Agenda item

Matthew Cole, presented the report and explained that the Public Health Programme Board and its sub-committee the Health Protection Committee had oversight responsibility on the national programme for immunisation and screening and how the screening tests helped to identify those at higher risk of a health problem: which in turn would enable early intervention to reduces mortality, morbidity and the economic cost of life-long treatment and support from health education and social services.

Matthew reminded the Board that further actions to improve performance in Antenatal Newborn Screening Programme at both BHRUT and Barts Health NHS Trust in regards to foetal anomaly, Sickle Cell, Thalassaemia and newborn bloodspot screening, and infant physical examination. 

Matthew pointed out the performance of other non-cancer screening for abdominal aortic aneurysm and diabetic retinopathy were performing well.  However, the uptake of child immunisation at two and five years and the seasonal flu vaccination were still areas that needed to improved performance.  The area that was showing a ‘R.A.G’ red rating was the uptake rates for cancer screening which was below both the London and England average within the last three years.

The Board was surprised to hear that there was a worldwide shortage of BCG vaccinations and UK stocks were almost totally depleted and reminded Public Health England that the duty of candour applied to them also.

NELFT advised that they only had BCG vaccine stocks for a couple of weeks maximum and as there were no further scheduled deliveries of the vaccine they were trying to ascertain when supplies would be forthcoming.  NELFT advised it had suspended accepting new BCG vaccination patients and were only immunising those already booked into the BCG clinics and they would also shortly be suspending the universal neonatal BCG programme.  With no vaccinations at birth or at the clinics being undertaken there would be an increasing backlog of individuals that would need to be followed up. 

Helen Jenner said she was concerned about the loss of ‘herd protection’ levels for children and asked what would happen if there was an Tuberculosis incident in a local school as the protocol currently was to immunise all children in contact within the school.  NELFT advised that they had been told there was a small amount of BCG vaccine held nationally for emergency, but not for a local emergency such as Helen had described.

The Board were very concerned about the lack of BCG vaccination supplies nationally and the number of high risk adults and children who were not being vaccinated.

The Board was also concerned about the need for a proactive plan to urgently obtain BCG vaccination supplies and the apparent failure of the national and London resilience plans in regards to this and any further vaccination supply shortages. 

In response to a question about the Measles outbreak, Public Health England advised that there were 64 confirmed cases across London and these were mainly in young adults.

Cllr Turner raised the issue of early testing in pregnancy for Sickle Cell and was advised that BHRUT expected 49.3% of women to have been tested before 10 weeks gestation.  The Board noted the pathway for testing and other options and that overall testing uptake of those at risk was over 99%.

The Board

(i)  Noted the report;

(ii)  Requested that Health and Social Care Commissioners provide performance updates as part of the Board’s quarterly performance report on the measures being taken to prevent Health Care Associated Infections within both the hospital and community settings.

(iii)  Requested that Public Health England to provide a quarterly performance report on the actions to improve coverage figures for immunisation and antenatal screening, including the sickle cell testing rates for at risk expectant mothers by 10 weeks gestation;

(iv)  Requested that the NHS agreed clear arrangements to manage babies moving into the area without full newborn screening;

(v)  Requested NHS England provide details to the Strategic Director, Service Development and Integration, within seven working days, of a proactive plan to urgently obtain BCG vaccination supplies and details of the national and London resilience plans in regards to this and any further vaccination supply shortages;

(vi)  Reminded partners that Breast Screening provision locally had been raised previously and still need to be included.