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G214(P) An Integrated Model of Care Pilot for Child Health: What Can We Learn?
  1. L Pakkiri1,2
  1. 1Paediatrics, West Middlesex Hospital, Isleworth, UK
  2. 2Hounslow Clinical Commissioning Group, Hounslow, UK

Abstract

Objective To evaluate the impact of an Integrated child health model pilot.

Design Mixed method service evaluation.

Setting and Patients: Children and their families registered in a pilot Child health GP Hub.

Interventions Hospital Paediatricians and GPs participating in Electronic advice, Vircon (Video) meetings and joint clinics. The pilot model was loosely based on the Connecting care for children (CC4C) model.

Main Outcomes Measures Casemix of referrals for the 3 arms of the Model of care. Hospital Episode data: Out patient, UCC and A and E attendances. Patient reported experience and paediatricians feedback.

*Length of time between referral and action. Number of DNAs.

Results There was a decrease of 16% to 31% in 3 of the 4 practices in the Hub. 66% of E-advice were directed to other specialties or sub-specialties. There was a 18% decrease in A and E attendance and 23% UCC attendances. The case mix data identified Allergy, Gastroenterology, Neurology and ENT as areas where secondary support is needed.

Patients supported the joint clinics at the GP practice. They felt listened to and would recommend the service to others.

Professional feedback was supportive of the Joint clinics and Electronic advice. The Video MDT was not popular among Paediatricians and GPs. Both sets of professionals felt that they benefitted from joint learning. GP presence at the joint clinic was thought to be poor.

Conclusions The Child Health Hub has decreased the number of referrals to Secondary care, patients are directed to the correct specialty swiftly. Patient satisfaction and professional satisfaction were good. The Hubs success is dependent on buy in, organisation and administrative support as well as financial investment.

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