Case study summary
Children’s doctors and GPs in North West London have reduced the number of unnecessary hospital appointments needed for children by up to 80 per cent through a new model of ‘child health hubs’ which see families closer to home or answer their problems through the GP.
GPs meet specialists once every four to six weeks at a GP surgery where they discuss patient cases widening the GPs specialist knowledge and getting patients an answer to problems faster.
A specialist clinic is also held during the visit so patients can be seen by a GP and the paediatric consultant at the same time if needed. They also have a number of other professionals involved in the hub such as Health Visitors, dietitians, mental health workers and others to give an holistic assessment of the child’s health.
Connecting Care for Children (CC4C) is a paediatric integrated care model which has been used to implement whole system change and to improve the way children’s care is commissioned, delivered and experienced across north west London.
It addresses the disproportionately high rates of paediatric A&E and paediatric outpatient attendance across the region.
Since 2014, this work has been driven by paediatricians at Imperial College Healthcare NHS Trust working with local GPs, commissioning leads and social care partners.
The six ‘child health GP hubs’,, each include four to five local GP practices or surgeries and a paediatric consultant.
In one of the hubs, 39 per cent of new patient hospital appointments were avoided altogether and a further 42 per cent of appointments were shifted from hospital to GP practice. There was also a 19 per cent decrease in sub-specialty referrals, a 17 per cent reduction in admissions and a 22 per cent decrease in A&E attenders.
A study of the hubs showed patients preferred appointments at the GP practice, gained increased confidence in taking their child to the GP and all respondents said they would recommend the service to family and friends. Professionals valued the improvement in knowledge and learning and, most significantly, the development of trust and collaboration.
Dr Bob Klaber, a consultant paediatrician co-leading the work for Imperial, says a specialist’s time could be better spent offering GPs time each month to help them to look after their population of children and young people.
“Our experience with children is that, while outpatients is still valid for a small number of patients, the sorts of activities where many of my GP colleagues want most of my time spent are different.
“They report that they’d rather have support on discussing cases, access to telephone ‘hotlines’, the ability to quickly and directly email with questions and worries; and data-driven work to improve the preventative care of different cohorts of children, for example supporting all of the children in the practice with asthma to have a well-thought-through asthma action plan.”
Thinking differently about the health and wellbeing of children and young people
The below video provides information about how our health and care system needs to adapt to the changing care needs of children and young people.