NHS Employers responds to NICE consultation on improving flu vaccine uptake 


The National Institute for Health and Care Excellence (NICE) has released a draft consultation on how to improve flu vaccination uptake. In the draft, there are specific recommendations for employers of health and social care workers.

NHS Employers welcomes the review of the evidence and the recommendations made by the NICE committee. NICE’s draft is open for consultation until 4 August and NHS Employers will respond on behalf of flu leads in NHS Trusts with the following recommendations and comments.

Recommendations and comments

  • The recommendation of using staff incentives, such as entry into a prize draw, could be seen as an inappropriate use of public funding. We would advise the use of other rewards such as the ‘Get a jab, give a jab’ sparked by Birmingham Women’s and Children’s Hospital. This reward offers ten tetanus vaccines in developing nations for every staff member that gets vaccinated and is more aligned with the values of NHS staff.
  • NHS Employers welcomes the recommendation on declination policies for staff who choose not to get vaccinated to be able to confirm they have read and understood the evidence before refusing the vaccine. Evidence suggests it was the single most effective approach, however, it was noted that it could result in some resistance. The flu fighter programme will work with trusts to establish what the best wording for these declination forms may be.
  • NICE recommends that employers focus on accessibility to the vaccines by publicising their availability through the use of social media, peer vaccination, sharing of data and the focus on using multicomponent approaches, which combine multiple interventions implemented together, rather than single interventions. NHS Employers appreciates the position taken by NICE that a multicomponent approach ensured strategies are targeting the breadth of the workforce.
  • NHS Employers agrees with NICE in its position on mandatory flu vaccination. NICE states: “Qualitative evidence indicates that such policies can negatively affect staff morale, leaving them disempowered, lacking autonomy and resentful of the perceived undermining of their professional work ethic”. Additionally, “[there is a] wealth of evidence that multicomponent interventions do not need to be mandatory to be effective.”

Cost-effectiveness of vaccinating health and social care staff

Based on the analysis, NICE states that “considering only the costs of vaccination and the cost of replacement workers, increasing the uptake of flu vaccination is cost-saving”. The full cost analysis can be found on page 76 of the guidelines on the NICE website

If you work at an NHS trust and you would like NHS Employers to add or edit any of its comments, please email flufighter@nhsemployers.org. The full draft consultation can be found on the NICE website which also includes more information on the recommendations.

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