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How fair is our service? Evaluating access to specialist paediatric care
  1. Francesca K Neale1,
  2. Edward J Armstrong1,
  3. Jonathan M Cohen2,3,
  4. Terry Y Segal2,
  5. Dougal S Hargreaves4
  1. 1 Medical School, University College London, London, UK
  2. 2 Paediatric Department, University College London Hospitals NHS Foundation Trust, London, UK
  3. 3 Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
  4. 4 Department of Primary Care and Public Health, Imperial College London, London, UK
  1. Correspondence to Miss. Francesca K Neale, Medical School, University College London, London WC1E 6BT, UK; francesca.neale.14{at}


Objective To assess equity of access to paediatric outpatient clinics in our hospital.

Design/setting Retrospective analysis of consecutive accepted referrals to allergy, asthma, epilepsy, general paediatrics, rapid access, chronic fatigue syndrome, diabetes and endocrine outpatient clinics.

Patients 32 369 new patients, April 2007 to June 2018.

Results Among local patients (58.1%) 0.2%–2.5% of patients referred to each clinic lived in the least deprived quintile, and 43.5%–48.4% in the most deprived quintile—similar to inpatient admissions and the local population. Tertiary clinics showed a much higher proportion of patients from the least deprived quintiles (15.9%–26.2%).

Conclusions Local outpatient referrals broadly reflected the socioeconomic distribution, although not necessarily the distribution of need, of our local population. A relatively high proportion of patients in tertiary clinics were from more affluent postcodes, highlighting the need for referral inequalities to be evaluated across networks or regions.

  • audit
  • health services research
  • public health
  • inequalities
  • general paediatrics

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  • Contributors FN, TS, JC and DH devised the study. FN and EA analysed the data and prepared the manuscript draft. DH assisted with statistical analysis.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.