Exec Summary: A Population Health approach to Flu 2021

White Paper: Population Health approach to Flu 2021

?Seasonal influenza (flu) is an unpredictable but recurring pressure that the NHS faces every winter.

Except in unprecedented times of COVID.

In an ‘average’ year c.11,000 people die of flu, in comparison in a week in January 2021 when there was 1 person in ITU with Flu.

2020 has been no average winter and social distancing and mask wearing has almost eliminated flu, but not forever. It is estimated winter 2021 could be worse than average (additional 50%) for Flu in England, and with no natural immunity in the population from the previous year the number of people becoming ill with flu will be higher, with the planned relaxation of COVID measures respiratory diseases are expected to rise sharply over the autumn and winter months. ?

It remains true, a person can simulations have both Flu and COVID at the same time, this will be a disaster for the person and the healthcare system as all Lockdown restrictions end. ?

Vaccination offers the best protection against flu; in this paper I outline my thoughts how England can prepare during summer for the 2021 flu season.

Summary

·????????Capitalise on the expertise of staff from COVID and in the greater knowledge the population has of vaccine. Primary care delivery of the COVID vaccine at PCN (neighbourhood level) has been exceptional over the past year, use the learning to continue to reach those at risk.

·????????Acknowledge the past year and consider staff wellbeing and fatigue (Burnout). Mass vaccination has been continuous since September 2020. ?

·????????Capitalise, and reuse, COVID tooling analytics to focus on the combined Flu and COVID vaccines to reach those most at risk. ?

·????????Use Population Health and Integrated System delivery approaches to make every contact count (MECC).

·????????Create opportunities for staff to make every contract count for those with long term conditions; surface gaps in their care and discuss 1 key metric that can completed during an immunisation appointment (i.e., 30-90 seconds | Blood Pressure and brief advice, smoking cessation).

·????????Show progression through the season of those eligible and received vaccine, against modelled system utilisation to drive equity in the vaccine and ensure those most at risk and historically underserved are proactively reached. ??

·????????Support strategic monitoring and commissioning across the Health Network (wider connected health and care system).

·????????Support payment reform modelling for integrated care system whose focus is on outcomes.?

·????????Allow people see their own immunisation status through patient portals / apps. ?

·????????Promote immunisation across acute clinical pathways including all maternal pathways.

·????????Include data science as a service for analysis of increased acuity / complexity / deterioration / risk.

·????????Engage directly with people through outreach to ensure sustained reach and vaccination coverage via media that they will / already engage with, social media, radio, SMS.

·????????Use alternative local routes to vaccine, retail (e.g. ASDA, Tesco) and community pharmacy, drug and alcohol services, homeless services, chamber of commerce to promote employer paid vaccination. ??

MECC Opportunity Size for England

·????????Eligible Population 2021: est. 36.4m (c.64% of total population)

·????????Eligible Population Stage1 Flu and COVID booster 2021: est.15m (c.43% of total population)

·????????Opportunity reduction in hospitalisations from flu ￡71m

·????????ROI of total Influenza vaccination programme to wider health economy: ￡361m

·????????Implementing a Making Every Contact Count (MECC) approach with Influenza Vaccination programme for the eligible population:

o??ROI of Smoking cessation: ￡8.9m (￡1.77:1)

o??ROI of alcohol services: ￡1.2m (￡1.51:1)

o??ROI of hypertension / high blood pressure control: ￡26.5m (￡5.10:1)

o??ROI Hospital-based postpartum influenza: ￡26,000

·????????The median ROI of a public health intervention is 14:1

Guidance on 2021 flu programme in England:

https://www.gov.uk/government/publications/national-flu-immunisation-programme-plan/national-flu-immunisation-programme-2021-to-2022-letter#fn:1