Chief Executive’s Message – Friday 12 March
March 12, 2021
Hello, colleagues
With mass Covid-19 vaccination efforts underway so successfully in the UK, we need to understand and redress the disparities in its uptake. Data to 14 February 2021 show that over 90% of adults in Britain have received or would be likely to accept the Covid-19 vaccine if offered. However, surveys have indicated much greater vaccine hesitancy among people from some ethnic minorities. In a UK survey in December 2020, vaccine hesitancy was highest among black, Bangladeshi, and Pakistani populations compared with people from a white ethnic background.
Even more worryingly, data up to 15 January 2021 show substantially lower rates of Covid-19 vaccinations among over 80s in ethnic minority (white people 42.5%, black people 20.5%) and deprived communities (least deprived 44.7%, most deprived 37.9%) in England. More immediately of relevance to us is data from many NHS Trusts show lower Covid-19 vaccination rates among ethnic minority healthcare workers (70.9% in white staff v 58.5% in South Asian and 36.8% in black colleagues in recent research). We are still validating and checking our data at SWBT, but we believe that our vaccination rates in black and Asian colleagues may be even lower than this.
This has serious implications, particularly given the populations we serve and the makeup of our staff in this Trust. The pandemic continues to have a disproportionate effect on people from ethnic minorities, with higher Covid-19 morbidity and mortality and greater adverse socioeconomic consequences. Without an effective vaccination strategy to mitigate the risks, the situation will worsen. The differential uptake will surely further exacerbate pre-existing health inequalities and marginalisation of ethnic minority groups.
Vaccine hesitancy, characterised by uncertainty and ambivalence about vaccination, is a legitimate viewpoint, underscoring the failure or lack of effective public health messaging. It should not and will not be dismissed in our organisation as a viewpoint based on being an “anti-vaxxer” or a conspiracy theorist. Nor will we attempt to tackle this by “busting myths”. We will NOT be making the COVID vaccine mandatory in this Trust. Whether white, middle aged, middle class people like me like it or not, there are genuinely held concerns and reservations about vaccination and we won’t tackle them by dismissing them.
The most common reasons for hesitancy are concerns about side effects and the long term effects on health, and lack of trust in vaccines. Trust is eroded by previous unethical healthcare research in black populations, under-representation of minorities in health research and vaccine trials and negative experiences of our healthcare system.
Trust can and will be established by funding and supporting community and primary care led vaccination efforts, as GPs are likely to be more trusted by the communities they serve because of relationships built over time. Engaging community groups, champions, and faith leaders, and resourcing targeted, culturally sensitive interventions should also help reduce vaccine hesitancy and we are doing this. For example, managing doubts regarding the religious acceptability of vaccines will require consistent non-stigmatising messages in targeted populations, co-designed, shared, and endorsed by people within the community, particularly health professionals. This is where we can all play our part in the wider effort. We have been prioritising high risk staff for vaccination and many of those colleagues are from minority communities. We recognise they can play a key part in tackling vaccine hesitancy. But we know those colleagues can only do this if their own vaccine hesitancy is tackled.
If you are a colleague who is hesitant about the COVID vaccine, please do make contact with colleagues of a similar background to you, who have had the jab. Discuss and explore how they were convinced it was the right thing to do. If you want advice on the science or evidence, for example about its impact on pregnancy or fertility, then there are any number of people who you can ask, including our occupational health team. If you haven’t had the vaccine yet, your line manager will possibly be approaching you to have this conversation. I hope that both people in that conversation explore the issues in a mutually respectful way, our organisational values demand it.
The legitimate concerns and information needs of ethnic minority communities must not be ignored, or worse still, labelled as “irrational” or “conspiracy theories.” We need to engage, listen with respect, communicate effectively, and offer practical support to those who have yet to make up their minds about the vaccine. Covid-19 vaccination is one of the most important public health programmes in the history of the NHS. Tackling vaccine hesitancy and developing immunity in our populations, is a responsibility that all of us can take on.
Earlier today I wrote to all colleagues to thank you for your commitment and dedication to the Trust throughout the pandemic and particularly during this latest wave. Your contribution is valued. My letter is linked here.
Congratulations to our star of the week, Jilly Croasdale. It is particularly apt to recognise Jilly around the time of International Women’s Day. Jilly was nominated for her sterling efforts to ensure supply of radiopharmaceuticals to a cancer centre across the border in Wales enabling their patients to be scanned the following day. Many of you know Jilly well for her commitment to women in science, particularly for the work she does to encourage young people to consider a career in healthcare science. I am delighted that she was selected as star of the week.
Our focus on wellbeing continues and Dr Makwana is once again on the dance floor encouraging us all to get moving with his latest dance 4 wellbeing. Do take the time to view and join in this month’s dance routine either on your own or with your teams. We’d love to see how you are getting on. And this week we marked stop smoking day with a short film about our smoke free sites campaign. This is an initiative that has confounded many NHS Trusts and I am pleased to see how well it is embedded here. The campaign is nominated for a HSJ award on Wednesday evening so good luck to the smoke free team and to our other entries covering sustainability, the alcohol service and Dr Sarb Clare for clinical leader of the year. You can keep up with the announcements by following the HSJ twitter feed @HSJ_Awards so feel free to follow the feed from 5pm and show your support to the teams who have been shortlisted.
Richard Beeken
Interim CEO