Integrated care boards (ICB) cutting funding to GP practices for text messages could lead to large numbers of missed childhood vaccinations, a GP leader has warned.
The British Medical Association’s GP committee chair Dr Katie Bramall told the Lords’ childhood vaccinations committee on Monday that GP practices have been relying on text messages to remind parents to attend vaccinations, and that funding cuts imposed by some ICBs could impact childhood vaccination rates.
Healthcare Leader’s sister title Pulse has reported on several ICBs imposing cuts, with one ICB delaying implementation of limiting funding for SMS messages following pressure from GP practices.
Giving evidence to the committee’s inquiry into childhood vaccination coverage in England Dr Bramall said: ‘Unfortunately, so many ICBs are now cutting SMS funding. This has not been explicitly shared with us, but reports are coming through from increasing numbers of ICBs across the country.
‘I think it particularly impacts those who may not speak English as a first language and who may not have access to a smartphone.
‘I think people sometimes live in their own bubble, and they don’t realise how the majority of the population communicate, live, work, and how chaotic their lives are.
‘And we’ve got to tailor our offer to the vast majority of the population who may not be signed up to the NHS App.’
NHS England has said that the NHS App should become the ‘default option’ for GP practices to contact patients starting from this financial year.
But Dr Bramall warned that ‘even small degrees of friction’ such as stopping SMS messages to parents could lead to large numbers of missed vaccinations.
She said: ‘I think parents want simple booking, text reminders, and local, familiar settings they can walk to without being reliant on public transport. So that’s why their GP surgeries are still preferred, because I think even small degrees of friction will lead to quite a large scale of missed vaccinations.’
But Sarah Walter, deputy chief executive of The NHS Alliance and director of the ICB Network, told Healthcare Leader that ICBs were having to make some ‘difficult choices’ due to the need to reduce their costs by 50%.
Last year the government told ICBs that they had to cut their running costs by 50%, equating to reducing staff by about 12,500 across the health system.
Ms Walter said that a range of communication methods, including the NHS App, should be used with a ‘blended engagement model’ alongside SMS and digital booking options to maximise uptake and decrease widening health inequalities.
‘Vaccination uptake is a key pillar in preventing ill‑health, and our members report that SMS has been an effective way of reaching patients – particularly when tailoring messages for communities where multiple languages are spoken,’ she added.
‘ICBs are committed to driving high rates of vaccination through their commissioning approaches and ensuring this addresses health inequalities and contributes to a healthier population.
‘Working closely with their system partners, including local government and schools, they will be exploring all their options to ensure parents are given appropriate reminders for childhood vaccinations, responding to the local needs of their populations.’
Professor Victoria Tzortziou Brown, chair of the Royal College of GPs, told the Lord’s committee that ICBs have the opportunity to ‘target funding where there is more need’.
She said: ‘It’s not just about funding, I would say it’s also about targeted workforce distribution too, because in practices serving more deprived populations, we have fewer GPs and also fewer numbers of other members of staff that can be very valuable for the delivery of the vaccination programme.
‘So in summary, I would say that the GP-led model for childhood vaccinations is fundamentally strong and has a proven track record of high performance, and the challenge we face now is not redesigning that model, but ensuring that it is adequately supported to meet current demands and reverse the recent decline in uptake.’
A version of this article was first published on Healthcare Leader’s sister title Pulse.
