Early identification of at-risk children: service improvement study using immunisation status

Article Figures & Data

Table 1. Summary of GP Connect practices

Practice	Met regularly with HV in 2017 (before GP Connect)?	Number of registered patients (on day search was run)	Number of LEAP children aged 0–3 years	Number of individual immunisations that were late (in LEAP children)*	Total number of GP and HV meetings during pilot	Number of LEAP children discussed during pilot
1	No	12 602	135	181	4	20
2	Yes	6204	33	24	4	31
3	Yes	7786	174	270	4	20
4	No	7868	129	115	6	31
5	Yes	7311	85	21	2	10
6	No	12 055	411	578	4	26
7	Yes	Not provided	129	246	4	20
					Total	158

LEAP = Lambeth Early Action Partnership.
*Computer searches of children late for immunisations on the GP system are done by searching for each individual vaccine which is overdue and then combining the lists, meaning that children who are late for several immunisations appeared on several lists and so would be counted more than once in these numbers.

Table 2. Questionnaire results

Detailed questionnaire results: ACEs or other risk factors (developmental, medical, social) identified and recorded for 21 children (three children per practice)	Number of children (out of 21)
Frequent attender A&E (>2 times in 12 months)	8
Calls to out-of-hours GP	1
Split family (children divided or living with another carer)	2
Did not attend developmental reviews	1
Mother thought child was registered at a different practice	1
HV 1-year review: child not crawling	1
HV unable to contact family	1
Child very active, HV to assess and refer to GP if felt to be a medical issue	1
Maternal concerns re: speech and language development	1
Maternal mental health problems; history of mental health illness; mother low mood postnatally	3
Homelessness	1
Previous domestic abuse	1
No recourse to public funds	1
Mother does not speak English	1
Poor family relationship	1
Social isolation	2
Not engaging with services or difficulty engaging	2
Ongoing social services contact with family	4
Ongoing follow-up by GP or other specialists	6
Documented evidence that parents previously refused immunisation	5

Table 3. Care plans

Action	Number of children (out of 21)	Attendance documented
Referral to children’s centre	1 (5%)	0 (0%)
Referral to health visitor	16 (76%)	9 (56%)
Referral to community paediatrics	1 (5%)	1 (100%)
Referral to GP	4 (19%)	4 (100%)
Advice to caregiver about immunisations	19 (90%)	N/A
Any other issues identified	12 (57%)	N/A
Other action points	5 (24%)	N/A
Child discussed at further HV and GP meeting	7 (33%)	N/A
Evidence child had immunisation	8 (38%)	N/A

Kilner_BJGPO.2022.0035_Supp.pdf -
Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.