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Editorials

Integrating acute services for children and young people across primary and secondary care

Sanjay Patel, Tamali Hodgkinson, Roland Fowler, Kate Pryde and Roisin Ward
British Journal of General Practice 2020; 70 (693): 158-159. DOI: https://doi.org/10.3399/bjgp20X708917
Sanjay Patel
University Hospital Southampton NHS Foundation Trust, Southampton; Project Lead, Healthier Together; Clinical Lead, Children’s Programme, Hampshire and Isle of Wight Sustainability and Transformation Partnership.
Roles: Consultant Paediatrician
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Tamali Hodgkinson
University Hospital Southampton NHS Foundation Trust, Southampton.
Roles: Paediatric Trainee and Education Fellow
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Roland Fowler
North Baddesley Surgery, Hampshire; Medical Director, Tri Locality Care Ltd; Clinical Director for Children and Families, West Hampshire Care Commissioning Group.
Roles: GP
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Kate Pryde
University Hospital Southampton NHS Foundation Trust, Southampton.
Roles: Consultant Paediatrician and Quality Improvement Lead
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Roisin Ward
Clift Surgery, Hampshire.
Roles: GP
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  • Integrating acute services for children and young people across primary and secondary care
    Vaishali Ferizoli, Kate Dharmarajah, Lucy Pickard and Mitch Blair
    Published on: 28 July 2020
  • Published on: (28 July 2020)
    Integrating acute services for children and young people across primary and secondary care
    • Vaishali Ferizoli, GP ST1 Doctor, Northwick Park Hospital
    • Other Contributors:
      • Kate Dharmarajah, Paediatric ST6 Registrar, Northwick Park Hospital
      • Lucy Pickard, Locum Paediatric Consultant, King’s College Hospital NHS Foundation Trust
      • Mitch Blair, Professor of Paediatrics and Child Public Health, Northwick Park Hospital
    We wish to share our service response to the COVID-19 pandemic on the health of the local paediatric population. In North-West London we have seen a significant reduction in the numbers of children accessing paediatric services, which risks jeopardising their non-COVID-19 related health.
     
    Similarly, our general practitioner colleagues have been facing challenges, moving from face-to-face interactions to largely virtual ones and we considered how we might work more collaboratively to optimise paediatric outcomes during this period. The article on integrating acute services for children and young people (CYP) across primary and secondary care published in the March BJGP issue on Child Health similarly discusses this relationship being instrumental in improving overall outcomes.1
     
    We developed an integrated service providing paediatric primary care advice by paediatric registrars and consultants, with a Monday-Friday direct telephone line and an email (48-hour turnaround for advice). This launched at the start of April 2020, advertised to GPs via our local Care Commissioning Groups and Sustainability and Transformation Partnership. We have recently evaluated the use of this service over 3 months throughout the COVID-19 outbreak, and we share some of our observations here.
     
    We received a total of 288 queries from GPs by phone and email, most commonly about gastroenterology (1...
    Show More
    We wish to share our service response to the COVID-19 pandemic on the health of the local paediatric population. In North-West London we have seen a significant reduction in the numbers of children accessing paediatric services, which risks jeopardising their non-COVID-19 related health.
     
    Similarly, our general practitioner colleagues have been facing challenges, moving from face-to-face interactions to largely virtual ones and we considered how we might work more collaboratively to optimise paediatric outcomes during this period. The article on integrating acute services for children and young people (CYP) across primary and secondary care published in the March BJGP issue on Child Health similarly discusses this relationship being instrumental in improving overall outcomes.1
     
    We developed an integrated service providing paediatric primary care advice by paediatric registrars and consultants, with a Monday-Friday direct telephone line and an email (48-hour turnaround for advice). This launched at the start of April 2020, advertised to GPs via our local Care Commissioning Groups and Sustainability and Transformation Partnership. We have recently evaluated the use of this service over 3 months throughout the COVID-19 outbreak, and we share some of our observations here.
     
    We received a total of 288 queries from GPs by phone and email, most commonly about gastroenterology (14.2%) and dermatology (10.8%) conditions; the latter particularly by email with photo attachments.
     
    After discussion with the advice line, outcomes included phone/email advice, paediatric outpatient follow up or further GP assessment. 62 (21.5%) children had an outcome of attendance to the emergency department (ED); of these 40 (65%) attended as advised and 12 (19%) did not, highlighting parents’ hesitation in attending hospital recently. Interestingly, the remaining 10 (16%) attended ED against advice given. Of those who attended ED, almost one quarter (24%) were diagnosed with a respiratory tract infection or an ear/nose/throat infection and these both typically require a face-to-face assessment, which GPs were often not able to provide at this time.
     
    This initiative has received overwhelmingly positive feedback from paediatric registrars and GPs, praising ease of access at a time of mainly virtual consultations, and we will continue this service in the COVID-19 recovery period.
     
    Reference
    1. Patel S, Hodgkinson T, Fowler R, Pryde K, Ward R. Integrating acute services for children and young people across primary and secondary care. Br J Gen Pract 2020;70(693):158-159. doi:10.3399/bjgp20X708917.
     
    Show Less
    Competing Interests: None declared.
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British Journal of General Practice: 70 (693)
British Journal of General Practice
Vol. 70, Issue 693
April 2020
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Integrating acute services for children and young people across primary and secondary care
Sanjay Patel, Tamali Hodgkinson, Roland Fowler, Kate Pryde, Roisin Ward
British Journal of General Practice 2020; 70 (693): 158-159. DOI: 10.3399/bjgp20X708917

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Integrating acute services for children and young people across primary and secondary care
Sanjay Patel, Tamali Hodgkinson, Roland Fowler, Kate Pryde, Roisin Ward
British Journal of General Practice 2020; 70 (693): 158-159. DOI: 10.3399/bjgp20X708917
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    • DELIVERING INTEGRATED CARE: WHY FOCUS ON CHILDREN?
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