Nursing staff have once again been urged to ensure they are vaccinated against influenza, while one of England’s most senior doctors has suggested that immunisation should be compulsory in future.
The latest focus on vaccination among NHS staff follows a surge last week in cases presenting in primary care and admissions to hospital for flu and other respiratory diseases – adding to the pressures already being felt by the system due to staff and bed shortages.
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The chief nursing officer for England, Professor Jane Cummings, and other clinical leaders have written a letter urging all NHS staff themselves to get vaccinated “as soon as possible” to reduce the spread of flu.
“We should have a measured debate about making this the norm for doctors and nurses before next winter”
Regulators have also written to trusts with the lowest staff uptake of flu vaccination to encourage them to redouble their efforts, according to letter sent yesterday from NHS leaders in England.
The letter, which follows up on an earlier correspondence and announcements on this year’s immunisation policy, reminds healthcare workers of the key role they play “in protecting the health of the public” and states their “shared professional responsibility” to protect patients.
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As well as the CNO, it is signed by chief medical officer Professor Dame Sally Davies and the medical directors of NHS England and Public Health England – Sir Bruce Keogh and Professor Paul Cosford.
They noted that latest data showed 59.3% of frontline health workers were vaccinated by 30 November, compared to 55.6% at the same period last year, with over 80% in some trusts.
“We can certainly say that last week flu in England took off, crossing the medium threshold”
Simon de Lusignan
While they “congratulated” some trusts on the increase, they highlighted that “significant variation” remained, with as little as 20% vaccination uptake in other organisations.
“It is not too late to get vaccinated and make a difference so NHS Improvement will be contacting the chief executives of the 20 lowest performing trusts,” stated the letter. “As you will be aware from your daily practice, the NHS is under considerable pressure this winter.
“Substantial levels of seasonal influenza have placed further strain on primary and secondary care, and hospitalisations and intensive care admissions have increased,” noted the letter addressed to NHS professionals.
It highlighted that this year three strains of circulating flu virus had generally been identified – named as influenza A/H1N1, influenza A/H3N2 and influenza B of the Yamagata lineage.
“All appear well matched against the quadrivalent vaccine and both the influenza A strains appear well matched against the trivalent vaccines in use this season,” it stated.
But commenting separately to the letter, Sir Bruce indicated that he thought the flu jab should be compulsory for NHS staff – reigniting a debate that surfaces almost every winter.
“We should have a measured debate about making this the norm for doctors, nurses and other frontline NHS staff before next winter,” he said in a statement published on the Department of Health website.
In response, Unison head of health Sara Gorton said: “The NHS flu fighter campaign, which encourages NHS and social care staff to have the flu jab, is a very positive initiative.
“But some people are allergic to the vaccine and shouldn’t be forced to have it,” she said. “Making it mandatory could also be counter-productive, potentially tying employers up in legal wrangles and further damaging already fragile staff morale.”
On Thursday, Public Health England published data showing that seasonal flu levels have continued to increase during last week – ending on 7 January – across the UK.
Over last week, it said there was a 78% rise in the GP consultation rate with flu like illness, a 50% increase in the flu hospitalisation rate, and a 65% increase in the flu intensive care admission rate.
“Making it mandatory could also be counter-productive, potentially tying employers up in legal wrangles”
Statistics also showed an 86% increase in people newly admitted to intensive care with confirmed influenza from the previous week – 114 compared to 61 the week before – Public Health England said in its Weekly National Influenza Report.
In addition, there was a three-fold increase in the rate of people admitted to hospital with confirmed flu since the previous week – 6.8 per 100,000 compared to 2.33 per 100,000 before.
Meanwhile, according to latest figures from the Royal College of General Practitioners’ Research and Surveillance Centre, flu affected nearly 22,000 patients in general practice in the first week of 2018.
In total, an estimated 21,736 patients presented with influenza-like illness in the first week of the year – an increase of 9,499 since the last week of 2017 and almost double the 10,955 that presented during the same week last year.
The latest weekly report (see PDF attached below), which looks at patient data from GP surgeries across England, also shows a rise in presentations of the common cold, acute bronchitis, respiratory system diseases and asthma.
- Acute bronchitis: increased from 116.9 to 146.6 per 100,000 population
- Asthma: increased from 13.3 to 16.2 per 100,000 population
- Common cold: increased from 116.5 to 142.6 per 100,000 population
- Influenza-like illness: increased from 21.0 to 37.3 per 100,000 population
- Respiratory system diseases: increased from 355.3 to 463.2 per 100,000 population
Professor Simon de Lusignan, the surveillance centre’s medical director, said: “We can certainly say that last week flu in England took off, crossing the medium threshold.
“However, given how unpredictable flu can be, it is impossible to speculate how this will progress moving forward – rates may increase further, they may level out or even decline,” he said.
Professor Helen Stokes-Lampard, chair of the Royal College of GPs, added: “Things are incredibly busy, and demand is increasing – not just with flu but other common winter illnesses as well.
“GPs and our teams are working extremely hard as these pressures intensify, as are our colleagues right across the NHS,” she said. “Practices have put measures in place to cope.”
Saffron Cordery, director of policy and strategy at NHS Providers, said the new figures confirmed that a rise in respiratory illness was “adding to the exceptional pressures we are seeing this winter”.
“When the system is already running at or beyond full stretch – as we are seeing now – it does not take much to put resilience under severe strain,” said Ms Cordery.
“It is clear that under the current funding constraints the NHS cannot deliver what is expected of it,” she said. “We need urgent steps to secure the long term sustainable funding of health and social care.”
Likewise, latest figures from Scotland showed the number of people suffering from flu-like illnesses more than doubled in the first week of 2018 compared to the previous week. It was also four times higher than the same week in 2017.
“Staff up and down the country are doing a remarkable job”
Health Protection Scotland’s latest report showed 107 people per 100,000 of the Scottish population were diagnosed in the week ending 7 January, up from 46 per 100,000 on the last week of 2017.
Scottish health secretary Shona Robison said: “The complexity of treating flu, including appropriate diagnosis and segregation to avoid cross-contamination, is putting our health system under significant pressure.
“Staff up and down the country are doing a remarkable job, and I am continuing to visit hospitals around the country to thank them personally for their hard work and dedication,” she added.
It has also been reported by the BBC and other national media that an 18-year-old woman has died after catching the flu virus. Bethany Walker, from Wester Ross, had been suffering with flu at home before it developed into pneumonia. She was airlifted to Raigmore Hospital in Inverness where she died last Friday.