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Covid vaccination programme community engagement across Coventry and Warwickshire

Health Care Partners across the system recognised the need to ensure that accurate vaccination information was available to seldom heard groups. Data showed that some groups and individuals were more disadvantaged or subject to the most harm from the pandemic.  It was crucial to reach out to our wider community and make sure that they had the facts available to make their own decisions about the benefits of getting the vaccination.
 
The Integrated Care System partners in Coventry and Warwickshire have been involving local communities and reaching out to seldom heard and vulnerable groups through many channels and approaches. 

All system organisations have collaborated to reach out to over 150 different local community and voluntary organisations, support services, groups and communities. Community groups have been participating confidently in vaccination Q&A sessions that were delivered by a GP/clinician from their culture/background and in their language and the ability to ask direct questions to NHS professionals has helped increase confidence in services across the board beyond the needs of Covid vaccinations and has built further trust in the NHS.

 

Why change was needed

The Integrated Care System partners in Coventry and Warwickshire have been involving local communities and reaching out to seldom heard and vulnerable groups since the outbreak of the global pandemic. In the early stages in 2020, communication of how to keep ourselves safe was of paramount importance. Test and trace soon became a focus and with the availability of two different vaccines in the UK, we began to roll out and deliver a comprehensive vaccination programme. 

Our Equality Impact Assessments highlighted the groups and individuals that may be more disadvantaged or subject to the most harm from the pandemic. Data from previous vaccination programmes showed us that hesitancy was to be expected in some areas of Coventry and Warwickshire and we knew from an early stage that there were concerns and barriers to vaccination acceptance, particularly amongst some of our local community groups. 

We recognised that we needed to make sure all pockets of our wider community had the facts available to make their own decisions about the benefits of getting the vaccination, whilst maintaining respect for cultural differences and an individual’s right to refuse. We knew we had to find many channels and approaches, some not previously well adopted, to ensure we clearly heard local residents’ concerns about the vaccine, communicated facts to dispel myths and to increase vaccine and testing uptake. 

 

What we did 

We were in a fortunate position when the vaccination programme started to rollout in January 2021, we had a wealth of community networks and links already in place and had established links with local people who were already engaged with the work of the NHS and local authorities across the area. 

As a system, outreach work has taken place to engage with people from diverse ethnic groups, including seldom heard and vulnerable groups, to support individuals who are due to receive a vaccine and those who may have questions about the vaccination process. We also wanted to encourage testing and social distancing.

We reached out to community leaders, faith leaders, volunteers and community influencers. We held more than 40 virtual events, online briefings and Q&A sessions and spoke to thousands of people from a range of communities and voluntary organisations in Coventry and Warwickshire. Meetings and events have taken place with NHS clinicians, public health consultants, vaccinators, pharmacists and community representatives, all to address clinical questions and concerns to reassure.

We have received the support of our local communities to help share key messages, to get people involved in the production of local resources, to keep everyone updated with national messages, and to give them a platform where they felt confident to ask questions and raise concerns with clinicians and programme leads.

Our close working relationship with the Equality and Inclusion Partnership has been instrumental in reaching seldom heard groups. We took into account that some of our communities do not speak English or are not confident enough in English to discuss detailed health issues and therefore required information in their own language. To support these communities, we produced a range of information in different languages and ran engagement sessions in Punjabi, Hindi, Urdu and Arabic. 

Outcomes


Our engagement interactions are continuing throughout 2021 and we are starting to see that the information and factual material shared is influencing people’s perception and their view of whether to have the vaccination. 

All system organisations have collaborated to reach out to over 150 different local community and voluntary organisations, support services, groups and communities. This has strengthened our NHS and local authority partnership working and developed our relationship as one cohesive system with our diverse communities and the voluntary sector. 

We have learned from colleagues in all sectors to implement the most appropriate and successful engagement activities and have developed our approach with virtual and online meetings becoming the new normal.

It has been encouraging to see some community groups participate more confidently in vaccination Q&A sessions that were delivered by a GP/clinician from their culture/background and in their language, and the positive impact this had on their perception of the vaccination. 

Crucially, the ability to ask direct questions to NHS professionals has helped increase confidence in services across the board beyond the needs of Covid vaccinations and has built further trust in the NHS.

The foundations we have created with our communities in Coventry and Warwickshire will be hugely beneficial in helping us achieve our local objective to tackle health inequalities in the future. 

Successful interventions

Below are a few examples of how we have delivered engagement on the ground:

Coventry Black Community Taskforce 
The engagement team held an insight session with this group to find out what the barriers and concerns are regarding the vaccination uptake within the Black communities in Coventry. Some people shared concerns about fertility, ingredients, side effects, local data and issues around what this meant for people who have no official documentation to stay in the UK. 

Another key concern that was shared was around the reason’s clinicians do not draw up the vaccinations in front of the patient. It was raised that some people were suspicious about the contents of the vaccination and what injections they were receiving.  

We are continuing to work with the community to run additional sessions with clinicians and public health representatives to answer their clinical questions. We have also agreed to get them involved in witnessing how the vials are prepared behind the scene with support from clinicians at Engleton House surgery, Coventry. 

Outcome from involving - Co-production of a vaccine video explaining the safety and sharing the facts for the African Caribbean communities in Coventry & Warwickshire
Healthcare clinicians and community members from the African and Caribbean community took part in the production of a video. The aim of this video is to build confidence and trust with the community so that they can relate, get involved and react positively to the vaccination programme by understanding what goes on behind the scene of a vaccination clinic. To share their positive experience of having the vaccine and the protection that it offers, Dr Una May Olomolaiye, Faith Marara (Nurse) from Engleton House surgery part in the production.

Local insight undertaken by NHS ICB Engagement
Considerations were put in place, knowing that some of our communities do not speak English and required information in their language. Some did not have access to a computer, instead they used a mobile phone to access the internet, it was encouraging to see some community groups participate more confidently in vaccination Q&A sessions that were delivered by GP’s/clinicians from their culture/background and in their language, this was having a positive impact about their perception of the vaccination. 

The Equality Group in Coventry  
This was attended virtually by; The Consulate General of India, Chief Executive of Coventry and Warwickshire Chamber of Commerce and Deputy Lieutenant representing Her Majesty’s Lord-Lieutenant of West Midlands, Suman Ghaiwal, Communications and Engagement Manager at the ICB who shared the progress of Coventry and Warwickshire’s vaccination programme and highlighted the importance of having the vaccination when invited, this public event was hosted by Ekta-Unity and The Equality Group in Coventry. 

Coventry Refugee and Asylum Seekers 
Dr Maisum Elftise from the Anchor Centre in Coventry presented a vaccination Q&A session in Arabic to refugee and asylum seekers to help them understand how the programme is being rolled out in Coventry and Warwickshire. 

Coventry Muslim Forum – Ramadan and Vaccination 
Discussions have taken place with members of the Coventry Muslim Forum. It has been agreed that ICB colleagues will support the community by taking national guidance and producing it into a localised information flyer that includes; vaccination information, testing, safety and protection when visiting the mosque during Ramadan. 

Coventry Community Messengers
The aim of meeting with the community messengers was to share an update about the vaccination programme. They wanted to know how many people have been vaccinated so far, the process of booking, the options of having a vaccine in different locations. They took the opportunity to ask questions and take information back to their contacts in the community. 

NHS Diabetes Community Champions
Our 30 champions across the area supported the ICB with the vaccination programme by sharing information within their networks who were already connected into the diabetes updates. 

Bilingual NHS Vaccination event for South Asian communities
NHS Healthcare professionals supported local people from South Asian communities to understand what the Vaccination programme means to them. 

The aim of the event was to encourage communities, groups, families and especially those who do not speak English to join us online and ask questions in Punjabi, Hindi or Urdu from the panel who were able to share facts and address concerns about any misunderstanding about the vaccine.

Ukraine communities in Coventry/Warwickshire 
Discussions are currently taking place with the Ukraine committee in Coventry, Public Health Warwickshire and Rugby Borough Council teams with regards to supporting Eastern European communities who are based in Rugby around the Benn Ward area

Developing resources for people with a learning disability (Coventry and Warwickshire)
The engagement team have been working closely with the Learning Disability Teams at CWPT, commissioners and Grapevine, a not for profit organisation that helps all kinds of people experiencing isolation, poverty and disadvantage. We co-produced a question and answer video about what to except when invited to have the vaccination. 

African Caribbean Community 
Local authority Public Health teams in Coventry and Warwickshire worked closely with NHS commissioners to host a virtual open Q&A meeting to support the Black African Community in Coventry. The aim was to give the community an opportunity to interact with a panel of healthcare professionals. We shared information, addressed myths and facts and encouraged the community to have the vaccine when they are invited, we also shared a reminder with them about testing and social distancing. 

Syrian Families in Warwickshire
Dr Maisun Elftise led a session in Arabic to support Syrian families in Warwickshire. This community has a younger population of child-bearing age and some of the female members have raised concerns regarding fertility. 

Chinese community in Coventry and Warwickshire
Discussions are ongoing with community members in Coventry about how we can support the Chinese community to have the vaccine when invited. 

Nepalese community in Nuneaton
The community lead for the Nepalese community in Nuneaton has reached out to support the community about having the vaccination when invited, he also aims to ensure that they continue to follow the social distance guidance despite having the vaccine. 

NHS organisations and the local authority Public Health teams work alongside EQUiP, the Warwickshire: Equality and Inclusion Partnership to reach this community and co-produce resources in Nepalese. The activity is predominantly aimed at supporting the elderly groups who do not speak English. 

Eastern European communities 
Posters have been developed in Polish and Russian to support people in C&W, the plan is to have these visual posters translated in Polish/Russian and be displayed in local Eastern European supermarkets and places of work. 

This information will be supported by Rugby Borough Council and other partners across the system who will share the information on Facebook groups/other social media platforms. 

Gypsy and Traveller Communities
An insight exercise has commenced with the Traveller community in Warwickshire, this will be undertaken by colleagues in Warwickshire County Council through liaison officers who have developed the trust of this community over time. This blended approach builds on existing regular conversations that currently take place with traveller families. 

Ramadan and vaccination 
Public Health Warwickshire and NHS commissioners supported the local Muslim communities/forums and mosques in the run up towards Ramadan. 

Warwickshire Covid-19 Champions 
The ICB’s engagement team supported by clinicians and public health teams delivered a vaccination update to the Warwickshire Covid-19 Champions. This event was also an opportunity to explore what type of resources and information would be useful to the diverse communities they link with. 

Foleshill women’s focus on pregnancy
NHS commissioners joined community leaders to reach out to women looking to become pregnant, currently pregnant or who have recently given birth. The leaders were provided with a thorough briefing and a comprehensive Frequently Asked Questions in order to prompt discussion and to respond to questions.

Community and faith leaders Edward St vaccination pop-up
In depth briefings were provided to faith leaders in order that they can disseminate information to their own communities about a one-day vaccination site in Nuneaton as part of the local response to the variant that developed in India and a potential surge in cases in Nuneaton. 

Using messages during prayers and social media including Whatsapp and Facebook, the engagement led to 300 vaccinations being delivered in a specific location of concern. Further pop ups have been arranged and are expected to be similarly successful with the support of the local community.