Until 2003, immunisation uptake statistics for Luton Primary Care Trust (PCT) were reported at county level, with Luton’s figures combined with others from within Bedfordshire. When these performance indicators started being reported by individual PCTs, it became clear that critical information had been masked.
Data showed that the uptake of childhood immunisation in Luton was much lower than the rest of the county. Luton’s uptake of primary immunisation and measles, mumps and rubella (MMR) at 24 months was also below the national average.
Luton has a diverse and transient population, including people who have entered the country without immunisation. It is important for Luton PCT to minimise the risk of a communicable disease outbreak and it decided to take action to improve the uptake of childhood immunisation.
A project was set up to review existing immunisation recording and monitoring processes. It soon became evident that data quality was a big issue and that an accurate representation of Luton’s immunisation data was needed.
Procedures were simplified and the roles of all stakeholders made clearer in a new protocol. This was designed to ensure the reporting of immunisation data to the correct database and the following up of defaulters. The next step was to analyse the 'cleaned’ data to determine if there were patterns in the defaulters.
Ordnance Survey helped Luton PCT to overlay other information onto Ordnance Survey data so that it could map the rates of MMR defaulters, identify areas of low MMR uptake and highlight the location of GPs and children’s centres. The results showed that high rates of defaulters were present in both affluent and deprived areas and that MMR defaulters are higher in the white ethnic category than in any other ethnic category.
- Areas of low immunisation uptake quickly identified.
- Accurate targeting of information and advice based on actual performance of individual surgeries.
- New systems set up to measure the effectiveness of changes to the child immunisation programme.
- Primary immunisation uptake rose from 86% to 98% over three months and increased to 99% in the following three months.
- MMR uptake rose from 82% to 91% over three months and increased to 92% in the following three months.
- Improvements well over the national performance target of 95%.
- Improvements sustained throughout the year.