by Queen Mary, University of London

Credit: Unsplash/CC0 Public Domain

A software tool developed by Queen Mary University of London's Clinical Effectiveness Group (CEG) and used as part of a facilitated quality improvement program has increased the number of children receiving their first MMR vaccination on time in North East London. The success of this program highlights the potential of a learning health system and data-driven solutions to enhance public health and improve vaccination uptake across the UK.

An evaluation published in Vaccine revealed that the APL-Imms (Active Patient Link tool for Immunization) has helped vaccinate over 1,000 more children since its rollout in North East London. The tool was created in response to long-standing low MMR vaccination uptake in the region, which had fallen further since the pandemic.

Measles, mumps and rubella are very contagious diseases that spread easily among unvaccinated people. These diseases can cause serious health problems. Studies have shown that one child with measles in a classroom can infect up to nine other unvaccinated children, making it one of the most contagious diseases in the world—more contagious than COVID-19.

The APL-Imms tool, part of a comprehensive "call and recall" quality improvement program developed by the CEG, assists GP practices in delivering the complex vaccination schedule for children under five. Using routinely collected health data from within the GP practice, APL-Imms identifies children registered with the practice who are due their routine vaccinations, ensuring children receive all 16 time-sensitive necessary vaccine doses. This ensures that children are protected on time and reduces their risk of catching vaccine-preventable diseases like measles. The program, including the tool, is provided to GP practices in North East London at no cost.

Dr. Milena Marszalek, local GP, lead author of the evaluation and research fellow at Queen Mary's CEG, said, "The success of our program demonstrates it is possible to deliver more vaccinations on time by simplifying the re-call process through digital tools and facilitator support. This is an exciting prospect for other areas of the country with a similar CEG-style support model in place. Health care professionals who used the tool reported that it helped to bring in more children for vaccinations on time."

To make the program even more effective, primary care facilitators based at the Clinical Effectiveness Group visited practices to assist with integrating the tool into their daily workflows and providing hands-on support. Practices who accepted the offer of a visit improved almost twice as much as those who were not visited, which demonstrates the importance of training and support as part of the program.

The study used a mixed-methods approach, combining time-series analysis of health record data from 255 GP practices, with qualitative feedback from staff through interviews and 'think aloud' exercises. The approach provided deeper insights into how the tool was used and its impact.

The tool has been used across NHS North East London Integrated Care Board (ICB), which serves a diverse population of 2.4 million people, as part of a proof-of-concept initiative to demonstrate the effectiveness of this approach to improving vaccination coverage. It was delivered by an existing long-term collaboration between Queen Mary and NHS North East London ICB.

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 programs and disease outbreaks."

Luke Readman, Director of Digital Transformation NHS England (London Region), said, "I congratulate the Queen Mary University team on their success in increasing the timely uptake of child vaccinations. As one of the OneLondon Pathfinder Projects we were delighted to support this pioneering work to help us learn valuable lessons about joining up and using data across the Capital. The insights from this successful project will support our work to develop the OneLondon Secure Data Environment that will be a world leading resource for health and care improvement in London."

More information: Milena Marszalek et al, TEMPORARY REMOVAL: Improving the timeliness and equity of preschool childhood vaccinations: Mixed methods evaluation of a quality improvement programme in primary care, Vaccine (2024). DOI: 10.1016/j.vaccine.2024.126522

Journal information: Vaccine 

Provided by Queen Mary, University of London