Ageing Well - Health
Vaccination and Screening
Adult Vaccination and Screening
Vaccination
Vaccination is the safest and most effective way to protect the population from vaccine preventable diseases. As well as protecting the individual form these diseases, they are less likely to transmit the infection reducing the risk to unvaccinated people. The result of this is herd immunity. For each vaccine preventable disease, a certain proportion of the population need to be vaccinated to ensure herd immunity.
The adult vaccination programme in the UK covers the Pneumococcal Polysaccharide Vaccine (PPV), Influenza and Shingles. These vaccine programmes offer protection to the older population who are at increased risk.
Screening
Screening is a way of identifying an increased risk of a particular condition in apparently healthy people. There are a range of screening programmes in the UK but this section will consider cancer screening for bowel, breast and cervical cancer. Screening looks for early signs that cancer is developing. This then means that cancer can be picked up at an early stage allowing early interventions that can either stop the cancer developing (such as with cervical cancer) or provide early opportunities for treatment.
Adult Vaccinations & Screening
Hartlepool's flu vaccination coverage for all at risk individuals is 49.9%. This is below the minimum recommended population coverage of 55%, and has been below this level for the entirety of the 8 year data collection period. However, during this same period neither the England or north east regional average has exceeded 55%.
Hartlepool's rate has largely recovered from a fall of 6.8%, from 51.5% to 44.7% in 2015/16, and has risen back up to 49.9% in 2017/18. While the Hartlepool rate continues to be below the optimal population coverage, it is following a very similar pattern to both the national and regional fluctuations.
Focusing in on flu vaccination coverage just for the over 65s, the rate is 71.9, which, whilst higher than for all at risk individuals, is also below the recommended level of population coverage of 75%. Again Hartlepool and England have not achieved the minimum recommended population coverage at any point in the eight year data collection, while the north east region has achieved it only once, in 2011/12.
Across both of these populations, over 65s and at risk individuals, Hartlepool has not achieved the desired population coverage to ensure as resilient a population as possible.
The pneumococcal polysaccharide vaccine (PPV) protects against 23 types of Streptococcus pneumoniae bacterium and since 2003 has been available to anyone aged 65 or over. Since the start of the data collection period in 2010/11, apart from one year of substantial increase, Hartlepool's population coverage for PPV has been in general decline. The coverage rate in 2017/18 is 12.6% lower than it was in 2010/11, and is in fact at the lowest rate in the eight year data period.
In the same period the England average has fallen by only 1% and the north east average by 1.4%. Both England and the north east have remained largely stable during a period where Hartlepool has fallen in large quantities. Hartlepool's current rate is the lowest population coverage for PPV in over 65s, which will have consequences for the health of that population.
Across the 3 reporting period for the Shingles vaccine for the over 70s, Hartlepool have fluctuated by large degrees, though again every year the rate has been below the recommended population coverage rate.
Hartlepool's rate was has varied across the 3 reporting periods, though has reduced by a similar amount across the whole period as both England and the north east. Hartlepool's rate has fallen by 24%. England's rate has fallen by 28.2% and the north east rate has fallen by 26.3%. Hartlepool's population coverage rate for shingles is at its lowest rate across the 3 year reporting period.
Hartlepool’s cancer screening levels for breast, bowel and cervical cancers have differing results. Both breast and cervical cancer screening are on an upward trend, whilst bowel cancer screening has moved very little and has the lowest take up rate of the three. Breast cancer screening is on a two year upward trend, from 72.2% in 2015, the lowest in the 8 year reporting period, up to 74.9% in 2017. This is the highest level since 2011.
Hartlepool is now, for the first time in the reporting period, statistically similar to the England average, which is 75.4%, but is still worse than the north east regional average of 77.1%. Up to 2015 Hartlepool’s rate had fallen to a much greater degree than both England and the north east, though the last two years have seen that reduce, and Hartlepool is now closer to the England and North East rates than ever before.
Cervical cancer screening in Hartlepool is at a similar level to Breast cancer screening, at 73.1%. Also like breast cancer screening, it has closed the gap on England and the north east, surpassing the England average for the last 2 years. In 2010 the gap between Hartlepool and England was 3%, and between Hartlepool and the north east was 5%. By 2017 the gap to England was now 1.1% in Hartlepool’s favour and to the north east was 1.1%.
Across this period both England and the north east have had their screening coverage decrease, by 3.5% and 2.8% respectively, while Hartlepool has increased its coverage by 0.6%. This shows a much greater level of stability than either England or the north east.
Bowel cancer screening in Hartlepool has remained very stable moving only 0.2% across 3 years, from 55.6% to 55.4%.
However across this same period both the England and north east screening rates have increased, though again by small amounts. England has moved from 57.1% to 58.8%, and the north east from 59.4% to 60%. The gap between Hartlepool and England, which was only 1.5% in 2015, has more than doubled by 2017 to 3.4%.
Current Services
- Hartlepool is a member of the Tees Cancer Locality group - a locality multidisciplinary group that meets to ensure good quality cancer services are provided for the populations of Hartlepool, Stockton , South Tees, Hambleton , Richmond and Whitby (CC) areas; within community , social , primary and secondary care settings in conjunction with tertiary centres, voluntary organisations and the Northern Cancer Alliance . The purpose of this group is to oversee implementation of the national cancer strategy across the population areas, with the benefit of sharing knowledge, expertise and resources to benefit local areas to improve patient pathway processes, patient outcomes and experiences. The group advises commissioning organisations on the priorities for resourcing across the whole cancer agenda, this includes screening , prevention, treatment and living beyond cancer.
Data shared in the group helps to inform local plans to achieve performance assurance against national targets.
For example -
In Hartlepool recent data has shown poor screening rates per GP practice - However 6 out of 9 practices do not meet the England rate for both cervical screening and bowel screening in the 60-69 years age group. ( see enclosed tables ) . work to address these rates are part of future intentions.
Future Intentions
- To help improve cervical screening uptake at practice levels and support GP practice staff to increase screening uptake. The ‘No Fear campaign’ is being launched across the region and work is planned to support practices to become no fear sites.
- Work directed from the Bowel cancer Screening Programme Board and Tees Cancer locality Group is supporting setting up a website for information around bowel screen. There is work planned in practices as part of the ‘reduce your risk’ work for bowel screening as part of a Teesside approach to screening.
- Work directed from the Breast screening Programme continues to offer screening and support for breast screening
- As part of the Public Health Strategy for Hartlepool the future intention is to support more companies to become involved with the Better Health at Work award (BHAWA). This will encourage employees to access health information, be more informed and access screening initiatives provided in the workplace.
