A software tool has been developed to support GP practices improve the MMR vaccination rate and help address health inequalities.
The free software created by the child health team at the Clinical Effectiveness Group (CEG) in Queen Mary’s Wolfson Institute of Population Health is now being used three-quarters of practices in the North East London ICB area.
It follows research that showed an already declining MMR uptake in the area dropped further during the Covid-19 pandemic.
The tool – called ‘APL-Imms’ (Active Patient Link tool for immunisations) – displays data from patient health records to simplify the ‘call and recall’ of children for routine vaccinations.
According to the CEG at Queen Mary, the tech has algorithms that account for 17 pre-school vaccine doses administered on nine occasions for every child registered at a practice. It means practices can quickly list children who are due or overdue for specific immunisations.
The software also works by flagging anomalies – for example, where a child’s vaccine schedule may have been disrupted or started abroad, which is common in London’s mobile populations – and making the childhood immunisation schedule easier to manage for both practices and parents, helping prevent inequalities in protection.
In other words, the data insight empowers practices to manage and deliver the childhood immunisation programme more effectively.
To make sure the tool is being used efficiently, practice staff receive support from primary care facilitators based at Queen Mary but who go out to surgeries to provide assistance on the ground.
A full evaluation of the APL-Imms tool will be published later this year, CEG has said. However, early findings show that the tool gives a vital insight into immunisation data, helping practices to tailor their strategies for improving local immunisation and prioritise the most vulnerable children for appointments.
Direct support from the team on how to use the software is also key, it has been found.
The software was created after research by CEG in December 2022 showed that the decline in MMR vaccine coverage had worsened since the pandemic.
It revealed that the proportion of children given the first dose of MMR on time in North East London dropped from 79% to 75% during the pandemic, significantly below the 95% coverage needed to prevent an outbreak, according to WHO.
The poorest neighbourhoods saw the biggest drop in timely vaccinations, almost 5% in the most deprived areas, compared with 1% in the least deprived areas.
The research also revealed an increase in ‘hotspots’ – neighbourhoods where measles outbreaks are most likely because fewer than 60% of children receive the first MMR vaccine on time.
These hotspots were clustered in the region’s most deprived neighbourhoods.
Carol Dezateux, professor of clinical epidemiology and health data science at Queen Mary University of London, led the team that built the tool for GP practices.
She said: ‘The risk of an unprotected child catching measles is much higher if they are surrounded by other unprotected children, so we are particularly concerned about ‘hotspots’ where timely vaccination is below 60%.’
She added: ‘At CEG, we’re working closely with the NHS and local authorities in North East London, so we understand the immense pressure on primary care teams. We have developed free software tools to support practices to manage and deliver the complex childhood immunisation programme as part of a region-wide quality improvement programme. Our data shows where more targeted services are needed and can support local initiatives to remove barriers to access and ensure all children in the region have an equal chance of protection.’
The team at CEG isn’t selling the tool for use elsewhere in the country but is willing to share its expertise on this clinical effectiveness approach with other NHS regions who may be looking to adopt a similar model of support for primary care. More information is available here.
Earlier this year, the UK Health Security Agency (UKHSA) launched a campaign to reverse a decline in childhood vaccinations across England.
