How a GP practice in Buckinghamshire overcame long term challenges to increase their childhood vaccination uptake rates
With support from the NHS SCW Improving Immunisation Uptake Team, Whitehill Surgery increased preschool booster uptake by 10.8% in just three months, showing the impact of robust processes and a whole-practice approach.
Challenge
Following the initial Improving Immunisation Uptake Team (IIUT) engagement with Whitehill Surgery, it quickly became clear that the practice had been facing a number of challenges, including limited staff capacity and heavy workloads. These challenges were hindering efforts to address issues affecting vaccination rates effectively.
The practice serves a transient population, making it challenging to obtain and translate copies of previous immunisation histories from overseas. In addition, some patients were moving away without notifying the practice. Vaccinations were also being coded incorrectly on the system, which led to scheduling errors and, in some cases, children missing vaccinations they were eligible to receive.
The goal of the practice, working in partnership with the NHS SCW IIUT, was to increase overall uptake percentage across all vaccine cohorts, with particular focus on preschool vaccinations. This also included reviewing and strengthening practice processes around immunisation and developing a tailored, whole-practice approach.
What we did
Ongoing support, including monthly meetings, enabled the practice to cleanse data using the NHS SCW CHIS Incomplete Immunisation Report (IIR) and review both administrative and clinical processes.
Targeted training: staff received guidance on using IIR, alongside best practice resources including the GP Immunisation Toolkit and the Practice Immunisation and Screening SOP. Training also offered advice on engaging effectively with families to address vaccination concerns.
Proactive practice team: the surgery demonstrated a proactive and motivated approach, working closely with the IIUT. They showed commitment to reviewing historical challenges and processes, and were keen to embed consistent, robust systems to support improvements in childhood immunisation uptake rates.
Activity
Child Health Information Services (CHIS)
The IIUT is part of CHIS. CHIS ensures that children aged 0–5 years have an accurate vaccination record and issues call and recall invitations in line with NHS England immunisation programmes.
Clinical effectiveness
We collaborated with a broad range of stakeholders, including NHS England, NHS Providers and Integrated Care Board colleagues, delivering expert clinical support crucial to the implementation of the NHS Long-Term Plan.
Analytics and business intelligence
We collaborated with the practice to analyse and interpret data essential for improving childhood immunisation uptake rates. This data was provided by our CHIS Informatics team.
Impact
The practice team highly valued working collaboratively with the IIUT, recognising the team’s expertise and ongoing support. Regular monthly meetings with the Administrative Vaccination Lead provided a structured forum to review data, share resources and reflect on vaccination uptake trends, fostering continuous improvement.
The team began working with the practice in April 2024 and significant progress was made across all 0–5-year-old vaccinations in an initial nine-month period:
- All vaccines: uptake increased by 8.8%
- Primary vaccinations: uptake increased by 3.7%
- 1-year booster: uptake increased by 5.1%
- Preschool booster: uptake increased by 10.4%.
At the start of the intervention, 189 vaccinations were outstanding or missing for children aged 0–5, according to NHS SCW CHIS records. By January 2025, this figure had reduced to 66 children – a reduction of 123 children, equivalent to a 35% decrease.
This collaboration demonstrates how targeted support, combined with data-driven review and resource sharing, can make a measurable difference to childhood vaccination uptake, ensuring more children are protected at the right time.
