Childhood vaccinations should be available in convenient locations for parents and out-of-hours to help to drive uptake, a review by NHS England and NHS Improvement has recommended.
Reform of the GP payment structure for vaccinations to provide “greater simplicity and transparency than the current system,” is also recommended by the report.
The report has been published amid a reduction in children getting vaccinated, with analysis showing that one in seven children aged five had not had both doses of essential measles (MMR) jabs. The report says payments to GPs should be reformed to ensure they vaccinate as many children and young people as possible against MMR.
Professor Stephen Powis, NHS medical director said: “Looking at ways to expand access to appointments will make it even easier for parents to protect their children and with the NHS playing its part, it is vital that everyone takes up this life saving opportunity and isn’t swayed by the dangerous marketing of false information by anti-vaxxers.
“The NHS in England will now bring together GP groups and other health professionals to agree collective action to reverse falling vaccination rates, which have dropped in each of the past five years.”
The report, Interim findings of the Vaccinations and Immunisations Review, says that the introduction of new “primary care networks” nationwide – groups of GP surgeries joining up to help their communities – could mean more access to evening and weekend appointments, to offer more convenient access for parents.
“There are vaccines which could be safely and efficiently delivered by providers in the network other than general practice, building upon the contribution of Community Pharmacy to seasonal influenza coverage,” the report says.
It recommends widening the range of health professionals who deliver convenient MMR vaccinations in particular, to include health visitors and community health professionals, in addition to expanding school health services.
In future incentives for vaccination coverage could be aimed at the primary care network, particularly where achieving optimal vaccination coverage is best addressed at a community level and where is a shared endeavour between different providers, the report says.
Amendments to the GP contract will make it clearer what is expected of individual practices. This reform “should seek to build on the current strong foundation for vaccine delivery, whilst addressing known weaknesses and potential areas for improvement,” the report adds.
There should continue to be three types of payment: a capitation payment to encompass provision of the necessary infrastructure to deliver the vaccinations and immunisations services; an item of service payment should reward actual delivery of vaccinations and immunisations; and incentives could provide an additional impetus to achieve optimal coverage of specified vaccines, the report explains: “However, the blend of these three payment types should be adjusted. In particular for MMR there was a case for greater weight on item-of-service payments.”
Other measures highlighted by the report as ways of boosting uptake ensuring that IT systems can alert staff to people who need to be vaccinated in the community and continuing to promote information on vaccine safety and effectiveness to tackle concerns about misinformation as two in five parents say they are often or sometimes exposed to negative messages about vaccination online.