London Borough of Barking and Dagenham: Community drop-ins to boost child vaccination and access to health services

The London borough of Barking and Dagenham has partnered with local NHS teams and the voluntary sector to run pop-up clinics offering child immunisations and access to GPs. Building on good practice developed during the Covid vaccination programme, the clinics have been run in a variety of community locations, including libraries, sports centres, community hubs and children’s centres. They proved incredibly popular with thousands of children getting vaccination and in excess of 10,000 adults visiting the adult health events.

“We are always looking to innovate and improve. It is important you don’t standstill” - Zoinul Abidin, Head of Universal Services

The London borough of Barking and Dagenham has an ethnically diverse population with high levels of deprivation and low levels of healthy literacy. During the pandemic, the council worked closely with voluntary sector organisations and the local community to run Covid vaccination clinics in community settings to target hard-to-reach groups that were not accessing the mass vaccination centres.

Faced with low rates of MMR and challenges accessing GPs since the pandemic, the public health team decided to re-boot this model to run a catch-up child immunisation programme as well as offering drop-in clinics to provide residents with access to doctors and other health and wellbeing services.

The vaccination work built on a London-wide MMR catch-up campaign run by NHSE and Vaccination UK, which had been targeting schools since September 2023. The council’s public health team worked alongside universal services, the council team responsible for buildings from libraries to children’s centres, and the local GP federation to host drop-in catch-up clinics.

The clinics were run in partnership with trusted voices, faith leaders and the local voluntary sector groups, whose representatives were trained up to become vaccination ambassadors.

Face-painting, arts, football – and vaccination

Public Health Practitioner in Health Protection Galina Nguekam said: “Vaccination rates were really low and an MMR action group was formed to look at what could be done. We knew the approach had worked well during Covid and we had established good links with community organisations so it seemed a good solution to try.

“We really delved into the data and mapped the wards with the lowest rates. We ended up working in six wards in particular.”

The drop-ins started in early 2024 and have been running ever since in a range of different settings from a sports centre and library to community centres and children’s centres. These were identified with trusted community voices. Alongside ones targeted at certain wards, whole-community drop-ins have also been held in central locations. Ahead of the events GPs send out text messages to families who are recorded as not having had children vaccinated and letters also go out from the schools.

 Around 15 representatives from community groups have been trained up to be ambassadors and they have been crucial to the smooth running of the events, said Head of Universal Services Zoinul Abidin.

“The ambassadors play a vital role. They have badges setting out what languages they speak and they help manage the queues, checking red books, explaining about vaccination and helping people complete consent forms. The local community trusts them so it helps us deal with any issues and means when parents reach the front of the queue the clinician can vaccinate the children straight away.

“It’s important these events run smoothly. You don’t want people going away saying it was not well organised. Every time we have an event at a new venue, I go there to see what we need. For example, the sports centre does not have tables and chairs so we brought those with us.

“Even when we have had queues of 80, 90, 100 people they’ve been prepared to wait. They know it’s a drop-in service so are expecting to queue. We have had face-painting, arts and crafts and football to keep the children entertained.”

Over the course of 2024, over 5,700 vaccinations were given to children of all ages together in GP practices and in the community drop-ins. “We are delighted with the response and believe it is already having an impact,” said Public Health Principal Carol Matenga.

“We had nine cases of measles last year, but no major outbreaks. I think that shows the effect of the work we have been doing – the fact we did not see it spread suggests we have help drive up vaccination rates to a level that is helping contain cases.”

But Barking and Dagenham continues to try to improve and refine the approach. During the recent February half-term break an ambassador and nurse have gone out into neighbourhoods door-knocking and raising awareness about the next drop-in clinics. “We are always looking to innovate and improve,” said Mr Abidin. “It is important you don’t standstill.”

Drop-in to see a GP and more

A similar approach has been adopted for the health and wellbeing events. Alongside the GPs the wider offer has been shaped based on the preferences and needs of the target populations to create an environment that allows them to engage about their health. There has been children’s entertainment, culturally appropriate free food, social prescribers and stop smoking services. Some have been themed around certain conditions, including diabetes, asthma and maternity with the local NHS trust sending clinicians.

“They have worked well,” said Mr Abidin. “The GPs love them. With all the services there on site they can simply walk out with their patients and introduce them to a team that can provide really important support. What we have found in the more informal, less medical setting is that people seem to relax a bit more and disclose more about issues such as safeguarding and domestic violence.

“And we have also diagnosed things like high blood pressure or suspected cancer that potentially has saved lives. We know people struggle to get access to a GP, based on trust, culture, understanding of UK health system issues, so having a drop-in service is invaluable. In fact, when we started, we were promoting them as health and wellbeing events, but some of our voluntary sector partners made a very good point – stress to them that they will get to see a GP and they will come. We now promote them as ‘See a doctor, no appointment needed’.”

And turn up they have. More than 11,500 people have attended the 30 events that have been held in the 12 months since they launched in late 2023. And the work has inspired a bespoke pop-up project with a local homeless charity. Alongside food and a haircut, a local GP has been sent to a homeless centre to offer health checks.

Mr Abidin said: “The thing we found when we first started visiting was that they wanted a shower, so we found a local charity that had a mobile shower unit. All they needed was water and electricity to plug into. It wasn’t easy, but we found a way to hook them up and it has gone from strength-to-strength. When you do this sort of work you constantly have to find solutions, but it is worth it.”