Lady receiving a vaccination at home

My 6-year-old son recently asked me 'What do you most enjoy about work?', which I thought was quite an insightful question to ask. My answer was, 'I really enjoy being a part of something that helps keep people healthy'.  Clearly, this didn't inspire him to ask any further questions as he went on to tell me about his favourite Christmas present (a lockable money tin)! It did, however, inspire me to reflect on our journey over the last 12 months and what the future holds for the Immunisation Management Service.


Back in July 2021, I wrote an article reflecting on the challenges we faced in the first half of the year and how we, as the Immunisation Management Service (IMS), invited the nation as part of the drive to encourage uptake of the COVID-19 vaccination 1st and 2nd doses. 

Fast forward six months and we have evolved our service to meet the needs of the booster rollout and, in what seems a blink of the eye, a whole year has now passed since the first vaccine was administered in December 2020, and since we sent out the first invites to encourage people to take up the offer of a vaccine in January 2021. 

And within this 12-month period, a staggering 110 million doses were delivered into the arms of the nation. Truly astonishing. 

I concluded my blog with a look ahead, which I'm happy to say was largely accurate, except for the words - '…a smoother journey'. Wishful thinking!

Commencing the next chapter, not smooth yet…

It fills me with pride that my team and I are one of the (now well-oiled) cogs within the overall COVID-19 vaccine deployment programme. And witnessing all my team, partners and all those involved with this historic programme step up to the plate (again), in support of the booster acceleration, is a truly remarkable feat.

As we entered summer 2021, the concept of maturing our processes and ways of working was not unique in terms of how we manage and deliver the portfolio of system feature changes and streamlining the invite service model. However, it was one that gave a level of confidence and assurance that we could respond to the likely demands of the booster programme that lay ahead of us. 

What we didn't anticipate, however, was the pace and surge of change, which felt like a huge tsunami at times. This was two-fold.  Firstly, the high rate at which system and service changes were needed to support the revised second dose and booster interval rules e.g. 6-month dose interval gap down to 3 months. Secondly, the acceleration of invites and citizen eligibility-setting of the cohort groups because of the new Omicron variant.  

Once again, our team had a lot of help here – working with our trusted partners – System C & Graphnet who provide and support the backbone platform to the service, and Synertec who provide the hybrid mailer service.  

Emotional intelligence - a skill worth honing

Not only has this programme been ‘unprecedented’ by anyone’s standards, but it has also required unprecedented levels of resilience, mental strength, and recognition that we're all in it together and rowing in the same boat. 

In high-pressured environments, such as this programme, even the tiniest of cracks in the hull would lead to a sinking ship, and by that, I mean conflict between colleagues, which leads to tension and things not getting done. 

But more importantly, it leads to emotional distress that has a significant impact on the health and wellbeing of those involved. This has been undoubtedly the toughest part of my job, where I've had to draw on my emotional intelligence skills to listen and understand different people’s viewpoints. To empathise and defuse conflict, and then manage my own emotions in positive ways to relieve stress. 

This is to the point now where I actively monitor the work environment, evaluate, and predict where conflict may occur both internally and externally with stakeholders. Then prior to it happening, I just have a conversation with those involved to manage expectations. And typically it's about talking openly through the opposing views and reasons why they exist, or just simply playing devil’s advocate. Emotional intelligence is a very important leadership skill to have and has been something I’ve learned and developed over the course of my career. I highly recommend you take a delve into the topic area. 

Marginal gains lead to significant improvements

I tend not to sit still and have a belief that change is constant, which is why I continually strive for improvement and better ways of working. Those who work with me will often hear me say 'just because you've always done it that way, doesn't mean it's right', and I think it's quite dangerous for teams or organisations to remain static, as those around you will innovate, improve, and move on. 

One of the reasons for this is that if you're not prepared to change, then you'll struggle to improve efficiency and effectiveness. Therefore, it has been so important to mature our processes and tools, but equally, evolve them to meet the changing demands of the COVID-19 vaccination programme.

On reflection, what we've been doing is introducing small incremental improvements to some of our processes e.g. fine-tuning the implementation steps to get a change live on our systems, so that all parties are clear on who or what is required to be performed and when. 

The challenge has been to not get lost in the detail at a particular time and take those impacted on the business change journey, so they've signed up to the new way of working. The key point being that small improvements amount to a significant improvement when they are all added together. 

All in all, upon looking back, it's been major progress.

What does the future hold for IMS? 

As we start 2022, we've still got the important role of providing our systems and services to continue to drive uptake of the Booster programme, and beyond that, we'll support whatever COVID-19 throws at us next. 

But as we look wider and further ahead, my vision is around the provision of an enduring service that protects the population: supporting immunisations, screening, and non-screening national services.

The Hedgehog Concept

I'm really passionate about what we do, we're really good at what we do, and our IMS service also drives our economic engine. 

These three important elements are the main ingredients from what Jim Collins calls the ‘Hedgehog Concept’, taken from his book ‘Good to Great’. He states that successful organisations translate their understanding into a simple, crystalline concept surrounding these core elements – a single defining idea. In the case of the hedgehog, to protect itself, rather than adopting multiple small strategies, it has one big idea - it rolls itself into a prickly ball. 

Or in a simpler way, in the famous essay ‘The Hedgehog and the Fox’, Isaiah Berlin divided the world into hedgehogs and foxes, based upon an ancient Greek parable 'The fox knows many things, but the hedgehog knows one big thing'.  And that’s us. If you’re interested in growth and improvement, Jim Collins is worth looking up.

To that end, I've now commissioned a piece of work within SCW, to look at how we can support future population health needs across national, ICS and regional levels. This is an exciting piece of work that will have citizens at the heart of the service, be exceptional value for taxpayers’ money and be one that neatly aligns with the vision of NHS England & Improvement and SCW.

For more information about the national Immunisation Management Service or to talk about the future of immunisation services This email address is being protected from spambots. You need JavaScript enabled to view it..

Operations Director, Immunisation Management Service

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