Report blames 2013 NHS reshuffle for falling vaccination rate

A report by the National Audit Office (NAO) has identified the government’s 2013 reorganisation of the NHS as a major factor behind the decrease in the number of vaccinations given to pre-school children.

The report by the NAO found that ‘anti-vaxxers’ had a limited impact on parents’ decision to vaccinate their children, and instead blamed fragmentation in the way the vaccination programme has been delivered for poor uptake rates.

The report said that NHS England had missed its 95% uptake target for six out of seven routing pre-school jabs in 2018-19, following a general downward trend since 2012-13.

While in July 2019, one in every seven children had not been given both doses of the measles, mumps and rubella (MMR) jab by the age of five. With current levels of uptake of the second dose falling to 86.4%, below the 95% recommended by the World Health Organization (WHO) to give herd immunity.

A review into the falling vaccination rate was also issued by NHS England which blamed anti-vaxxers, saying that parents were being influenced by negative messages about vaccines on social media.

However, when PHE conducted its annual survey into the wider public’s and parents’ attitudes to vaccinations, it found that 95% of parents had confidence in vaccinations and only 3% had refused one or more vaccines.

The NAO also said there was evidence that the 2013 health system reorganisation in England, which saw the 152 administrator-lead Primary Care Trusts (PCTs) replaced by 211 primarily GP-lead Clinical Commissioning Groups (CCGs), resulted in fragmentation in the way the vaccination programme has been delivered. The NAO said:

‘The way healthcare professionals remind parents to vaccinate their children is inconsistent. Parents are contacted to book an appointment through being called and recalled by healthcare professionals.

‘When primary care trusts were abolished in 2013, NHS England took responsibility for commissioning call/recall, but has not set out the requirements of GPs for call/recall under the new arrangements. This has led to inconsistencies in how the system works in different parts of the country.

‘Some parents have reported finding it difficult to access vaccination services due to the timing and availability of appointments. There are also communities which are ‘under-served’ when it comes to healthcare, such as travellers, which may also affect their vaccination rates.’

Health leaders said they will look at introducing new measures, including boosting cash given to GPs for ensuring children have the MMR. And introducing a new primary care network, which would see GP surgeries join together to provide more access to evening and weekend appointments.

Since 2018, NHS England and Public Health England have been developing a plan to improve the uptake of vaccinations. NHS England is creating an MMR catch-up programme for children aged 10-11 and published guidance in August 2019 for regional teams on how to improve uptake of MMR vaccination.

A spokesman for NHS England said health bosses plan to bring together GP groups and other health professionals to agree on collective action to reverse falling vaccination rates.

Professor Stephen Powis, NHS medical director said:

‘One of the most effective, cheap and essential tools for keeping us all safe is a simple, free jab – it can save the life of your child.

In July 2019, the Department of Health and Social Care announced that it would launch a new strategy on vaccination by spring 2020 and the Prime Minister has since requested it be brought forward to Autumn 2019.

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