OP61 Reaching disadvantaged groups to increase the uptake of the COVID-19 vaccination: the experiences of Local Authority Public Health Teams

Background

Local Authority Public Health Teams (LAPHT) were crucial to the Covid-19 vaccination programme. Although the vaccine was delivered by NHS staff, LAPHT endeavoured to increase uptake in disadvantaged groups, namely those who found it difficult to, or may not routinely, engage with health services. We describe how LAPHT engaged with disadvantaged groups, the collective action taken to improve uptake and the challenges they encountered.

Methods

This was a qualitative study using semi-structured interviews conducted on-line. The target population was Directors of Public Health or their representative. Data were analysed using a thematic approach (Braun and Clarke 2006).

Results

28 DsPH/representatives from 21 English LAPHT were interviewed between July 2021 and March 2022. Overwhelmingly interviewees believed in a grassroots approach to improving vaccination uptake particularly in disadvantaged groups. LAPHT could improve access to the vaccination but a lack of trust in the vaccine, local and central government and the NHS required honest and frequent engagement with communities. To facilitate this engagement LAPHT utilised community connections through local authority service leads/development officers and link workers of commissioned services, for example with homeless people and gypsy and traveller communities. Due to local authority cutbacks over the years, some had lost these links. Other links were primarily through community and faith leaders and the voluntary sector. A few local authorities had existing relationships with these, but the majority had to engage with new ones. Community links enabled a two-way process of learning about, and addressing, current concerns about the vaccine. Through these, LAPHT could seek advice as to how and where to focus their efforts to improve uptake, identify the ‘trusted voices’ and Covid-19 Champions who would promote the vaccine, and those who would translate and tailor resources to the needs of their communities. The challenges included adapting ways of working to meet the needs of the community leaders; engaging communities who were geographically dispersed and/or with no clear faith or community leader; and placing trust in groups in their translation of messages and materials.

Conclusion

The need for collective action in response to the pandemic had broken down barriers between LAPHT and communities. There was a strong desire from LAPHT to build upon and maintain these relationships, to address health inequalities. However, this requires long term investment in local authority and support with specific communities where engagement remains a challenge.