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Covid-19: NHS England pledges extra funding to local areas to reduce vaccine inequalities

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n580 (Published 26 February 2021) Cite this as: BMJ 2021;372:n580

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Covid-19 vaccine hesitancy among ethnic minority groups

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  1. Gareth Iacobucci
  1. The BMJ

Local NHS commissioners are to receive extra financial support to boost uptake of covid-19 vaccine in ethnic minorities and marginalised and deprived communities.

NHS England will distribute £4.2m (€4.8m; $5.9m) to local clinical commissioning groups (CCGs) in areas of greatest need to help target hard to reach groups and reduce vaccine inequalities.

The move is part of a coordinated effort to reduce the gap in vaccine uptake between different patient groups, with evidence showing that it is lower among ethnic minority patients and deprived communities.

In a letter to local and regional commissioning bosses sent on 24 February,1 NHS England’s medical director for primary care Nikita Kanani and director of primary care Ed Waller advised that the extra funding could be used to set up temporary vaccination clinics at community sites, such as places of worship, to improve take-up. “It is critical that nobody is left behind, and we are writing to make you aware of some further opportunities to reach out to communities with lower uptake levels by operating temporary vaccination clinics in community venues,” they wrote.

In a separate letter2 to heads of local CCGs, NHS England said, “CCGs with low uptake in ethnic minority communities or low uptake in marginalised or deprived communities will be provided with data on vaccine uptake within their local primary care networks and at a postcode level to support a focused and granular response to local challenges,” it said.

England’s 42 regional sustainability and transformation partnerships will each receive a notional £100?000 and will decide how to allocate funds across its constituent CCGs. NHS England said, “We would expect the shares to take account of the relative health inequalities and existing sources of funding.”

In its letter to CCGs, NHS England said its targeted approach would be guided by the three factors of vaccine hesitancy identified by the World Health Organisation: confidence, convenience, and complacency. “CCGs will be asked to develop a plan in collaboration with the local community, agreed with the local director of public health, detailing how they intend to use the initial funding and outline any additional longer term strategic and systemic engagement required to tackle local needs.”

The action follows an adjustment3 to the national covid-19 enhanced service on 22 February, which said that NHS England “may make additional discretionary payments available to GP practices” to boost vaccine uptake in hard-to-reach groups.

The government has also emphasised the importance of tackling vaccine hesitancy after the second quarterly report4 from its race disparity unit showed that while disparities in risk of infection and death improved for some other ethnic groups in the second wave of covid, they worsened for people from Bangladeshi and Pakistani communities.5

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