The public health team serving Central Bedfordshire, Bedford Borough and Milton Keynes has set up flexible COVID-19 team that has moved seamlessly from local contact tracing to encouraging local residents to get vaccinated against COVID-19.
The team, as part of the Health Protection Acute COVID-19 Response, has persuaded thousands of people to get vaccinated thanks to a proactive partnership with the local NHS.
Surge of cases prompted re-think
Up until late summer 2021 the public health team had been running a successful local contact tracing team. In fact, it was one of the areas that did not use the national test and trace service at all. Most areas were leaving it to the national team to attempt the first contact, but across Central Bedfordshire, Bedford Borough and Milton Keynes all those who tested positive were contacted by the 20-strong local team.
Senior Health Protection and Public Health Specialist Dr Fatumo Abdillahi said: “It was really working well. The local approach to contact tracing has real strengths. They know the area and are really motivated to get through to people and get full details of all contacts.
“But last summer we saw a surge of cases and we were struggling to get through to all contacts because of the sheer numbers. The value of contact tracing diminishes when that happens so we decided to pause the local contract tracing service and hand it over to the national team. We wanted to focus our efforts on where we could have most impact.”
That led the public health team to focus their efforts on increasing vaccination uptake by phoning those who had not yet had one dose of a COVID-19 vaccine.
Dr Abdillahi said: “We looked at the data and it showed there were 120,000 people in the area who were unvaccinated so we decided that would be a much better use of the team. They were given some extra training, including in having difficult conversations and how to answer questions about the vaccines and within two to three weeks we were putting in our first calls.”
How the most at-risk were prioritised first
Key to the programme – known as the vaccination support service - was a data-sharing agreement with the local CCG so the team could get detailed information and contact details of the unvaccinated. It was decided to prioritise calls with the older age groups rung first, but within the age bands the most deprived areas, which are at the highest risk of severe illness, were targeted first, along with people from ethnic groups that were known to have had more serious outcomes with COVID-19.
Dr Abdillahi said: “We found there were a multitude of reasons why people had not been vaccinated – and being outright against vaccination was a just one factor. Many people had simply not got round to it, so the fact we were able to book them in directly over the phone was a real benefit.
“For others it was needle phobia, while others had questions and were pleased someone had rung them. And we found as we moved down the ages we had to alter our approach. For working-age people we found we had much more success ringing at weekends and in the evenings.”
To support the service, the public health team once again worked with the local CCG. A bespoke talking therapy service was set up to offer those with needle-phobias a three-hour session to encourage them to get a vaccine.
A locum GP was also taken on to answer more detailed questions the team could not answer, while a midwife was on hand for women who were pregnant or breastfeeding and had concerns. “It has given us a real insight into some of the barriers and concerns and that has meant we have been able to set up support to directly address those,” added Dr Abdillahi.
Flexible team ‘invaluable part of COVID-19 fight’
Once the team got to the younger age groups – 39 and under – they reverted to sending personalised letters. Each person received a letter addressed to them and the content was tailored towards their age group. The letter sent out to people under 30, for example, pointed out the benefit of vaccination in terms of going out and socialising and getting away on holiday.
And as we move into a new phase of the COVID-19 pandemic, Dr Abdillahi still sees a vital role for the vaccination support service. In recent months the size of the team has reduced – there are now 10 people involved. But this has meant the council has enough funding left over to keep the team operational for the whole of the 2022-23 financial year. The team also supports other councils nationally in setting up a similar services.
“The team are all on short-term contracts – like many councils when we set up the contact tracing team we used agency staff and as some of those staff have found other jobs and we have not replaced them. But we are keen to keep the service going in a slimmed-down format.
“We have got the spring booster campaign starting and in the autumn there will be another round of COVID-19 vaccinations. Their skills will be needed. But we are also using them for other things – five of them have been helping deal with school, workplace and care home outbreaks. They have become an invaluable part of our COVID-19 response.”
Dr Fatumo Abdillahi, Senior Health Protection and Public Health Specialist, Public health – Central Bedfordshire, Bedford Borough and Milton Keynes: Fatumo.firstname.lastname@example.org