Power of collaboration: Preschool MMR uptake soars beyond expectations
A GP practice in Berkshire adopted a whole-practice approach, actively involving all staff to enhance childhood immunisation rates for children aged 0-5 as part of their routine work.
Challenge
The COVID-19 lockdown led to a decline in MMR vaccinations and a national rise in measles cases. To tackle this, NHS England identified GP practices with low preschool booster uptake for intensive support from our Improving Immunisation Uptake Team (IIUT).
One particular practice faced significant challenges: the clinical lead managed childhood immunisations single-handedly, with minimal administrative support, limited nursing resources and a transient, multilingual patient population. Additionally, the practice lacked clear and robust processes.
Our goal was to overcome these barriers, increase preschool MMR uptake to protect against preventable diseases, and support the practice in reviewing and implementing clear, efficient immunisation processes.
What we did
We championed a whole-practice approach, ensuring that everyone—from reception and administrative staff to clinical teams and management—took responsibility for childhood immunisations and made every contact count. Our goal was to showcase how a well-coordinated, collaborative effort can deliver measurable results.
Over six months, the IIUT reviewed immunisation data and practice processes, offering tailored recommendations, guidance, and resources, which included access to our bite-sized masterclass sessions—six virtual sessions designed for healthcare professionals, covering a range of topics to further support the delivery of best practice.
Training was provided on utilising the NHS South, Central and West (NHS SCW) Child Health Information Service (CHIS) Incomplete Immunisation Report to enhance MMR uptake. Monthly meetings were held to identify children missing immunisations, reinforce improvements, and track progress.
Both clinical and management staff worked closely with IIUT, adopting a proactive approach and implementing best practice. Their dedication led to significant organisational and process improvements.
A multi-professional, whole-practice strategy was established with clearly defined staff roles. The clinical lead took responsibility for immunisations, supported by administrative staff managing call and recall tasks. Dedicated weekly time was allocated for reviewing the NHS SCW CHIS Incomplete Immunisation Report, while nursing staff received training to administer childhood immunisations, increasing appointment capacity and flexibility. Management oversaw transient patient deregistration, conducted weekly follow-ups for non-attenders and introduced pop-up alerts for missing immunisations in patient records—ensuring every contact truly counted.
Activity
Improving Immunisation Uptake Team
Provided targeted, time-sensitive support to GP practices identified through a range of contributing factors.
Data-driven decision-making
Reviewed the practice-level data and provided an evidence-based decision-making system to support informed choices.
Health improvement and inequalities
Provided tailored support to help reduce inequalities.
Impact
Over a 10-month period, our intensive support led to a remarkable 12.4% increase in the uptake of the MMR preschool booster.
The number of unimmunised preschool children fell significantly, dropping from 99 to 35 — a reduction of 64 children, equating to a 35% decrease.
Every immunisation age group for children aged 0 to 5 saw notable improvements in uptake:
- All vaccines: Increased by 9.6%
- Primary immunisation: Increased by 2.4%
- 1-year booster: Increased by 4.8%
The number of children aged 0 to 5 with outstanding or missing immunisations dropped from 145 to 63 — a reduction of 82, reflecting a 43% decrease.
