TY - JOUR T1 - Which urgent care services do febrile children use and why? JF - Archives of Disease in Childhood JO - Arch Dis Child DO - 10.1136/adc.2010.210096 SP - archdischild210096 AU - Sabine Maguire AU - Rita Ranmal AU - Sirkka Komulainen AU - Sarah Pearse AU - Ian Maconochie AU - Monica Lakhanpaul AU - Ffion Davies AU - Joe Kai AU - Terence Stephenson AU - on behalf of the RCPCH Fever Project Board Y1 - 2011/06/01 UR - http://adc.bmj.com/content/early/2011/06/03/adc.2010.210096.abstract N2 - Objectives To explore how parents navigate urgent and emergency care (U&EC) services when their child <5 years old has a feverish illness, their views of that experience and whether services are meeting their needs and triaging in line with national guidance. Design Parents of a febrile child <5 years old contacting any U&EC service in three localities during a 6-month period were invited to participate in a telephone questionnaire supplemented by case note review. A subset participated in an in-depth interview. Results Of 556 parents expressing an interest, 220 enrolled, making 570 contacts (median 3, range 1–13) with services during the child's illness which lasted 3 days on average. Parents' first preference for advice in hours was to see a general practitioner (GP) (67%; 93/138) and when unavailable, National Health Service Direct (46%; 38/82). 155 made more than one contact and 63% of the repeat contacts were initiated by a service provider. A range of factors influenced parents' use of services. Parents who reported receiving ‘safety netting’ advice (81%) were less likely to re-present to U&EC services than those who did not recall receiving such advice (35% vs 52%, p=0.01). Parents identified a need for accurate, consistent, written advice regarding fever and antipyretics. Conclusion Parents know the U&EC service options available, and their first choice is the GP. Multiple contacts are being made for relatively well children, often due to repeated referrals within the system. Safety netting advice reduces re-attendances but parents want explicit and consistent advice for appropriate home management. ER -