Collaboration with Plunket boosts Waikato immunisation outreach

A pilot collaboration between the Pinnacle Midlands Health Network (Pinnacle MHN) Waikato immunisation outreach team, Whānau Āwhina Plunket - Waikato (Waikato Plunket) and Te Whatu Ora Waikato has highlighted the power of working together to provide more responsive services that better engage families around childhood vaccination.  

The ongoing decline in childhood immunisation rates is a national issue, one that is accurately reflected in vaccination rates in the Waikato. The region has a large number of children in the population, including a high number of tamariki Māori, for whom immunisation rates are even lower.   

Helen Connors, Pinnacle MHN clinical services manager – child health, says COVID-19 lockdowns, where general practices were less able to provide Well Child vaccinations for healthy children, had a major impact on immunisation rates.    

“Referrals to the outreach services have been increasing significantly over the past three years,” says Helen. “Everyone in general practice is working really hard to try and improve immunisation rates, but there are more referrals coming to the outreach teams than any one service can handle, and no more funding.”  

In early 2022 at a regular meeting between Helen, the Te Whatu Ora Waikato service improvement manager childhood immunisations and Plunket Waikato clinical services manager, the three services were sharing ideas about how they could use their current resources to make a difference.   

The answer was a collective service piloted in the Waikato between June-December 2022, that focused on sharing immunisation outreach expertise and skills across all three services. Using no extra funding, it proved highly successful at increasing engagement with whānau referred for immunisation outreach.  

The pilot programme was designed to harness the knowledge, skills and expertise in all three services to better connect with people who were referred for immunisation outreach.   

“We wanted to find different ways of engaging families being referred for outreach services, and provide a more cohesive, comprehensive service for childhood immunisations in the region,” says Helen.  

Referral clients, systems and processes, along with cold chain, vaccines and outreach equipment from Pinnacle MHN were combined with the established, trusted relationships of Plunket kaiāwhina visiting people in their homes, with the addition of a Te Whatu Ora Waikato registered nurse/authorised vaccinator available one day a week.  

The process was simple: any children referred for outreach services were cross-checked against the Plunket database. If they were a match their Plunket kaiāwhina would get in touch to book the next visit and, with the permission of each whānau, a registered nurse/authorised vaccinator would come along to talk about immunisations and provide vaccination as needed.  

During the six month pilot in 2022, over half of 215 possible referrals were identified as enrolled with Waikato Plunket (127 total). This number was more than the pilot programme could cover with a nurse only available one day a week, but the team was still able to vaccinate 70 children identified, of which 69 per cent were tamariki Māori.  

Helen Connors says the trusted relationship each client already had with Plunket made a big difference. “There were less appointments cancelled or not accepted in the first place compared to a cold call. People trusted the system and relationship they already had with the kaiāwhina.  

“The main thing was the families said they valued the service and the fact that the person doing the vaccination was coming to their home, it made it easy for them to achieve. It was a comprehensive service and it was introduced well, it was acceptable – they felt able to open the door, much more than to a stranger.”   

There were also secondary benefits for the teams involved. Helen says the Pinnacle MHN outreach team learned a lot about the Well Child Tamariki Ora service, allowing them to more confidently promote it to families they work with who are not already engaged with the service. In return, Plunket kaiāwhina were able to learn more about immunisation, building their confidence to further promote vaccination to their clients.  

The registered nurse/authorised vaccinator also enjoyed working alongside other service providers, noticing how it enabled them to work more efficiently and complete tasks while the kaiāwhina was talking to parents about other things. 

For all its success, a redesign of the pilot is currently underway to make this kind of service collaboration more sustainable.   

The Pinnacle MHN immunisation outreach team is still supporting the work with Plunket in the Waikato, albeit in a slightly less active capacity with Te Whatu Ora bringing on more staff and providing their own cold chain system.   

The vision, Helen says, stays the same and Pinnacle MHN is currently in discussion with other partners to see how the framework from the pilot could be applied more widely.   

“We are willing to work with many partners, contributing the knowledge, skill and expertise of our team and working collectively to find different ways of engaging with families around immunisation, to get rates increasing again.   

“It’s very much about breaking down barriers and getting vaccination to all tamariki – a huge job, but one that we can do together.” 

Pinnacle MHN outreach and mobile immunisation services work one-on-one with families, spending time to help them understand vaccines, how they work and the benefits of immunisation. They suppport people to make decisions for their families about vaccination, in a respectful way – no matter what they choose.   

The team has a strong focus on breaking down barriers, working collectively with partners and sharing their knowledge and skills to support immunisation for all tamariki.