Article Text

G89(P) Crossing boundaries – the Programme for Integrated Child Health (PICH)
  1. KL Dharmarajah1,
  2. M Menden2,
  3. C Macaulay3,
  4. M Watson4
  1. 1Paediatrics, London North West Hospitals Trust, London, UK
  2. 2Paediatrics, Royal Free Hospital NHS Trust, London, UK
  3. 3Paediatrics, Evelina Hospital NHS Trust, London, UK
  4. 4Paediatrics, Imperial College Hospitals NHS Trust, London, UK


Aims Clinical care is moving away from the hospital setting with more emphasis on integrated working, self-care, and care delivered more locally, by the right person at the right time1,2. As a result, training needs to anticipate the skills required for working in this different way. The Programme for Integrated Child Health (PICH) 2014/15, the first comprehensive integrated child health program in the UK, is an innovative educational programme for interested trainees to develop competencies in integrated care.

Methods PICH is a 1-year, learning programme for senior paediatric trainees designed to run alongside clinical placements. Participants are guided through key themes of integrated care at monthly seminars. The main learning is achieved through self-directed project work, with reflection and mentoring from a faculty of clinicians with expertise in integrated care.

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

The programme was evaluated by a blinded, externally validated midpoint, and end point questionnaire.

Results 21 paediatric trainees were recruited in 2014/15 (Table 1). Feedback from responding participants demonstrated that through ambitious and complex integrated care projects, participants achieved learning in the key themes, as well as developing strong leadership and improvement skills. Participants reported great richness of learning via the project work undertaken. Comments included:

  • “Thinking about patient experience has transformed the way I think”

  • “working together improves outcomes”

  • “I have learnt the power of limited data to effect change.”

  • “the real way to bring about good integration is with patient involvement and co-production”

Conclusions PICH delivers opportunities to work clinically in an integrated way and challenges trainees to use patient experience and data meaningfully. PICH prepares trainees to be the future leaders of integrated services; one step closer to Facing the Future’s vision of better connected care for children.2

As a natural progression, PICH 2015/16 recruited 15 general practice and 15 paediatric trainee participants. Interest has already been expressed from other specialties due to the transferability of the concepts involved in PICH.


  1. The NHS five year forward view – Simon Stevens

  2. Facing the Future – Together for Child Health – RCPCH 2015

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