Influenza: People with Learning Disabilities

Question

Asked by

To ask Her Majesty’s Government, in the light of Public Health England’s anticipation of a particularly virulent strain of the seasonal flu virus, what steps they are taking to ensure that clinicians prioritise patients at the most risk, particularly individuals with learning disabilities given the potential lack of awareness amongst this group of people of the danger of influenza.

Based on the latest intelligence from the WHO, Public Health England does not anticipate a virulent flu strain this season but remains vigilant. The Government are committed to extending the effectiveness of vaccinations, particularly for vulnerable groups. As a result, NHSE has advised GPs that all individuals with learning disabilities are eligible for the enhanced service specifications. To raise awareness of the opportunity for vaccination, PHE, in partnership with NHSE/I, produces a range of easy-read leaflets for individuals with learning difficulties.

My Lords, I thank the Minister for his reply and for the helpful conversation that we had earlier. There has been a recent government consultation about how to introduce mandatory training on learning disability and autism. Can the Minister advise when the Government’s plans will be published and how soon they expect training to be offered? Everybody hopes that such training, especially co-delivered by people with learning disabilities, would lead to improved access to immunisations as well as health screening and health checks, and everybody hopes that that might lead to reductions in the shocking, avoidable and premature mortality experienced by people with learning disabilities and those with autism.

My Lords, I pay tribute to the extraordinary work of the noble Baroness, Lady Hollins, in this area, where she has worked so hard to improve the life chances of those with learning difficulties. The impact she has made is enormous. She is quite right that the life chances of those with learning disabilities are deeply hit by influenza. That is why the Minister of State for Care commissioned the mandatory training consultation. The response has been tremendous, with more than 5,000 submissions. It has taken longer than expected to work through this material, but publication is expected shortly. In the meantime, we are working with professional bodies and other stakeholders to reach agreement on the development of the core curriculum.

My Lords, is the Minister interested in the views of the pharmacist I consulted yesterday on this Question? He said that his difficulty was identifying the local people with learning difficulties, because unless they have a physical problem that keeps him and the local GP in contact with them, it is hard to get to know them and, therefore, to encourage them to have the flu vaccine. Does that not indicate the need for a major public information campaign in accessible terms to indicate the safety and efficacy of the flu vaccine and vaccines such as MMR?

The noble Baroness makes a very important point. The question of the learning difficulty register is undoubtedly one that affects this area enormously. Each GP should have a learning difficulty register where the names of those with learning difficulties are recorded, but it is recognised that those registers are not necessarily always up to date. At their board meeting on 27 June 2019, NHS England and NHS Improvement made a commitment to improve the quality of registers for people with learning disabilities for precisely that reason.

My Lords, as it stands, one of the major overseas suppliers of anti-flu vaccine is experiencing delays in getting the vaccine through to the UK. Is that likely to have any major impact on the supply of vaccinations?

The noble Lord makes an excellent point, and this is an area of concern, but I should like to reassure him that these are not delays; they are in fact phasing. What we learned from last year is that the identification of which particular flu strain is likely to hit the northern hemisphere is not always clear at the beginning of the season, so we have learned to phase the delivery of the vaccines in case the strain of the influenza virus changes or is not as anticipated. This is interpreted by some pharmacologists as a delay, but in fact it is a pragmatic decision made at the very highest levels.

My Lords, one of the difficulties of encouraging flu vaccination among vulnerable people is that the rates among NHS staff themselves is disappointingly low. What action are the Government taking this coming winter to encourage NHS staff to take up the vaccine?

My Lords, it is entirely correct that the struggle to get NHS staff vaccinated is one that concerns the Government greatly. There is an in-depth education programme, and the offer of eligibility for NHS staff has been rolled out to a considerable degree already. Uptake is not as high as we would like it to be, and it remains an area of focus.

My Lords, the Minister reassured the House that the vaccine that we use in this country will be against the appropriate strain, as advised for the northern hemisphere, but we must accept that the vaccine that will be used in the southern hemisphere is against a different strain. It is not such a long time ago that using the wrong vaccine resulted in several thousand excess deaths in this country—it was two years ago. Can he further reassure the House that the vaccine that we use for the over-65s will be the aTIV one in order to administer a better precaution?

The noble Lord makes a very good point. The Government are aware that the 2019 Australian flu season had an early peak, and that has raised concerns that the Australian flu may be transferred to the northern hemisphere. To date, there is no evidence that the new drifted strains emerging in Australia have indeed crossed over. For that reason, we are holding steady in our prognosis. I assure the noble Lord that we will be giving the right vaccines to the over-65s.

My Lords, I was not aware until yesterday that a separate strain was to be used in flu vaccines for those aged over 65. I discovered that, while the under-65s can be vaccinated within the Palace of Westminster through the health service, the over-65s cannot. We should be setting an example, not least at this end of the Corridor, or is there a cunning plan to implement the Burns review more quickly than intended?

If there is a cunning plan, they have not briefed me on it.