The Health Protection Agency has strongly criticised the interim child health systems used by ten primary care trusts in London after a fall in immunisation rates of up to 19% by primary care trusts using the system.
The HPA said eight out of ten PCTs using the Child Health Interim Application (CHIA) supplied by the local service provider for London, the Capital Care Alliance (CCA) led by BT. were unable to submit data because of problems with the system.
Of the two that did, Barking and Dagenham and Havering, coverage for the MMR vaccine had fallen by between 7% and 10% and coverage for the five-in-one vaccine by between 10% and 19%.
In its report on immunisation coverage the HPA commented: “Falls in coverage of this magnitude not only indicate that individual children may be at risk, but also represent a potential major public health threat to the control of the diseases in the community.”
Dr Kambiz Boomla, a GP in east London, said practices and PCTs were continuing to struggle with problems cause by the switch to CHIA which he described as “one disaster after another.”
He told EHI Primary Care that when PCTs moved to CHIA it was not possible to electronically transfer the existing immunisation data which had to be inputted manually.
He said: “PCTs built up huge great paper stockpiles of immunisations that had to be added and there weren’t enough clerical officers to do it. We are in an area with 20-70% patient turnover and if you don’t know what immunisations children have already had you don’t know what to do next. On top of that in our PCT we also found it wasn’t capable of printing new appointments.”
The quarterly report of the Cover of Vaccination Evaluated Rapidly (COVER) programme for January to March 2006 says that it is the third quarter in which national trends could not be reported due to problems with the new child health systems being implemented in London. It also highlights “a variety of problems” with other new child health systems including what it says are continual problems reporting in the correct format for the system implemented in the Eastern cluster by Accenture.
It adds: “Comparing the year 2005/6 to 2004/5, the number of children in London who are missing from the COVER programme is nearly 18,000 for children turning 12 months, over 14,500 for children turning 24 months and nearly 19,000 for children turning 5 years of age.”
The report goes on to say that the children may not necessarily be unvaccinated but because no information has been collected on their vaccination status those who have missed out are unlikely to have been identified and followed up.
The report adds: “As other new child systems are implemented in other regions of the country as part of Connecting for Health, lessons need to be learnt to avoid similar problems occurring as have happened in Eastern and London regions. Child health systems are pivotal to the good local management of the national vaccination programme, to ensure the protection of children and to protect the public health. “
When criticism of CHIA arose in February this year NHS Connecting for Health promised that problems would be resolved within weeks.
This week a spokesperson for NHS Connecting for Health told EHI Primary Care: “London’s CHIA system was implemented at short notice because the previous supplier withdrew support for its ageing system from the market. The system has taken longer to develop than anticipated.
“A joint team with input from NHS Connecting for Health, BT CCA and the local NHS has been working to address the issues with the CHIA application and overcome the backlog of data requiring input. The CHIA system was always intended as an interim application and detailed plans are now being worked up for the migration to a more robust long term solution.”
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