highlight potential side effects they may experience. If they have been missed, use opportunities and make every contact count, such as through appointments and call/recall services to discuss the vaccination. Always offer advice and answer questions about vaccinations, and if you are not aware of the answer make it clear you will go and find the correct information for them and advise them of the answer as soon as possible.