Aims To assess the feasibility of referrals for social support as a locally designed Quality Indicator in the West Bank.

Methods Three quality indicators (referrals for social support, safe prescriptions and exclusive breast feeding at 6 months) were piloted to evaluate the success of a RCPCH supported Masters in Child Health (MACH) at Al Quds University. This MACH student collected data on the referral rate of children to a local psychosocial centre from her clinic population in Nablus and the data informed interventions.

Results In her reflection on the project DN wrote ‘after May I felt that there is something wrong because I advise people to go and I told the doctor working in my clinic to complete the referral form but the results didn't improve. I thought I might need further help, so a friend working in the municipality as a social worker to go and to do home visits to these families and give me feed back’.

What emerged from the social worker was ‘people thought a referral to the Al Makhfia centre is just like a referral to the mental hospital, so even giving them a referral form they will not go there. The centre will not accept a patient without a formal referral, and didn't do home visits. So my friend who was working with disabled children as a social worker, and already doing home visits as a follow up and treatment session, was the key to successful referrals’.

Conclusion Referrals for psychosocial support was sensitive Quality Indicator in this health system. Simply collecting data resulted in changes of behaviour at the clinic led by the MACH student and her conclusion at the end of the pilot was ‘I think that if we can arrange a day during the week or the month for the social worker to be with the team in the clinic, it will be very helpful to the patients and their families’.