Social care workers and the swine flu vaccination: Qualitative research

Knowledge and understanding of Swine Flu • Swine Flu was often a top of mind workplace health issue for both employers and employees, with employers being more knowledgeable about it than employees. • Swine Flu and Seasonal Flu were mostly understood as different illnesses with similar symptoms, with some awareness that Swine Flu also involved vomiting and diarrhoea. The audience however were not confident they would be able to self-diagnose. • The sample had a clear understanding of how to prevent Swine Flu. Hand-washing and cleanliness techniques were top of mind and “Catch it, Bin it, Kill it” was a well known message. • “Vulnerable” people were assumed to be the same as those vulnerable to Seasonal Flu including the elderly and those with medical conditions. This meant that carers did not necessarily recognise the people in their care as being at risk if they did not fall into these groups. • Most employers in our sample claimed to have adopted a two-fold strategy of reinforcing RHH measures to prevent Swine Flu (mainly via information dissemination and tightening up of procedures, although some had also invested in new equipment such as hand gels), and making contingency plans should a Swine Flu outbreak happen. Some smaller private agencies with no local authority ties had done little as they were aware there were no official consequences; and evidence from single service carers showed that individual employers had also done little. • Measures implemented did not add additional pressures to the workforce. • Typically information-dissemination appeared best in residential homes or day-care centres where there were the greatest opportunities for group discussion and signage. Information-dissemination to domiciliary employees and single-service carers appeared much more haphazard, but also harder due to fewer opportunities. • Employers and employees typically trust official NHS information and CQC was also mentioned as another trusted source for best-practice procedure by some employers. Concern about Swine Flu • Swine Flu was often described as of greater concern than Seasonal Flu, although not a cause for panic. A key misperception was that Swine Flu can be more severe than Seasonal Flu, rather than it being more contagious or widespread. • Personal and professional concern levels varied and key factors affecting concern were how serious they perceived Swine Flu to be (which was affected by experiences of Flu and others who had had Swine Flu); how vulnerable they perceived the people they cared for to be (and how much direct contact they have with them) and the balance between personal concern and client concern. • There was some sense of a ‘wait and see’ attitude about Swine Flu, with media reporting of numbers of cases, and trend in cases being seen as a useful indicator of level of threat. • The lack of testing for Swine Flu also fuelled belief that Swine Flu was not being reported accurately. • Actual concerns across the sample varied. Employers, while being concerned for their clients’ welfare, were also concerned about the financial and logistical implications of an outbreak. Employees had broader concerns focusing on three areas: not taking time off work and loss of earnings, fear of passing it to their friends and families (particularly the vulnerable) and fear of passing it to the people in their care. The order of these concerns varied but each contributed to interest in vaccination. Attitudes to the Swine Flu Vaccination • The principle of a vaccination against Swine Flu was well received and the fact that social carers were to be a priority group also made sense even if it was not expected. • Across the period of the research, the Swine Flu vaccination received media coverage and knowledge of social carer priority was greater by the end of the research. • Most in this sample would accept or consider seriously the vaccine when offered. • Vaccine considerers and rejecters sought reassurances about long-term side effects and confirmation about need. The key concern raised was about long term side effects linked to the speed of vaccine production, which led to a trade off between altruism and personal health concerns for some. • Employers were positive about their staff being offered the vaccine and about distributing information, although it was important to them that staff be allowed to make their own choice. Reactions to creative materials • Both proposed social carer executions were considered ‘nice and friendly’ but not particularly visually engaging or dramatic. • Although the ads clearly related to Swine Flu, the vaccination message was not clear because the bottom copy of the ads was often not seen. This copy was also central to understanding the relevance of the headline. • “If you can’t catch it, you can’t pass it on” was a strong message highlighting the value of vaccination although it did raise questions about the level of protection offered by the vaccine. • Not passing Swine Flu onto those who are more vulnerable than yourself in the workplace was felt to be a good but altruistic message. Widening the message to including protecting yourself and your family felt stronger and more inclusive. Conclusions and recommendations • Targeted communications within the workplace, aimed at Social Carers and using Four Nations branding, are appropriate to confirm availability of the vaccine to this audience as they may not expect to be included in the programme, and may not recognise the people in their care as vulnerable to Swine Flu. • Although the social carer executions are liked there is the potential to better reinforce: o That they concern the Swine Flu vaccination o Who is being targeted – focus on social carers and why o The benefit of having the vaccination– to yourself, your family and the people you care for who are more vulnerable than you o Where to go for more information (a website or phone number) • Additional information about the likelihood of catching and passing on Swine Flu as a carer, and information about the side effects are particularly interesting. The audience can be sensitive to reassurances about the safety of the vaccination, and for those who have serious concerns, the fact that a similar vaccination had been tested on 1000s of people does not feel strong enough as a reassurance. • The need for the vaccine, even if someone thinks they have had Swine Flu (but not had it lab tested) and that this is a different vaccination to the Seasonal Flu vaccination are considered important pieces of additional information. • Care homes are simplest to target with key communication routes to staff including staff rooms and communal areas, staff meetings and even vaccination being offered on site. • Domiciliary carers/agency workers can have an uneasy relationship with their employer; however they are also receptive to information coming to them in the post with for example timesheets and payslips. Agencies also suggest occasional staff meetings or training sessions. • Carers who work in individuals’ homes feel hardest to reach. Key routes defined by the audience are including information with payslips or schedules or encouraging distribution of information across a team of carers potentially lead by the ‘lead carer’. • Employers are happy to facilitate information dissemination and discussions so it is useful for them to be equipped with additional information about Swine Flu and the vaccination.