Preschool immunisation rates in London, especially against measles, mumps and rubella, are among the worst in England. Too many of London’s children are not fully protected, and this is worse in deprived areas. We are leading a quality improvement programme to help primary care teams turn this around.
Our childhood immunisations programme was selected as a 'pathfinder' for the London Health Data Strategy. It was launched in the North East London NHS region in February 2022.
See an overview of the programme's progress in our recent Childhood immunisations poster [PDF 383KB].
The programme centres on a “call and recall” software tool called APL-Imms that CEG developed for use in GP practices. The tool displays relevant information from the practice’s patient records, allowing staff to navigate the complex childhood immunisation schedule easily and work smarter when prioritising patients for appointments. Using APL-Imms, the practice team can quickly:
The toolkit also includes data entry templates so that the tool has high-quality coded data to draw from. The resources support a patient-centred and systematic approach to ensure no child misses out.
Professor Carol Dezateaux explains how the APL-Imms tool helps GP practice teams call and recall children for their routine immunisations on time.
CEG facilitators provide training and support for each practice using the tool, including online and in-person visits to help staff download and use it effectively. We’ve also produced step-by-step guidance and demo videos.
As the programme develops, we will be introducing maps that use aggregated near-real time data to highlight areas where timely immunisation is particularly low. These will be available to local authorities and NHS commissioners to inform public health campaigns and local initiatives to prevent disease outbreaks.
Our project team has consulted parents, primary care staff and local community organisations to understand the challenges that prevent immunisation in young children. From these conversations, we have gained insights on how to improve access to services and better communications with parents to support timely and equitable childhood vaccinations.
A protocol for a mixed methods evaluation of this quality improvement programme has been published in BMJ Open.
Ana Gutierrez, Anna Billington, Prof Carol Dezateux, Isabel Dostal, Dr Milena Marszalek, Nicola Firman and Zaheer Ahmed.
Pathfinder collaborators:
The London pathfinder programme was jointly funded by the London Health Data Strategy partners, which include NHS England (London region), the five London ICSs and a number of London’s NHS organisations and universities, and further supported through Health Data Research UK. The programme builds on CEG’s previous work to improve childhood immunisation rates which is funded by NHS North East London Clinical Commissioning Group’s Digital First programme and Barts Charity REAL Health programme (MGU0419). Milena Marszalek is funded by the NIHR School for Primary Care Research.