The NHS wants all front-line healthcare workers to have a flu jab this winter, praising trusts which hit 90% coverage last year.
Figures show that last winter the East Lancashire Hospitals Trust had the highest uptake of the flu vaccine in England, while more than 90% of front-line NHS workers at the East Lancashire Hospitals Trust were vaccinated against the flu last year.
Public Health England figures show that 6,462 front-line healthcare workers at the trust received the flu vaccine between September 2017 and February 2018 - an uptake rate of 92%, much higher than the England average of 69%.
But 539 of the 7,001 doctors, nurses, clinical staff, and support workers with direct patient contact were not vaccinated - during the worst flu season in a decade. As healthcare workers prepare for another difficult winter, NHS bosses have warned that staff refusing the vaccine this year could be banned from treating patients.
Vaccine uptake varied considerably between trusts. At the Essex Partnership University Trust, the uptake was just 39%.The NHS said making vaccination "near universal" is to protect patients in higher-risk clinical environments, like neonatal intensive care and cancer wards, and limit their exposure to unvaccinated staff.
Up to 50% of people with the flu may not even know they have it - but for patients with weakened immune systems or respiratory problems, the flu can be life-threatening. The NHS said that trusts should "take appropriate steps to maintain the safety of the service", including transferring unvaccinated workers away from high-risk patients.
It outlined several reasons why healthcare workers with direct patient contact should be vaccinated, including recent NICE guidelines outlining a link between lower rates of staff vaccination and increased patient death. It also said that flu-related staff sickness puts pressure on other staff members.
Public service trade union Unison, which represents healthcare workers, said that the NHS should encourage staff to get the flu jab, but not make it compulsory.
Unison head of health Sara Gorton said: "We need to understand why vaccination rates vary so much between different health organisations. Some struggle to get teams who are trained to administer the jab to staff working in remote or varied locations.
"Healthcare staff may choose not to get the jab for fear of allergic reactions, or a phobia around needles," she added.
Chief nurse for NHS England Professor Jane Cummings said that "myths" persist around the flu vaccine, with the "big one" being that it gives people the flu.
She said: "By getting vaccinated against flu, healthcare workers can protect themselves, their families, colleagues and patients, making sure we have a healthy workforce and helping to reduce the pressure on services over winter."
Public Health England said that it encourages action from professional health bodies to increase vaccine uptake, with PHE medical director Professor Paul Cosford saying: "There is a dual responsibility on trusts and healthcare workers to get rates as high as possible."