Effort Of Public Health Organization For MMR Vaccination Campaign Homework Answer

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Question :

Case Study On MMR 2000 words

Please put some good references for example WHO, BMJ, Lancet, CDC etc.
However, you can research for other examples of good practice on the same topic and reference these it if helps to discuss. You also need to go through the assignment guidance and in your presentation you should have identified the challenges of implementing change (with reference to your case study) and included relevant theories of change management and leadership.
In Summative Assessment 2: You should discuss the challenges of implementing change and include an analysis of the relevant theories of change management and leadership (as applied to the case study)
Your discussion/analysis should focus on the above and should include:
discussion of  public health organisations, their interventions and relevant  leadership concepts / partnership working / change management 

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Answer :



Public Health in the United Kingdom is one of the significant aspects catered by the government in protecting and improving the public's health and wellness. The issues recognized in taking the MMR vaccine in the city of Bristol comprise deprivation of the proper health care, inadequate immunization among the children, and people living under poverty are less likely to get the opportunity of getting vaccination (Edelstein et al., 2019). The children are identified as the substantial group suffering from the ailments like measles, mumps, and rubella. The case study envisages the coordinated effort of the public health organization as NHS, local authority, social health workers, community service providers, and other relevant groups to drive the MMR vaccination campaign. The campaign was focused on immunizing children and teenagers from the age of ten to sixteen in Bristol's inner city. The leadership styles are also assessed in the case study involving transactional and transformational leadership styles. 


Synopsis of the case study

A multidisciplinary group was involved in the year 2013 to uptake the immunization drive for the children suffering from MMR diseases. The chosen area of Bristol is ethnically diverse, with the indication of deprivation of relevant healthcare opportunities. The group identified the lowest MMR uptakes among individuals' ethnic and language characteristics by applying a software package named Onomap (Public Health England, 2014). They also involved the manual searching process by taking up the General Practice Records to tally the information. 

The meticulous research on the communities enabled the Black and Minority Ethnic (BME) health workers to facilitate the deprived families of the Somali Community the access to primary immunization drive through the local clinics.  The case study focuses on the national urgency to support local improvement by understanding the deprived communities' public health needs in the selected area (Santibanez et al., 2014).  The Health Link Workers played a significant role in establishing contacts with the patients, community leaders, and administrative staff in recognizing the importance of immunization among the children and teenage groups. The initial work of screening and leading the immunization drive was conducted by a public health consultant, thereby involving a network of partnerships in the public health system to steer the group. 

Explicating the significant elements of the organizational sphere of public health and its principles of governance

The significant elements of public health's organizational sphere are the rapid access to the healthcare facilities and behavioral health system, comprehensive whole family care, outcome-based care facilities, and high-value services. The public health organizations identified in the case study context involve the NHS England, the local authority of public health, Bristol Clinical Commissioning, PHE Field Epidemiology, General Practitioners, and Health Protection Unit (Pencheon, 2018). The public health organizations induce innovation, technical improvement of healthcare services, practical partnership measures, effective performance management of the public health organization, and ineffective communication commitments. 

The elements of the organizational sphere visible through the case study are the health organizations' coordinated efforts. The helm of affairs was initiated by the field epidemiology team, who devised the software package in identifying the most deprived community of the significant medical intervention through the MMR vaccine (Moten et al., 2018). Innovation through the software was the primary change noticed in the functioning of the public health system in England since it coordinated with the local health workers to identify the Black and Minority Ethnic population comprising the Somali community. The PHE epidemiology team specialist was the crux of the innovation. The analysis and making specialists were from the information would not have been possible without them (Wilder-Smith and Qureshi, 2020). The G.P.s' worked in an integrated way with the community service providers and health link workers who invited the children to access the appointment and follow-up procedure where the parents did not attend. 

The principle of governance that is visible in the public health organizations is to form solid foundations like the construction of a steering group to monitor the campaign and make decisions, as well as managerial and operational elements, are supervised by the team which was constituted for the case study as Screening and Immunization Team and Public Health Bristol (Kostkova, 2018). The principle of governance constitutes the major). ethical and accountable decision-making abilities by the group that addresses the opportunities of healthcare services, protection of the group and assets, compliance to the rules and regulations, best resolution to the conflicts, and integrating the efforts of partners involved in the mission (Leask et al., 2019). The group constituted for monitoring public health organization activities also identifies the possible risks and devises measures to manage them. 

Assessing the range of leadership styles

Public health organizations in the case study involved transactional and transformational leadership styles. The transactional leadership style reflects transactions or exchanges between the leaders and the followers (Saravo et al., 2017). The G.P.s involved in the team could not match the available data in the child health system.  They did not seek the opportunity to consult the local schools to record how many children received the MMR vaccination in the campaign. The chain of command followed in this leadership style was directed from the Screening and Immunization group, which facilitated more coordination with the partners working for the campaign. Fewer errors happened by eliminating confusing directions. However, the challenge faced in this leadership style's initial application was that creativity and innovation were missing in coordinating efforts to lead the campaign (Deshpande et al., 2018). More followers in the campaign than the leaders who just followed the team's directions constituted as a steering group. Poor availability of child health data was the major constraint found through the application of this leadership style. 

The transformational leadership was brought by the public health consultant who identified the challenges within the group and committed to lead on the team (Boameh et al., 2018). The steering group also identified the issues and held on to the consultant for the campaign's effective direction. The transformational leadership style results were virtually visible when the vaccination effort rose from 59% to 74% with the contribution of local public health workers and the Screening and Immunization Team (Olvera et al., 2017). The links were established among the key partnering organizations for future works and accessing benefits from the present. The transformational leadership benefited the team with the healthcare vision on other vital issues since it has attended success in this process.

The steering group formed with the transformational leadership style and delivery encouraged the partners to experience better vaccination drive outcomes. The end of the phase 2 campaign witnessed the surge of vaccination drive from 85.9% to 91.7%. This drive helped establish the theory that even a small increase in vaccination uptake reduces an MMR disease outbreak's risk. Transformational leadership helped establish a high value on the relationships with the partnering agencies committed to working together in the future issues on healthcare. 

Discussion on the challenges of partnership working

Partnership working is crucial in healthcare service delivery. The integration of the partners' efforts is considered with shared commitments on the organization's objectives.  In the case study, the partnering agencies came together to facilitate vaccination for the deprived section of people in Bristol. The national data recognized that a poor healthcare system in the city's inner circle might give the chance of an outbreak of MMR diseases since the uptake on vaccination was low (Clavel et al., 2019). The particular issue of low uptake compelled Public Health England to raise awareness among the deprived community of Black and Minority Ethnic to take the vaccination in preventing the outbreak. The drive was supported by the Director of Public Health, which highly endorsed the healthcare campaign.

The challenges faced in partnership working involving the Health Link Workers, Health Protection Unit, GPs, Bristol Clinical Commission, PHE Field Epidemiology, NHS England, and several other healthcare groups lacked leadership direction to the drive. There were no particular leaders to this MMR campaign as all the public healthcare organizations involved had the data to vaccinate the children, and no particular process was followed. The data revealed that out of 1000 children, only 82 were successfully vaccinated, which is just a small number. There was a lack of planning in the vaccination process. The disadvantaged group of people was only identified, and not the right numbers were calculated to make the drive measurable. The G.P.s had less information on the child health system. The schools were not approached to get the right data of the students who would receive the vaccine among the Somali and BME community in Bristol (Witjas et al., 2018). The funding of the initiative was another major challenge that appeared in the campaign. The public health organizations were confused about who and how the initiative should be funded within the public health system. 

The lack of committed efforts on the parts of the G.P.s, local authority, and sharing of responsibilities in the campaign was not apparent. The steering group identified the disparities in roles and responsibilities when the desired outcome was not achieved in the first phase of raising awareness among the vaccine takers. Financial commitment to such a big drive and roles and responsibilities towards the drive make it a barrier among the shared partnerships. 

Discussion on the significance of change management

Change management can be defined as the transformation process within the organization's internal and external functioning. The process facilitates the phases of preparation to accept the change, incorporate the change, implement the change in its functioning, survive resistance against the change, and take steps to change (Rosenbaum et al., 2018). The organizational change that can be viewed through the case study is mapping Bristol's underprivileged section through the software Onomap. The uptake of the vaccination drive was the second visible change. The White population here was not focused on the city of Bristol. The gap identified was that the planning process of the drive was not relevant in its first phase. The success measure of the drive that appeared to the public health organization was a meager number of 82 children vaccinated among the 1000 children in the city.

The second phase of the drive was substantially planned by the steering group, where the measurable amount of vaccinated children raised from 85% to 91%. The change management here reflected the vision for healthcare improvement of the selected minority group of community where healthcare drive is poor and lack resources, strategy implementation of vaccinating the children ranging from ten years to sixteen years to prevent the outbreak of the diseases, and implementation of the drive by the steering group within the timeframe of September 2013 to May 2014 (Domingues et al., 2017). The change management was possible with the coalition of various healthcare agencies and groups, local community leaders, and creating a relevant road map in the second phase of the drive to achieve considerable MMR vaccination success. 


In conclusion, it may be suggested that while planning for a big venture or initiative, the partnering agencies must approach with a relevant road map to achieve SMART objectives through the venture. The initiative has faced several challenging aspects in determining the leadership style, funding of the drive, accessing the information on the child health system through new software, and coordinating the partnering groups' efforts in the campaign. The missed aspect of coordinating the local schools and pursuing a drive towards engaging the stakeholders and the children's parents could have been mitigated with proper plan and execution. The consultant's efficiency is visible in the case study, who took the initiative in leading the work with the groups and local people. The drive's outcome was successful in the second phase when the new public health system was understood by all the stakeholders involved who have worked through the partnership.