In recent years, the efficiency of the UK winter flu vaccine campaign has come under scrutiny. As the eligibility criteria increases, questions are being asked about whether the infrastructure is in place to deliver the rollout in the time constraints set by the government. While most questions tend to focus on staffing capabilities, the NHS supply chain is a critical part of implementing a fair and effective rollout.
This is particularly true of 2023, where the government announced that they would be bringing forward the Autumn rollout to 11th September with only two weeks' notice. In order to deliver this, the NHS would have to have an immensely robust supply chain to manage the distribution of the vaccines across the country. Unfortunately, the analysis shows that this is not the case right now.
So how can we determine how likely meeting the deadlines will be? Here at 7bridges, we asked that exact question in 2023. Using the 7bridges platform to create AI modelling, we mapped how long it would take the GP surgeries in the UK to administer vaccines and whether they would meet the government's very tight deadlines. We also looked at whether certain areas were at greater risk of not administering the vaccines in time, building on what we found in 2022.
Methodology
Our analysis is based on modelling using publicly available data on patient eligibility and UK demography. The model accounts for expected vaccine uptake based on the latest NHS data, expected uptake in the private market (e.g., pharmacies or other commercial avenues for which individuals can purchase vaccines) and the administering of vaccines in schools and care homes. We then mapped areas of high eligibility with the provision of NHS services that administer vaccines to identify high risk areas.
Utilising publicly available data on patient eligibility and UK demography, the 7bridges’ platform modelled the expected vaccine uptake based on the latest NHS data, expected uptake in the private market (e.g., pharmacies or other commercial avenues for which individuals can purchase vaccines) and the administering of vaccines in schools and care homes. We then mapped areas of high eligibility with the provision of NHS services that administer vaccines to identify high risk areas.
2023 key findings
The added pressure of the 31st October deadline made the 2023 analysis especially interesting:
Question 1: Is the supply chain and infrastructure there to administer the vaccines?
First we looked at how long it would take to administer the vaccine to the eligible groups:
- The total number of eligible people is estimated at 28 million (this includes ‘at risk’ people, children aged 2-16 years old and NHS staff)
- The number of working days between the start of the flu vaccine campaign (11th September) and the deadline (31st October) is 41 days
- We then removed 5 million people based on the number that went to pharmacies in 2022 to get their free vaccine
This data means that approximately 562,000 jabs would need to be given every day to meet the deadline. There are 6,523 doctors surgeries in England, which means they would need to be ‘jabbing’ for 14.4 hours per day to meet the target which is equal to 2 full time nurses per surgery running the vaccine campaign.
Conclusion:
Based on this data, the assumption can be made that the government’s target to complete the rollout by 31st October is not feasible with the current NHS infrastructure and supply chain solutions available.
This is further supported by data released on the 22nd October by the NHS. This reports that they have administered 11,756,000 vaccines so far out of the 23 million predicted to be administered. This meant they were just under half way to reaching the target with 9 days to go, which with the deadline now passed was not met..
Question 2: Are certain areas more at risk of longer flu vaccine waiting times? (I.e. do certain areas have a less efficient supply chain and infrastructure than others?)
Looking at the number of eligible people and the number of surgeries nearby to administer their jabs, we found that:
- The area most at risk of delay is the North of England where GP surgeries will be expected to service 38% of all patients, given higher eligibility for jabs
- “High risk” are parts of the Southwest and coastal towns. Over half of GP surgeries (57%) in this region have more than 35% of their patient roster entitled to the flu and Covid-19 jabs
- Other areas identified as at risk include cities such as Exeter, Plymouth, Stoke or Stockport and coastal areas including Bournemouth, Scarborough, Devon & Cornwall
Conclusion:
When you compare this to London, where on average just 20% of patients per surgery are entitled to receive both jabs, the reality facing GP surgeries and NHS vaccine administrators across vulnerable areas becomes clear. Patients in the North could face nearly double the waiting time of those in London. Likewise, patients in the North West and North East could face a 33% higher waiting time than those living in cities like London, Birmingham or even Manchester.
How can the winter flu vaccine rollout be delivered more efficiently?
Thankfully, vaccine supply chains are some of the simplest in the pharma industry as flu vaccines arrive already in syringes and only require being refrigerated rather than stored at exceedingly low temperatures. The flu vaccines are delivered in batches to surgeries across the UK, and by using AI and plotting robust and real-time maps of where demand is highest, the NHS – and other organisations with nationwide supply chains – can ensure they are transforming the way they are on top of complex programmes such as this. The last few years has highlighted just how fragile supply chains are, but technology provides the opportunity to drive better outcomes, improve efficiencies, and in this case, could reduce the risk for those who are vulnerable by ensuring they receive their vaccine in the right time frame.
In addition, as in 2023, setting such an ambitious target with a tight deadline emphasises the need for health services in the UK to be sufficiently agile to accomplish such logistical challenges at a quick turnaround.
2022 key findings
2022’s winter flu vaccine rollout saw 50-65 year olds included in the eligible group, adding approximately another 11 million people to the free pool. In addition, we were facing a ‘twindemic’ of both flu and Covid-19 cases, as seen in Australia over the months prior. This spurred a Government marketing campaign urging millions to get their flu vaccination.
Question 1: Are certain areas more at risk of longer flu vaccine waiting times?
The modelling in 2022 showed that:
- Residents in coastal areas such as Devon, Northumberland and Cornwall may wait up to 33% longer than cities such as London and Manchester to receive their jabs
- North West has the greatest variance when it comes to vaccine requirements. Here, the percentage of registered patients eligible for an NHS jab varies from 17% in some surgeries to 40% in others
Conclusion:
According to the 2021 census, the South West is one of the areas with the greatest proportion of over-65s. Our data reflects this, indicating that the South West is likely to have the highest number of stretched clinics with the ability to administer flu vaccines much lower than expected demand.
In addition, looking at regions with high variance like the North West, it is clear that for future rollouts, they could benefit from sharing supplies between local clinics or encouraging those who are able to to travel to less subscribed surgeries for their jabs.
Read more about the story in:
Sky:
https://news.sky.com/story/the-real-cost-of-a-seasonal-flu-vaccine-with-residents-of-coastal-towns-facing-longest-delays-12741543
Express:
https://www.express.co.uk/news/science/1695078/flu-jab-nhs-influenza-vaccination-jab-wait-delays-demand-supply-england
HT World:
https://www.htworld.co.uk/news/ai-platform-reveals-thousands-at-risk-from-flu-vaccine-holdups/
Pharma Voices:
https://pharmavoices.co.uk/why-robust-supply-chain-operations-are-the-missing-piece-to-deliver-successful-vaccine-roll-outs/
Data Sources:
https://www.gov.uk/government/statistics/seasonal-influenza-vaccine-uptake-in-gp-patients-monthly-data-2022-to-2023
https://digital.nhs.uk/data-and-information/publications/statistical/patients-registered-at-a-gp-practice
https://cpe.org.uk/our-news/new-pharmacy-record-over-5-million-flu-vaccinations-administered/
https://digital.nhs.uk/services/organisation-data-service/export-data-files/csv-downloads/gp-and-gp-practice-related-data