I am very pleased to hear the word ‘herd’ replaced by ‘community. It just fits – I live in a community of people and not a herd. But it also makes me reflect on the system in place for supporting the community achieve their immunity.
The government has also added to this debate by considering immunisation a part of ‘health’, by putting much of the responsibility with Public Health in the Local Authority and not with ‘illness’ in the CCG, although the commissioning will still remain with NHS England through the Area Teams.
There is a problem here with immunisation even thought we have a very advanced national Program. Some areas fail to hit their flu targets. We have significant issues with MMR. And new vaccinations are entering our national program. Nasal flu for the under 2 years, shingles vaccine for aged 70-79, meningitis C to 12-13 year olds and there will be more. So as a community we have lots to do to achieve the community immunity that protects us. the immunisation schedule is getting more complex and is often changing. I do not know how people keep up.
Where do we go to get vaccinated? Well we have to sit in waiting rooms with ill people, blocking appointments. It’s funny that I live in Croydon and am sent to a community pharmacy for my rabies vaccine, but they aren’t commissioned to give me a flu vaccine on the NHS.
So why doesn’t the NHS commission community pharmacy to deliver immunisation services? Well in some areas community pharmacy has been commissioned to deliver flu vaccination to reduce the pressure on general practice, hit more stringent targets and offer patients a choice. But even then my immunisation is divided. I can get my flu, but my child can’t get their MMR at the same time. If I am over 70, I can get my flu, but not my shingles.
It is ridiculous. Most community pharmacies have facilities to administer a vaccine. They can be trained and supported – some are already trained and have hundreds of vaccinations under their belt. You can walk in off the street, ask and be immunised.
So go on Public Health – just do it – create thousands on new immunisation centres across England and make community immunity through community pharmacy a reality.