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How we developed and implemented an e-Consent process to our immunisation programme

Now more than ever, it is essential that we are able to provide an efficient immunisation programme, one that is effective and allows us to vaccinate over 100,000 children every year.

In the current climate we’re living in, effective immunisation is incredibly important in keeping our population safe. If you’re at a higher risk from coronavirus, you’re also more likely to suffer complications from flu. If you were to fall ill with both at the same time, it’s possible to become seriously ill.

Vaccinating against the flu helps to reduce pressure on the NHS, which is especially important now as we battle the peak of Covid-19. In 2019, our uptake figures for our flu vaccination programme were as follows:

  • Bath and North East Somerset – 66.9%
  • Wiltshire – 65.9%
  • Swindon – 60%
  • Devon – 66.1%
  • Plymouth – 58.5%
  • Torbay – 56.7%

In 2018, we began working in partnership with RIVIAM, a digital immunisations consent service, with the aim of transforming the way that we give children important vaccinations, improving patient care, saving the NHS money and reducing risks.

By introducing e-Consent into our immunisation programme, not only are we speeding up the process, making it easier for both school nurses and parents, but we are ensuring that we can vaccinate all children that we are commissioned to do so, in the short window of October to December each year.

Virgin Care
Virgin Care

The Challenge

Immunising children not only prevents young people from becoming ill, but also prevents them from spreading it to their friends and families.

Although targeting key workers, the elderly and the vulnerable is the initial focus with the rollout of the Covid-19 vaccine, mass vaccinations in schools will be necessary to protect both the children of our country and the older generation.

Prior to RIVIAM e-Consent, the immunisation process was time-consuming.

Currently, we are responsible for delivering vaccinations to children in Bath and North East Somerset, Swindon and Devon.

Our first year of flu delivery for children in 2018 was entirely paper-based, meaning that 12,000 consent forms had to be printed, attached to a letter and a leaflet, and then hand delivered as sending by post was too expensive. Printing of the forms alone was £15,000.

With only a short window to vaccinate every year (October to December), this was a waste of precious time and resources. Forms were filled out improperly, when vaccinations were complete, the results had to be hand-written on the forms. Incorrect consent is simply something our teams do not have time for.

Over the following year our flu immunisation programme grew exponentially. We started with just Wiltshire and 2 year groups, we now have 6 contracts and 8 year groups, taking us from 12,000 vaccinations to 100,000, with still just a 2 month window for completion.

The process was becoming increasingly inefficient, with too much time being spent on admin, and some staff working overtime just to ensure we completed the programme.

The Solution

The immunisation programme needed to be adapted so that it was flexible and reliable.

The clear solution was an electronic consent programme to make the process less stressful and much more efficient and cost effective.

We identified RIVIAM Digital Care as a provider, their services would allow us to co-ordinate a digital, completely paper-free immunisation programme which would improve uptake and create efficiencies.

The e-Consent system was designed within 3 months and had a 2 phase approach. The first year in 2018 focused on sending out consent electronically so that we could triage online and go into schools with spreadsheets of consent at the ready. The second stage, which we are currently in, is the development of the e-Consent app. Information goes in, gets triaged, a closing date for each school can be assigned and consent forms can be accessed anywhere at any time.

With the app, immunisations nurses have secure access to clinic lists of children with their consents and triage history on their device.

When the app is online, it automatically updates the vaccination outcomes in RIVIAM. When RIVIAM is connected to our clinical system, SystmOne™, outcomes are recorded and updated in real time.

RIVIAM e-Consent also ensures clearer governance and accountability, therefore avoiding lost or incomplete forms and costly recalls to schools.

The Difference

During the immunisation programme in 2020, we had 98,000 consent forms for Devon and 90,000 for Wiltshire.

Due to our e-Consent service, we have been commissioned to vaccinate increased numbers of children and deliver effectively on the contract. Because of this programme, we are the only provider in south west that is continuing to provide this service in schools.

We are able to vaccinate up to 2000 children a day with RIVIAM. With the numbers of immunisations on our contract rising by the year, without e-Consent it would be difficult to deliver. We have also reduced nurse triaging by 94%.

“Using RIVIAM has enabled us to reduce the amount of time our team spends triaging consents by over 90%. This is a significant saving that we can reinvest in our immunisations service.

“The new app brings further efficiencies because it updates the child’s clinical record as soon as the vaccination is given,” said Charlotte Forward, Professional Lead 5-19 Public Health Nursing & School Age Immunisations, Virgin Care.

The programme has also been highly rated by service users.

During 2019’s vaccination programme for ‘flu, more than 9 in 10 (98%) said they would recommend the service, with one saying: “it was easy to book, [ran] on time, the nurse was very good with the children…”

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