1. Commissioning Support for
London – Products and
Services
Michael Wilson, Assistant Director – Prevention and
Wellbeing
February 2010

2. Confidential-3rd February 2010

3. What we are now
Confidential-3rd February 2010

4. Strategic themes
The London Integrated Strategic Plan identified four priority actions
for the next financial year:
Quality Productivity
Putting prevention into practice Acute providers
Improving London’s response to urgent Non-acute providers
care in the community
Prevention, early identification and better
management of those with long-term
conditions
Moving planned care closer to home.
Pathways New care settings
Staying healthy Polysystems
Acute Hospital care, especially implementation of
Long-term conditions major acute hospitals.
Planned care
Confidential-3rd February 2010 3

5. Key products for Public Health
The web based information portal to
support London's NHS Quality
Agenda.
An interactive resource to support
London’s health needs assessment
and health intelligence analysis.
An online suite of tools helping PCTs
make informed commissioning
decisions by showing commissioners
how their providers are performing.
Confidential-3rd February 2010

6. Confidential-3rd February 2010

7. Confidential-3rd February 2010

8. Confidential-3rd February 2010

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Confidential-3rd February 2010
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10. Insight with MMR ‘doubters’ audience
The UCL study found that socio-economic status
influences uptake of MMR, with low uptake in both low and
higher SEG groups.
It recommended further examination of why particular
audiences do or do not vaccinate.
NICE guidance found some evidence that uptake of MMR
has declined at a greater rate among children of more
highly educated parents and among those living in more
affluent areas. This audience accepted other vaccinations
(they were not immunisation ‘rejecters’ as such) but had
specific concerns about MMR. The primary concern driving
their reluctance to accept MMR was the perceived link with
autism.
Confidential-3rd February 2010

11. The imbalance of risk
• This fear was not limited to the ‘Higher SEG Doubters’
• It seems to have permeated all sections of society
The perceived
Risk of measles
(short term)
The perceived
risk of autism
(Long term)
Confidential-3rd February 2010

12. Key differences higher / lower SEG
Higher SEG parents….. Lower SEG parents….
Keeping the MMR under Heard bad things
constant review
Not agonising about it
Interested in up dating their
There must be something to it
knowledge
if all these people think there
Torn between the horns of is.
their dilemma
More comfortable with their
Feel guilty, because they decision
should vaccinate their
Don’t feel guilty
children
More likely to ignore further
And they understood that
communications about it
there were arguments for and
against Did not want to be persuaded
Confidential-3rd February 2010

13. Workshop
What approaches would you implement to increase
uptake of MMR vaccination?
Confidential-3rd February 2010

14. Effective Immunisation and Vaccination
Programmes require:
• Active information management
• Active patient management
• Active performance management
Confidential-3rd February 2010

15. Behaviour Change I
• One size fits all communications / messages are not
effective
• Trust in NHS staff (on this particular issue) is generally
poor amongst higher SEG doubter parents, however they
are not at ease with their decision and are open to re
evaluating it
• ‘Doctor knows best’ approach not successful in changing
their behaviour. Training for Health Care Professionals
(HCP) needed to enter into debate with higher SEG
parents?
• Lower SEG parents have decided not to have vaccination,
influenced by personal networks, not actively concerned
about this decision, but do respect HCPs on this issue
Confidential-3rd February 2010

16. Behaviour Change II
• Are existing interactions with services fully exploiting trust
in NHS staff? Do all staff actively support MMR?
• ‘One in ten’ campaign not a great success, how best to
communicate risk which is motivational whilst remaining
honest and not sensational? Don’t avoid discussing the
autism link as will not be effective.
• LSMU have commissioned discourse analysis; - reviewing
wide range of recent communications inc. invite letters, web
coverage and media to understand the language that is
used to inform future intervention pilots.
Confidential-3rd February 2010

17. The ‘1 in 10’ campaign
Confidential-3rd February 2010