Audit of the implementation of selective neonatal BCG immunisation in south east London.

The implementation of a selective neonatal BCG immunisation policy adopted in south east London boroughs of Lambeth, Southwark, and Lewisham in 1992 has been audited. A survey conducted 18 months after the policy was implemented showed that only 11% of infants identified as eligible for neonatal BCG immunisation had been immunised. The results of the survey were fed back to neonatal units, which were encouraged to improve access to BCG immunisations for eligible infants. A second survey 17 months later showed that 14% of eligible infants had been immunised. Difficulties in applying complex selection criteria, rapid turnover of trained staff in acute units, and short neonatal stay were thought to contribute to the poor uptake of the selective programme delivered in the neonatal units. A community based BCG immunisation service has been commissioned to improve uptake.