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G584(P) Programme for Integrated Child health (PICH) – a trainee designed programme to develop new competencies
  1. KL Dharmarajah1,
  2. M Menden2,
  3. M Watson3,
  4. H Boyd4,
  5. C Macaulay5
  1. 1Paediatrics, London North West Healthcare NHS Trust, London, UK
  2. 2Paediatrics, Royal Free Hospital NHS Trust, London, UK
  3. 3Imperial College Healthcare NHS Trust, London, UK
  4. 4Barnet Hospital NHS Trust, London, UK
  5. 5Evelina Children’s Hospital NHS Trust, London, UK


  • This programme was designed by members of the London School of Paediatrics Trainee Committee, supported by the Curriculum Delivery TPD. The programme had 20 Paediatric trainees for its first year 2014–15.

  • We know that Paediatric Care is often disjointed and suboptimal. PICH was designed to address Facing the Future and The Five Year Forward View’s vision of working differently. Currently Paediatric trainees are trained almost exclusively in the hospital setting.

  • The Mapping the future analysis performed in 2014 established that paediatric trainees in London feel under skilled and undertrained in delivering integrated care. PICH aimed to get trainees out of hospital, working across boundaries collaboratively with others, and leading the development of integrated services.

  • PICH is a one year programme designed to run alongside clinical attachments. Participants work through four key themes by attending monthly seminars and workshops, and completing project work.

The key themes are:

  • Using data to drive change

  • Patient experience and involvement

  • Working clinically in an integrated way

  • Leadership and development of integrated services

Participants are allocated a mentor who has particular experience in integrated care to help facilitate and support their work. They have the opportunity to present their projects at monthly “project surgery” workshops and receive review and feedback from the rest of the group.

  • PICH is an educational program rather than a formal research project.

  • In addition to the formal participants on the programme, PICH also involved 10 mentors and the monthly seminars were open to anyone interested. Nursing, managerial and third sector colleagues regularly joined the group and contributed to both discussion and project work.

  • PICH was evaluated by a blinded, externally validated midpoint, and end point questionnaire. All participants reported valuable learning and an increase in confidence and knowledge of integrated care. All respondents agreed with the statement “I now feel equipped to engage others in the integrated care process” The programme offers true experiential learning – learning by doing. In addition, several participants completed impressive project work which represents real change for their organisations.

In addition, the mentors have reported valuable learning from taking part.

  • The fact that the development of this programme was largely driven by trainees has shown us that as trainees we can effect change. This year the programme has extended to GP trainees in addition to Paediatric trainees – an exciting development.

  • If you feel something is lacking in your training – do something about it!

  • Get ahead of the curve, we believe working outside hospital is the future. If you have some experience you will be ahead of others. You don’t need formal training in things to be an “expert”.

  • All the mentors are enthusiastic working clinicians with an interest. Anyone could contribute this programme!

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