Local government: Vaccine data so far too limited to track inequalities

Sir Simon Stevens told MPs at a select committee hearing this week that the NHS is sharing local data on uptake with directors of public health. However, public health directors have told HSJ they are not getting enough granularity to help ensure equal access to the vaccine.

Association of Directors of Public Health vice president and DPH for Hertfordshire Jim McManus said: “We recognise the data is a work in progress, but we don’t yet have it in sufficient granularity, especially not yet on ethnicity, to be able to meaningfully monitor inequalities in uptake and access.

“Some of our members have also had conflicting instructions about who they can share this data with. We need data to be timely, accurate, granular and able to be shared so we can all play our part in supporting the NHS with making sure their fantastic work on the vaccine reaches everyone.”

Mr McManus added: “We call on NHS England to work with directors of public health urgently to get the data to be the best it can be.”

The covid pandemic has put health inequalities under renewed scrutiny, with disproportionately more deaths among Black, Asian and minority ethnic communities and in the most deprived areas.

It has been widely recognised vaccine rollout must take into account these issues, with local rollout programmes told to ensure equitable access to the jab in their vaccination strategies.

Public health directors have so far received local authority-level counts of the number of people vaccinated, broken down by age cohorts and by ethnicity at the lower tier local authority level, which cover a district or borough council. 

While local public health officials have welcomed what data has been made available to them, they also expressed frustration at the slow progress, with local government continuing to push the NHS to provide more data after weeks of discussions. HSJ understands they have been promised individual patient-level data from the NHS, but there is no clear timeline for providing this. 

There is also confusion around data sharing, with one DPH telling HSJ they were allowed to share the data with colleagues in local government but not with local NHS organisations.

The reliability of the ethnicity data currently on offer has also been questioned, as this has not been routinely recorded in the Pinnacle IT system used for the vaccine rollout. It can be drawn from GP patient records, but ethnicity data is thought to be recorded in only 60 to 70 per cent of these. NHSE has now agreed to routinely collect ethnicity data when people get their covid vaccination.

An NHSE spokesman said the directors of public health were wrong because they “ regularly receive up to date information which provides granular local detail on vaccine uptake down to very small areas averaging just 8,300 people within their local authority areas, while protecting patient confidentiality and anonymity”. He added: “Furthermore the chief executive of Southwark Council is embedded within the vaccine programme to lead work with local authorities as they engage with their diverse communities and faith groups to promote vaccine acceptance from everyone in the priority groups who are being offered the vaccine equally.”

Updated at 4.15pm with NHSE’s statement.