Bury council: Making sure vulnerable groups are not left behind

Bury set up an uptake and inequalities task group, composed of council, NHS, HealthWatch and voluntary sector representatives to make sure vulnerable groups do not get left behind in the vaccine rollout out.

This is part of a series of case-studies published on 3 March 2021

  • Task group set up to focus on reaching out to groups at-risk of low uptake
  • Proactive outreach with gypsy and traveller community, homeless, people with disabilities and care workers alongside ethnic minority groups
  • Systematically undertaking phone calls to all those who have not taken up the offer of vaccination to understand reasons and help allay concerns

Local context

The metropolitan borough of Bury is home to nearly 200,000 people, taking in Bury and made up six small townships. It is part of the Greater Manchester region.

The council and local clinical commissioning group are fully integrated - the council chief executive is also the accountable officer for the CCG and joint senior roles and shared teams, including communications. 

The response to Covid-19 and delivery of the vaccination programme has therefore very much been a single endeavour between the two organisations in partnership with the wider system.

There are four local vaccination clinics – two hosted at NHS premises and two at council venues.

Looking for those who are not vaccinated

Bury has set up an uptake and inequalities task group, composed of council, NHS, HealthWatch and voluntary sector representatives to make sure vulnerable groups do not get left behind in the vaccine rollout out.

Director of Public Health Lesley Jones said: “The vaccination programme is being done at such pace which is great but we want to make sure no-one gets left behind. So the key questions we are continually asking as we roll out the programme is ‘who has not been vaccinated, as well as who has, and why?’.

“We have a data intelligence team who are providing data on this – but you can only get so much from that because of the way vaccination is recorded so we are also using the close relationship we have with different partners across Bury to help identify where there may be problems with uptake.”

As part of this the council has carried out an equality impact analysis. It is a live document that is constantly updated. The analysis has identified a number of groups where we would anticipate uptake will be lower.

Ms Jones said: “It is easy to assume it is all about ethnic minorities – that is where a lot of the attention is. We are responding to that. We ran a very successful pop-up clinic at a local South Asian community centre which was delivered jointly be local GP practices and local Asian community groups.  Around 200 people from the community were vaccinated.

“But when you start looking you realise it is much wider than that. We are concerned about the gypsy and traveller community and homeless people in particular. We have also noticed there is some vaccine hesitancy among care workers.

“We are now engaging with these groups to see what the potential problems are. As the local authority, we have teams who work with these groups so our officers have been out to the traveller sites to discuss what the issues are.

“You can’t assume the answer is a pop-up clinic. We worked with the Muslim community, they were keen on that and we supported them to organise it. But other groups may want a different approach and we will be flexible to support what they think will work.”

The council is working with its five neighbourhood hubs, partnerships involving the council, health and care staff, faith and voluntary sectors. The government’s Covid Champions funding is being used to produce material and videos for community representatives to circulate.

There are also fortnightly webinars for the community champions to keep them up-to-date on what is happening with the vaccination rollout and for them to provide feedback on the barriers they are hearing about.

Councils ‘are the glue in the system’

The council has also started planning some bespoke work targeting care workers. The adult social care team worked with providers to carry out a survey of care staff about why they were not getting vaccinated.

Public Health Registrar Steven Senior said: “What was interesting was that half of it was down to vaccine hesitancy and half down to other issues – sickness on the day, having tested positive recently or because they were pregnant. Some of it is about accommodating them for vaccination in the future and not assuming they do not want to be vaccinated.”

Many of the care home workforce are young female staff and like other areas one concern that has been raised is what impact the vaccine has on fertility alongside the risks when pregnant or breastfeeding. To help allay concerns, the council has arranged for a young female GP to host an “Ask Any Questions” webinar for care home staff.

The council’s community hubs – set up in partnership with volunteers to support those who have been shielding - have also been phoning all the extremely clinically vulnerable groups to see why they have not been vaccinated, provide reassurance and support them to book an appointment.

Dr Senior said: “Some were waiting to talk to their GP or consultant. They are very vulnerable groups – organ transplants and cancer patients – so we are keeping in touch with them and will accommodate them when and if they are happy to be vaccinated.

“I think councils act as the glue in the system. We can help get things done and bring people together. We can make the connections that can help the NHS. We worked at the start with the primary care networks to identify the vaccination sites.

“We have also taken the lead at identifying health and social care staff who are eligible – there are lots of diverse services out there from drug and alcohol teams to care agencies that are not employed directly by either the council or NHS.”

Contact details

Lesley Jones
Director of Public Health
Bury Council