TY - JOUR T1 - Early identification of at-risk children: service improvement study using immunisation status JF - BJGP Open JO - BJGP Open DO - 10.3399/BJGPO.2022.0035 SP - BJGPO.2022.0035 AU - Rachael Gail Kilner AU - Adam Glen Cunliffe AU - Carla Stanke Y1 - 2022/10/06 UR - http://bjgpopen.org/content/early/2022/10/04/BJGPO.2022.0035.abstract N2 - Background Children who have adverse childhood experiences (ACEs) tend to have more physical and mental health problems when they are adults. Evidence suggests that partial or no immunisation status can be associated with factors (including ACEs) that make children at higher risk of poor outcomes.Aim To explore the idea that ‘missed immunisations’ could be used as a proxy indicator in identifying children at risk of worse outcomes.Design and setting Service improvement study in seven GP practices in South London, UK.Method Children aged 0–3 who were three or more months late for immunisations were identified; their computer notes were reviewed during interdisciplinary meetings between health visitors and GP practice staff. A bespoke template was used to guide discussions and to record action plans. Evaluation methods included a survey of practitioners and anonymised questionnaires about care management for a sample of children.Results Issues of concern including some ACEs (eg, domestic abuse, mental health concerns in parent) were identified in 57% of children. 94% of practitioners found multidisciplinary meetings useful; 62% of practitioners changed the way they thought about providing care to very young children and their families. Of the children discussed during multidisciplinary meetings, 38% subsequently caught up on immunisations.Conclusion ‘Late for immunisations’ appears to be a useful indicator for proactively identifying children with issues that make them at risk of poorer outcomes. Integrated working between GPs and health visitors is important for ensuring targeted care is provided to families. ER -