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Which urgent care services do febrile children use and why?
  1. Sabine Maguire1,
  2. Rita Ranmal2,
  3. Sirkka Komulainen2,
  4. Sarah Pearse2,
  5. Ian Maconochie3,
  6. Monica Lakhanpaul4,
  7. Ffion Davies5,
  8. Joe Kai6,
  9. Terence Stephenson2 on behalf of the RCPCH Fever Project Board
  1. 1Department of Child Health, Cardiff University School of Medicine, Heath Park, Cardiff, UK
  2. 2Royal College of Paediatrics and Child Health, London, UK
  3. 3Department of Paediatric Emergency Medicine, St Mary's Hospital, London, UK
  4. 4Academic Division of Child Health, Department of Medical Education and Social Sciences, Leicester Royal Infirmary, Leicester, UK
  5. 5Emergency Department, Leicester Royal Infirmary, Leicester, UK
  6. 6Division of Primary Care, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
  1. Correspondence to Dr Sabine Maguire, Department of Child Health, Cardiff University School of Medicine, UHW Main Building, Heath Park, Cardiff CF14 4XN, UK; sabinemaguire{at}


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.

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  • Funding This study was funded by Department of Health for England.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the St Thomas' Hospital Research Ethics Committee.

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