New ways of working that local NHS chiefs were forced to find during the pandemic to overcome mistrust in medics from some communities will be used to help tackle major health inequalities. The Covid mass vaccination programme has seen 2.3 million doses administered to residents in Bristol, North Somerset and South Gloucestershire (BNSSG), including 38,000 in outreach clinics targeting people with traditionally poor access to services.
But much of this success only happened after the region’s health bosses made the “shocking” discovery that trust in doctors and nurses among some groups is very low, so they came up with innovative methods to “get jabs in arms”, a health board heard. One main tactic involved handing control to community leaders to persuade neighbours to get vaccinated, and now this could be adopted to target disparities in other areas of health, including the heart, mental wellbeing and services for pregnant women and new mums.
Existing projects focusing on a single goal will be brought together to support individuals, families and communities, a meeting of BNSSG Integrated Care Board (ICB) was told on Thursday. Covid-19 vaccination programme lead Clare Armour said: “There is a lot of learning in terms of our approach, our culture and how we ran the programme that could be captured and used for the future.
“We knew we had to get jabs in arms as fast as possible without leaving anyone behind – everything we did was focused on that single goal. We adjusted our programme to meet local needs.
“What is really at the heart of this is the real need to build trust with our communities, and the way we start to build that trust is to work with those groups and community leaders because they are the messengers, they are the people who are trusted by the local communities.” She said the first outreach clinic was at a Bristol mosque where its leaders told the health team to leave everything to them except the vaccinations.
“That was really scary because it wasn’t our natural way of working, but we did and within 24 hours they had booked 400 people and had a waiting list,” Ms Armour said. “That learning about handing control and power over to a community really drove our whole approach.
“In some communities, vaccination is not popular, so it was really important we wrapped vaccination up with other services that did matter to people and that we genuinely listened and understood what was happening to people in their lives.” BNSSG chief nurse Anne Morris told the meeting: “We don’t want this learning to be lost.
“This is about communities and what they need. We know what might work in Bristol won’t necessarily work in South Gloucestershire.
“We did some insight work with one community and what we found was their lack of trust in the health service, which I found quite disturbing as a nurse. They do not trust GPs, they do not trust nurses, they trust community volunteers.
“That came across really strongly and it’s really shocking.” She said the pandemic taught them new ways of doing things that had continued and would be used to tackle other health inequalities.
The ICB – which replaced the CCG in July – is about to roll out coronavirus booster jabs to the first eligible cohorts and is urging people to take up the offer. BNSSG clinical director for the vaccination programme Dr Geeta Iyer said after the meeting: “Vaccination works, and I strongly encourage everyone who is eligible for a seasonal covid-19 booster or flu vaccine this autumn to take up the offer.
“It will help protect them and their loved ones over the winter months. I’d also like to remind everyone that it’s not too late to come forward for any of your Covid vaccines, including first, second or first booster doses.
“We understand some people will take longer to choose whether or not to have the vaccine and they are very welcome at any of our clinics. Information about all the ways you can have your Covid vaccinations in our area can be found at www.grabajab.net”
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