The Adult Social Care and Health Scrutiny Panel met on Tuesday 29 September 2026 to discuss barriers to immunisation uptake and support for unpaid carers in Middlesbrough. The Panel received an overview presentation on immunisation uptake, highlighting key challenges and initiatives, and an update on the support available for unpaid carers, including progress on the South Tees All Age Carers Strategy.

Barriers to Immunisation Uptake

The Panel received a comprehensive presentation on the barriers to immunisation uptake in Middlesbrough, which generally shows lower vaccination rates compared to regional and national averages. Sarah Slater, Advanced Public Health Practitioner, outlined that immunisations are a critical public health intervention, with programmes delivered by GP practices, pharmacies, and school-based services.

Key concerns were raised regarding maternal immunisations, with RSV vaccine uptake at 56.4% and Pertussis vaccine uptake at 75.7% for pregnant women registered with Middlesbrough GPs. Barriers identified included a lack of awareness of newer vaccines, misinformation, and time constraints during antenatal appointments.

For childhood immunisations, uptake rates for several vaccines, including the 6-in-1 vaccine (91.2%), Men B (91.3%), Rotavirus (87.9%), and PCV (93.9%), remained below the national target of 95%. MMR1 uptake at age two was 88.5%, and MMR2 at pre-school age was 82.5%. The presentation highlighted that uptake is closely linked to deprivation, with further inequalities stemming from language and cultural barriers. Common issues cited included confusion over schedules, inconsistent recall systems, transport and childcare difficulties, and the impact of misinformation. Initiatives to improve uptake include identifying low-uptake practices, developing an optimised toolkit for GP practices, and offering community-based catch-up clinics.

Adolescent immunisation uptake also showed concerning figures, with HPV vaccine uptake at 56.4% for females and 54.8% for males, and MenACWY at 66.2%, all significantly lower than regional and national averages. Barriers for this age group included parental engagement in the consent process, digital exclusion, language barriers, and needle phobia. A video developed for use in Middlesbrough secondary schools was shown to help alleviate anxiety among young people regarding the vaccination process.

Seasonal immunisations, such as flu and COVID-19, also face challenges with complex eligibility criteria, a lack of awareness, and difficulties navigating booking systems. Older adult immunisations, including pneumococcal, shingles, and RSV vaccines, are hindered by lower awareness, mobility issues, digital exclusion, and a perception among some that they are not at risk.

Common barriers across all age groups identified were complex information, language barriers, practical access issues, inconsistent recall systems, concerns about side-effects, misinformation, and a lack of culturally tailored information. The implications of low uptake include increased risk of outbreaks, pressure on NHS services, and potential long-term health complications. Potential areas for further scrutiny include developing a Tees Valley Immunisation Strategy, improving local data intelligence, supporting community-based delivery models, and strengthening community engagement.

Councillor Zafar Uddin queried the limitations in available data, and the Advanced Public Health Practitioner explained that access to granular local data is a challenge, preventing targeted interventions. Councillor Christine Cooper highlighted the decline in seasonal immunisation uptake and suggested Elected Members could assist by promoting eligibility and sharing promotional materials through local channels.

The Panel agreed to note the information presented and for members to submit further comments and suggested lines of enquiry to the Democratic Services Officer. Draft Terms of Reference for the review will be presented at the next meeting.

Unpaid Carers in Middlesbrough

The Panel received an update on the support available for unpaid carers in Middlesbrough. It was noted that an estimated 12,541 unpaid carers reside in Middlesbrough, and the proportion of people providing 20-49 hours of unpaid care weekly has increased. The Care Act¹ underpins statutory duties to support carers, recognising their role as vital to families and health and care services.

Middlesbrough Council and Redcar and Cleveland Borough Council are collaborating on the South Tees All Age Carers Strategy, which has been shaped by extensive engagement with carers. Key priorities for the strategy include clear information and early recognition, access to flexible and joined-up support, promoting physical and emotional wellbeing, providing time away from caring, and offering help with finances and employment.

Significant improvements have been made through the Carers Improvement Journey, including the introduction of a strengths-based Carers Conversation to replace the previous Carers Assessment. Between January and August 2026, 327 Carers Conversations were completed, and 345 carers are supported through an ongoing Support Plan. Mandatory Carers Awareness Training for staff, monthly staff drop-in sessions, and Carers Champions in social work teams have been implemented. Support services have been commissioned from organisations including Carers Together, MIND, The Junction, and Age UK.

New initiatives include a pilot with Carers Together, allowing them to undertake Carers Assessments and commission support services directly, aiming for a more streamlined service. A co-production group, Care for Carers, facilitated by PCP (formerly Healthwatch), meets monthly to allow carers to directly shape services. A permanent Carers Co-Production Worker has been recruited to support this work.

During discussion, a Member inquired about the reasons for the increase in unpaid carers, particularly in Middlesbrough. The Lead for Specialist and Lifelong Services suggested this could be due to strong community ties and improved identification and recognition of carers. The need to identify hidden carers and promote available support through various channels was acknowledged. Support for young carers is commissioned through The Junction, with a focus on ensuring their education and development are not negatively impacted. The potential introduction of a Carers Mark across South Tees to encourage employers to support employees with caring responsibilities was also mentioned.

The Panel agreed to note the information presented.

Adult Social Care and Health Scrutiny - Work Programme 2026/2027

The Panel considered and noted the content of its Work Programme for 2026/2027.

Date and Time of Next Meeting

The next meeting of the Adult Social Care and Health Scrutiny Panel was confirmed for 27 October 2026, at 4:00 pm.

Any Other Urgent Items

The Corporate Director of Adult Social Care and Health informed the Panel of an upcoming inspection by the Care Quality Commission (CQC) from 9 November 2026. Inspectors may wish to meet with the Panel or its Chair as part of the inspection process.