A process evaluation of how the routine vaccination programme is implemented at GP practices in England.

摘要: In recent years, the incidence of several pathogens public health importance (measles, mumps, pertussis and rubella) has increased in Europe, leading to outbreaks. This included England, where GP practices implement vaccination programme based on government guidance. However, there been no study how implementation takes place, which makes it difficult identify organisational variation thus limits ability recommend interventions improve coverage. The aim this is undertake a comparative process evaluation routine at England. We recruited sample geographically demographically diverse through national research network collected quantitative qualitative data as part Time-Driven Activity-Based Costing analysis between May 2017 February 2018. conducted semi-structured interviews with practice staff involved vaccination, who then completed an activity log for 2 weeks. Interviews were transcribed coded using framework method. Nine collection from geographic socio-economic contexts, 52 clinical non-clinical participated 26 interviews. Information relating 372 appointments (233 childhood 139 adult appointments) was captured logs. have defined 14-stage care delivery value chain detailed map vaccination. Areas greatest include method reminder recall activities, structure task allocation groups. For mean appointment length 15.9 min (range 9.0–22.0 min) 10.9 min adults 6.8–14.1 min). Non-clinical administrative activities comprised 59.7% total 48.4–67.0%). Appointment time not related coverage, whereas capacity terms per eligible patient may Administrative tasks had lower fidelity implementation. There England programme. Further work required evaluate factors wider range practices, alongside other contextual factors, including working culture within practices.