Published: 08/12/2005 Volume 115 No. 5985 Page 35

Jacky Chambers is director of public health and Janice Nelson immunisation co-ordinator at Heart of Birmingham teaching PCT.

HSJ readers can access more information on this subject at www. uk/publichealth

In January, Heart of Birmingham teaching primary care trust set up a unit for active management of unimmunised children.

The PCT was disappointed with immunisation and vaccination uptakes, particularly measles, mumps and rubella at 24 months. Although the Department of Health recommends that children are immunised at 13 months, the effectiveness of a PCT’s immunisation service is monitored by uptake at 24 months.

The PCT established a system that, every month, identified 16-month-old children who had not been immunised.

Each month it also obtained lists older cohorts of 20-month-old children.

A manager set up a database and obtained patient contact information from the relevant practices where children were registered. Contacting the practices produced one of a number of possible outcomes:

l Patient is vaccinated and a record is made in system but subsequently lost.

l Parents declined vaccination.

l Parents opted for single jabs.

l Patient no longer registered with the practice.

l No known reason.

Parents of children still registered with the practice and whose MMR vaccination is outstanding were sent an appointment by post.

Since January, 1,376 unimmunised children have been identified, with resolution obtained on 59 per cent - 38 per cent were immunised.

The team also hired a nurse and driver to visit the homes of 306 children, with 46 per cent resolved and 20 per cent immunised.

MMR uptake at 24 months has risen from 82 to 92 per cent. The aim is for the unit to be irrelevant within one year.