A software tool that helps identify when immunisations have been missed has been used successfully in GP practices in London to boost uptake of the MMR vaccine.
Roll-out of the call and recall tool in North-East London which has seen long-standing low uptake of the MMR saw over 1,000 more children coming forward for vaccination, researchers have reported.
GP practice staff who took up the offer of training on the software – which enables stratification of preschool-aged children registered with that general practice according to vaccination status – had even more success on its use, the team from Queen Mary University of London said.
In the population tested, most children were from non-White ethnic groups and 70% lived in the two most deprived quintiles, the researchers noted.
The introduction of the tool – known as the the Active Patient Link Immunisation [APL-Imms] tool – was associated with an immediate 5·3 % in the proportion of children who had received the MMR on time.
Uptake went from from 77·7 % to 81·8 % – and 92 more children were immunised each month, the researchers reported in Vaccine.
But the system did not have the same impact on uptake of the DTaP/IPV vaccine offered to infants at two, three and four months, they noted.
The team explained that the current childhood immunisation programme gives practices multiple challenges, especially in populations of children who may have started their lives abroad or who spend long periods abroad as is the case in London.
Sustaining the improvement also proved challenging, the results showed but issues include ‘unattainable national targets in the absence of a local financial incentive, workforce and appointment capacity due to under recruitment of practice nurses and administrative staff, and increased pressures on primary care with conflicting clinical priorities’, they concluded.
Local incentive schemes may be needed in conjunction to provide the resources for practices to drive up immunisation rates further, the researchers said.
Dr Milena Marszalek, study lead and a GP in the area where the tool was being tested said: ‘The success of our programme demonstrates it is possible to deliver more vaccinations on time by simplifying the re-call process through digital tools and facilitator support.
‘Healthcare professionals who used the tool reported that it helped to bring in more children for vaccinations on time.’
Similar results could be achieved in other parts of the country through existing primary care clinical effectiveness networks, she added.
Practices who accepted the offer of a visit to explain how the tool could be used in daily workflows improved almost twice as much as those who were not visited, which shows the importance of training and support as part of the programme, she noted.
Professor Carol Dezateux, co-author and professor of epidemiology and health data science at Queen Mary, said: ‘This tool is especially relevant in North East London, where diverse and mobile communities have some of the lowest childhood vaccination rates in England uptake.
‘We will be taking our findings to the NHS North East London ICB to discuss how a local incentive scheme can be devised to better support local practices and avoid costly catch-up programmes and disease outbreaks.’
