COVID-19 has been the single greatest public health emergency in the history of the NHS. As well as continuing to provide care for people who needed it, the NHS contributed to the important global effort to develop safe and effective vaccines for the virus and deliver it in hundreds of hospitals, vaccination centres, pharmacies, and care homes across the country.
NHS England and Improvement (NHSE&I) South East was responsible for delivering the programme across the six health and care systems in the region, overseeing local deployment of the novel COVID-19 vaccines to priority cohorts as specified by the Joint Committee for Vaccination and Immunisation (JCVI).
The challenge
The vaccination programme had to be mobilised while there was still a significant strain on NHS resources. Staff were having to manage the main pandemic response while simultaneously recovering non-Covid services to pre-pandemic levels to meet the nation’s wider health needs.
To effectively discharge their regional duties within the programme, NHSE&I South East needed a team of more than 80 people at peak. While much of this capacity was eventually provided by redeploying staff from within the regional team, in the early stages there was a need to bring in capacity and specialist skills from outside. SCW was asked to provide multi-disciplinary support during the mobilisation phase (starting September 2020) and then through the delivery phase (from December 2020 onwards).
Our approach
Initially, SCW assigned a programme director and PMO team to co-design and mobilise the regional programme with senior stakeholders from NHSE&I, the six Integrated Care Systems (ICS) in the South East, and the national vaccination programme team.
Early mobilisation involved substantial networking and relationship building across the six systems, to rapidly form a region-wide programme planning & mobilisation capability. Our role included direct liaison and support to the Hospital Hubs, which were the first vaccination sites to go live, with a strong focus on operational processes and supply chain issues.
The liaison and interaction with the national team was significant – we had to engage closely and frequently with the national team on programme design issues as they evolved, to both inform design decisions and take on board new features of the programme, for example the policy shift to include Primary Care, and adjust mobilisation and delivery plans accordingly.
SCW also played a significant role in workforce and recruitment planning, working with the regional Director for People and Vaccination Workforce Lead to plan and design the recruitment mechanisms and processes.
In addition to the core programme team, SCW brought in other resources from SCW at different stages of the mobilisation phase to support planning and assurance and facilitate delivery of the first vaccines in December 2020. This included the following:
- Demand and Capacity Modelling. For every phase of the COVID vaccination programme, SCW produced innovative, complex, and flexible demand and capacity models. This included week-by-week, site-by-site and PCN-by-PCN analysis for each ICS and for the whole South East region. These models took account of weekly changes to site capacity, population demand and vaccine supply, and, using PCN population travel analysis from SCW’s GIS team (see below), highlighted which sites a PCN’s population could reach in a 15- or 45-minute travel time, should site capacity and vaccine supply allow.
By delivering a model with this level of complexity and flexibility, we enabled the regional programme team and individual ICSs to undertake detailed scenario planning and ‘what if?’ analysis, vaccine allocation planning, and highlighting geographic areas where additional vaccination provision was required to meet the demand of those areas’ population.
The modelling we produced for the South East region was highly praised and well-received by national, regional and ICS vaccination programme stakeholders and, based on feedback, is considered one of the leading models in the country.
- Geospatial mapping services. SCW’s Geospatial Modelling team supported the NHSEI regional team and individual ICSs by creating online mapping tools to facilitate the following activity:
- Site search and site optimisation for all types of vaccination site.
- Travel analysis for all site types – which populations were within a 15- or 45-minute drive time and by other modes of travel including public transport at peak and off-peak times.
- Creation of catchments for individual sites, defining the population demographics for each area served by a vaccination site.
- Mapping health inequalities for different catchment areas.
- Housebound patient routing optimisation.
- Combined geospatial modelling with demand and capacity modelling (see above), and the creation of time series dashboards and further visualisations for programme and system leaders to inform decision making.
Bespoke geospatial solutions were created for specific tasks such as site identification for individual ICSs, which included active workshops working with ICS leaders to shortlist sites and create the optimum combination that best served their area.
The team also provided a geospatial analytics service for the national team on individual projects such as the Gatwick super site, testing unique vaccination centre capacities, and testing the populations they would serve.
All geospatial solutions were created to bring together the wide and disparate datasets, along with derived datasets, so that solutions provided actionable insights and enabled decision making at pace by leaders across the ICSs and Regions.
Our geospatial support for the COVID vaccination programme led to the SCW team winning the ESRI 2021 Customer Success Award for Analytical Insights.
- Estates and facilities management. Supporting the programme to align all regional delivery models (hospital hubs, large vaccination centres, general practice and community pharmacies) with national estates policies and facilitate best in class delivery in terms of citizen access and value for money.
- Site finding for mass vaccination centres where no suitable NHS Property facility was available.
- Site reconnaissance and negotiation of occupation fees, amenity charges and business rates.
- Alignment of occupation agreements with national policy, employing licence agreements rather than leases or tenancies at will.
- Oversight, pre-approval, and monitoring of site set-up works and budgets.
- Alignment of nationally provided equipment and consumables into a working logistics and replenishment delivery model.
- As nationally arranged replenishments were not always aligned to activity levels, resulting in high overstocking, SCW’s estates lead developed a regional equipment collection and mutual aid solution to reduce waste and storage cost.
- Rapid assessment of VFM benchmarks using live data, and in comparison with peers in other regions.
- Analysis of proposed costs and actual reimbursement claims to identify/address variance.
- Site maintenance, operational problem solving and responding to planned relocations, occupation extensions and emergencies.
Additional support
Once the vaccination programme went live, SCW continued to provide the specialist support above as part of the ongoing delivery team. Additionally, we brought in operations management and clinical quality resources to help maintain vaccination performance across the region, including:
Regional Vaccination Operations Cell (RVOC). The role of the RVOC was to identify and resolve operational issues and to coordinate the continual flow of information between local, regional, and national stakeholders so that sites could keep vaccinating at pace. SCW provided a senior operations lead to recruit, train, and direct a team of 24 staff from NHSE&I and SCW to provide this critical function between 08.00-20.00 seven days a week.
Clinical Quality and Safety: Assurance and improvement of safety within the programme by monitoring provider organisations’ management of clinical incidents and investigation of serious incidents. This included reviewing incident safety data, undertaking safety data analysis and the production of patient safety reports (both planned and reactive analysis/reports) related to the investigation process. Additionally, we supported improvement in patient safety by undertaking safety activities such as training, risk assessments, audits and supporting patient safety projects.
The outcome
With an effective blend of internal staff and specialist support from SCW, the NHSE&I South East vaccination programme achieved high take-up rates across all JCVI-prioritised cohorts.
SCW staff remained embedded in the programme throughout 2021 and played a key role in planning for subsequent phases of development, including children’s vaccinations, the winter booster programme, and alignment with the national flu vaccination programme.
SCW has been a great partner for us during this hugely complex and demanding programme. They created value by giving us access to the specialist skills and expertise we needed to complement our in-house team, and by moving people in and out of the programme quickly and seamlessly as our needs changed. The people they assigned to work with us took real ownership of their objectives and often went ‘above and beyond’ to help us meet our programme aims. The result has been a fantastic vaccination programme for the South East region, as evidenced by our high immunisation rates and extremely positive feedback from the populations we serve - Olivia Carmichael, Programme Director, NHS England and Improvement
For more information on the South East vaccination programme contact Ben Krempel, Programme Director
