Background

The World Health Organization recommends that >75% of health/social care staff are vaccinated for flu. This target was met for healthcare staff in England during 2020–21; however, despite the COVID pandemic, the Department of Health and Social Care (DHSC) Capacity Tracker only reported 34% of care home staff as vaccinated.

Aim

Undertake a two arm, open label, cluster randomised controlled trial to assess the effectiveness and cost-effectiveness of FluCare, a behaviour change intervention designed to improve uptake of influenza vaccination by care home staff, compared to usual care, with embedded process evaluation.

Setting

Community based private, charity, corporate or local authority care homes (residential or nursing) in England.

Methods

Care homes registered to provide care for older adults, with at least 10 members of staff and a staff flu vaccination rate <40% during 2021/2022 flu season were eligible. Care homes expressing an interest to participate were consented and randomised to the FluCare intervention (comprising of in-home vaccination clinics, a promotional campaign, monthly performance monitoring and care home CQUIN incentive payment if >70% staff vaccinated) or usual care. Care homes identified their preferred GP/pharmacy, who were invited to participate. Care homes maintained a vaccination log which was submitted to the research team monthly. A vaccination log was completed by GPs/Pharmacies after each clinic.

Sample Size

Based on the assumptions that mean (standard deviation) cluster (care home) size is 54 staff (25), a coefficient of variation of 0.48, control vaccination rate is 55% (assumed higher than the historical rate as COVID has increased interest in vaccination), intervention 75%, intra-cluster correlation coefficient of 0.2 and with 90% power, we require 31 care homes per arm at two tailed 5% level of significance (62 total). Allowing for 20% attrition, 78 homes were required.

Results

Seventynine care homes were recruited, 75 randomised, 37 to intervention and 38 to control. To date, 27 care homes have been paired with vaccination providers. 28 staff focused flu vaccination clinics have been held and more are planned. Follow-up data collection is ongoing and will end 31^st March 2023. Process evaluation is ongoing.

Conclusion

At the time of abstract submission the trial is ongoing. Findings are due August 2023 and will be presented at the meeting.

Funder

FluCare is funded by the NIHR Public Health Research (NIHR133455). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.