In 2017 East London NHS Foundation Trust (ELFT) became one of the most improved trusts in the country increasing its uptake among staff of the flu vaccine from 21 per cent the year before to 67 per cent.
More than 3,000 staff were protected (up from 1,000 the previous year!) following an ambitious campaign engaging staff across more than 100 sites ranging from Bedford and Luton to east London.
A survey carried out the previous year showed the extent of the challenge. Staff were cynical about the merits of the flu jab and were sceptical of its relevance, especially in mental health.
The decision was taken to have a bespoke campaign tested with staff that tackled the myths around the vaccine and ensured it was as easy as possible for staff to get the jab.
The previous year’s survey of ELFT staff showed the top three reasons for refusal were:
•The vaccine doesn’t fully protect
•Flu isn’t a serious illness
•Events should take their course
It was decided that the myth busting campaign, which ran for four weeks prior to the vaccinations starting, would relay four key messages:
•All patients are at risk
•Flu is a serious illness
•You’re better protected with the flu jab
•You can’t catch flu from the vaccine
Publicity materials were created and tested with staff focus groups and the theme chosen from four options were striking images of staff as Marvel comic superheroes fighting off the flu bug. It was also clear that the messages which resonated best with staff values were that by getting protected themselves, they could best protect their patients. The campaign slogan chosen was: ‘Protect Don’t Infect’. The Trust also tested other messages, including whether emphasising the potential loss of CQUIN incentive money would work, but these were less well received and therefore only used as a sub-message.
The campaign was launched with a photo shoot featuring the chief executive and Medical and Nurse directors brandishing specially branded umbrellas symbolising protection from the elements. The message was clear that this had buy-in from the top of the Trust and its clinical leads.
Each week, over four weeks, a different theme was used for the myth-buster campaign with posters and flyers sent to all sites, a specially dedicated intranet page featuring frequently asked questions, and a letter was sent to the home of all staff from the chief executive asking for their support. A new story appeared on the staff intranet almost every day including an interview with the chief pharmacist to emphasise that the ‘science behind the jab does work’ and that the main cause of staff illness were colds and flu and the impact that had on colleagues struggling to provide cover. Another story provided evidence that mental health patients were more vulnerable to physical illness and flu could prove fatal.
This was supported with a flyer attached to payslips and the publication on the intranet of clinical evidence from NHS Employers.
Vaccinations began with an intensive two week campaign with clinics at more than 50 sites. This was supplemented with 121 specially identified peer vaccinators available on request in every team. Stories appeared on the intranet and in staff bulletins introducing peer vaccinators to staff so they knew who they were. The peer vaccinators were celebrated for their successes in internal publicity and a thank you tea was held with the chief executive and incentivised with a day off if they jabbed 50 staff. One peer vaccinator jabbed more than 100 staff.
It was made easier for staff to prove they’d received the jab elsewhere, for example at their GP or pharmacist.
On the day text messages were sent to staff business phones informing them of clinics near them. Traditional posters advertising when and where clinics were taking place were put up featuring a mental health patient who’d contracted pneumonia having got flu. His story was also told on the intranet. Reminders were issued in regular staff bulletins and departmental blogs.
Those vaccinated received a sticker and a branded chocolate saying: ‘I’ve Had The Jab’. Branded golf umbrellas were given to staff who’d had the jab at specific milestones and these were publicised. The entire campaign cost less than £10,000; an excellent rate of return for the release of £67,000 of CQUIN monies.
Friendly competition was encouraged with league tables published on the intranet showing how departments were doing and a daily thermometer on the intranet home page illustrating progress towards our target of getting 3,000 staff vaccinated.
Our Twitter campaign #ELFTflu was seen by more than 9,000 people and included a photo wall of staff receiving the vaccination. The chief executive and senior clinical officers were also photographed setting an example by getting the jab.
Buy in from the senior management team was essential. The Trust Board also received regular updates on progress and the communications staff visited most departmental management meetings to encourage all staff to get jabbed.
After initial quick progress , there were still some hard-core resistance. This was tackled through a letter from the Medical Director reminding them of their obligations; individually calling managers to account; and the chief executive reinforcing the message at management meetings.
The entire campaign ran from September 2016 to March 2017. ELFT ensured the Trust’s success was celebrated and those we’d rely on for next year’s campaign, especially the peer vaccinators, were thanked. An extensive survey has already been launched with staff to find out what worked well and what didn’t so we can start already preparing for next winter.
In the meantime, ELFT’s patients are better protected, myths have been busted changing the culture of the organisation to make it easier in future years to encourage staff to be vaccinated and the Trust looks set to realise £660,000 of CQUIN incentive money to invest in frontline services.