Since November 2004, the Department has taken forward a wide-ranging assessment to investigate how best to support the improvement of child and adult immunisation services through commissioning including:
an examination of the systems and commissioning routes needed to improve access and increase low uptake; and
a review of the way services could deliver more effectively for the people currently missing out.
Primary care trusts' (PCTs) experience of the new commissioning routes for immunisation is still growing and there is an opportunity to share good practice on planning and service delivery using these mechanisms. In support of this, the Department has:
prepared guidance for the wave two national purchasing pilots of alternative providers for immunisation services (referred to as the alternative personal medical services (ARMS) wave two pilots);
developed a series of targets for local use as part of the Better Metrics project in conjunction with the London Health Observatory to allow service managers to monitor the performance of services targeted at deprived or disadvantaged groups;
held two national events with national health service primary care contracting to share good practice and facilitate learning networks; and
in the recent White Paper, announced measures to free up the target payment funds and allow them to be carried across into other contract forms. It also highlighted a recent example of a nurse-led personal medical services that successfully increase immunisation uptake rates among poor and deprived groups who were planning to apply for ARMS status.
The Department is working in partnership across policy teams, NHS employers, other Government Departments (including the Department for Education and Skills, Social Exclusion Unit and Neighbourhood Renewal Unit) and a range of NHS implementing agencies in order to improve childhood immunisation take up for families. Specifically:
continue collaboration with our stakeholder to examine the systems and commissioning routes that have worked to improve access and increase low uptake;
requiring the Health Protection Agency to promote the benefit of opportunistic immunisation, in order to reach disadvantaged groups more effectively;
continue to deliver a series of reports and seminars and generate concrete recommendations for PCTs and commissioners; and
issued joint guidance with neighbourhood renewal unit on local partnerships that led to a number of PCTs and councils to submit and secure a local area agreement for immunisation among disadvantaged groups.
The information in the form requested is not available.
There is currently no nationally available analysis of the impact of those general practitioners opting out on immunisation uptake rates.
Recent analysis of the proportion of general medical services partnerships in England opting out of childhood immunisation schemes as at 30 September 2004 showed that though the majority of partnerships (93.7 per cent.) had not opted out, some had. The practices opting out are disproportionately likely to be in deprived areas.