What is the NHS Vaccination Strategy?

On 13 December 2023, NHS England announced an updated Vaccination Strategy. The renewed plan builds on the 2019 Vaccinations and Immunisations Review, recommendations from the National Institute for Health and Care Excellence (NICE), and the UK Health Security Agency’s (UKHSA) strategic plan.[1]

The Vaccination Strategy has been launched following calls from pharmaceutical companies and trade bodies for a national Vaccination Strategy to tackle issues of accessibility, misinformation, and distrust around vaccination.

The Strategy is for people and organisations involved in the commissioning, planning and delivery of NHS vaccination services in England.


Why do we need a Strategy for the delivery of vaccination services?

Vaccinations play a central role in preventing ill health, saving up to three million lives worldwide each year and helping many more people avoid hospitalisation.[2] High vaccination rates prevent the spread of diseases and protect vulnerable individuals for whom vaccination is not safe or effective. Some vaccines, like HPV, can also help to prevent cancer.[3]

England has historically achieved high uptake rates for both life-course and seasonal vaccinations. The NHS Covid-19 vaccination programme has been the biggest vaccine drive in the history of the NHS implementing the largest volume of novel vaccines in the shortest time.[4] The NHS Covid-19 vaccination programme required new roles, responsibilities, and operational processes. It succeeded through the collaborative effort from the NHS, local governments, volunteers, and other partners.[5] It also drove innovation and investment in service delivery, including the use of pop-up and walk-in sites, working with community leaders to build trust, and creating national booking systems. [6]

However, over the last 10 years, the UK has witnessed a decline in vaccine uptake. Coverage rates for pre-school immunisation are lower than the WHO-specified threshold for many vaccines and overall, UK uptake rates are lower compared with other advanced economies.[7] Recent outbreaks, including lesser-known infectious diseases, such as mpox, also demonstrate the ever-evolving nature of infectious diseases. The Vaccination Strategy outlines how the UK must ensure it is prepared to respond effectively to new threats and implement new vaccines and other technologies as they are developed.[8]

NHS England has stated that the future approach to vaccination will focus on outcomes: reducing morbidity and mortality by increasing vaccination uptake and coverage. To achieve this goal, every system in the country will need vaccination services that are:

  1. High quality, convenient to access, and tailored to the needs of local people.
  2. Supplemented by targeted outreach to increase uptake in underserved populations.
  3. Delivered in a joined-up way by integrated teams working across the NHS and other organisations to improve patient experience and deliver value for money.


What will improved vaccine delivery networks include?

The Vaccination Strategy sets out three features that a newly improved delivery model will include:

A vaccination ‘front door’

Providing a ‘front door’ to vaccination means making it easy for people to understand why they should have a vaccine, be well-informed about where and how to obtain it, and conveniently reach the designated service locations.[9]

The Strategy promises to:

  • Provide information to people about vaccines from a trusted source.
  • Better incorporate the NHS App to join-up user journeys including access to vaccination records, in-app bookings, and appointment notifications.
  • Work with GPs and community pharmacies to expand the online booking capacity used for Covid-19 vaccination.
  • Design a vaccination delivery network or networks that deliver vaccine campaigns through the location and settings that will best meet the needs of the population.
Targeted outreach for underserved populations

The Strategy sets out how not all people and every community can be served by a core vaccine service. The NHS it states needs to provide supplementary outreach services designed to meet specific needs to increase uptake.

The Strategy promises to:

  • Provide systems with digital tools that help them identify those who are unvaccinated or who need a catch-up offer.
  • Plan outreach services alongside the core offer, as an integrated part of the system’s vaccine delivery network.
  • Tailor the outreach service to the community being targeted and the local partnership opportunities available.
  • Work nationally and regionally to support robust evaluation of the effectiveness of different outreach approaches to choose those that are most effective and best value for money.
Integrated teams who put vaccination at the heart of prevention and wellbeing

Integrating the delivery of vaccinations with wider person-centred healthcare services, planned and delivered by neighbourhood teams, can help make the most of the vaccination event.

The Strategy promises to:

  • Integrate neighbourhood teams to be adaptable and work across the vaccination delivery network.
  • Integrate programmes with wider prevention activity.
  • Integrate programmes with clinical pathways with greater joint working across all local service providers including acute, community, mental health and local authorities.


How will NHS England deliver vaccines collaboratively?

The updated Vaccination Strategy outlines six ways NHS England will collaborate with partners to deliver an effective vaccine delivery programme:

  1. Build strong system leadership that enables local responsibility and flexibility for Integrated Care Boards (ICBs).
  2. Develop a new commissioning and financial framework for ICBs.
  3. Establish a diverse, integrated, flexible and skilled vaccination workforce.
  4. Ensure timely and accurate data.
  5. Enhance outbreak response capability and pandemic preparedness.
  6. Ensure efficient and responsive vaccine supply.


Next steps

In 2024-25, NHS England will implement as many changes as possible, which may include:

  • Moving towards shadow population-based Integrated Care System (ICS)- level budgets for vaccination.
  • Commissioning and contracting changes.
  • More formal joint working between regional commissioning teams and ICBs as a step towards full delegation.
  • Delivering some changes to digital services.

NHS England will evaluate the impact of the proposals across the short, medium and long term on vaccination uptake, collaborating across national, regional and system levels.



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[1] NHS England, ‘Shaping the future delivery of NHS vaccination services’, 13 December 2023, link

[2] Ibid

[3] Ibid

[4] Ibid

[5] Ibid

[6] Ibid

[7] Ibid

[8] Ibid

[9] Ibid






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