Offering specialist child health expertise to local communities

Paediatricians at St Mary’s Hospital understand a visit to hospital can be very daunting, especially for children. That was one of the main drivers for developing Connecting Care for Children (CC4C) – a new model of care that brings hospital specialists, GPs and patients and their families together in the community. Consultant paediatrician Dr Mando Watson explains how CC4C is helping children and young people take more control of their own health.

We need to get to really know our patients and understand their needs if we want to continually improve the care we provide. One of the best ways to do this is to bring the specialist child health expertise of hospital paediatricians to a place where patients feel more comfortable – their local GP practice. That’s one big reason why we launched Connecting Care for Children (CC4C).

At its core, CC4C takes the child health expertise that sits in the hospital and makes it available in the GP practice. We know patients often have wonderful relationships with their local GPs. There’s real trust built up over time, and patients often find it easier to go to their GP with questions or worries. Coming into hospital can be very daunting. If we, as paediatricians, are in a local practice working with GPs, patients can access our expertise much more easily. It also means the GP feels better able to respond to children’s health issues, meaning more children can get the care they need without being referred immediately to hospital.

By working with GPs, we can be more proactive about supporting children. As a hospital doctor, you generally have to wait for a sick child to come to you. By working with the GP, I'm more likely to anticipate and prevent problems that could otherwise lead to a child coming to hospital. For the patient that means easier and earlier access to specialist child health expertise.

We’ve set up child health GP hubs across Westminster, Kensington and Chelsea and Hammersmith and Fulham, and we cover about a third of the population in our north west London patch through our partner practices. This year, we’re hoping to extend our offer to cover all GP practices and their patients in the sector.

We work really closely with a broad range of professionals – as well as GPs, this includes practice nurses, local health visitors, community dieticians, mental health workers, dentists, social workers. It enables us to offer much more holistic, joined-up care. The team around the child is much more streamlined, and a lot of patients are finding they can now cover off all their needs through a single appointment rather than having to arrange to see several different professionals.

We also want CC4C to help children and their families take a more active role in their healthcare. We run workshops that give children and families a chance to get involved. Our puppet show, ‘Fix Freddie,’ encourages children to work with their parents to take more control of their own health. Our life support workshops, held in children’s centres, have been very rewarding – you can actually feel the load falling from parents’ shoulders as they learn how to offer emergency lifesaving care to their to their children.

CC4C is about identifying the needs of local communities and giving them the tools to develop creative solutions to problems great and small. We cannot be in the communities all the time, so we work with volunteer practice champions to identify community needs and develop practical solutions. Our ‘practice champions’ are young people, adults, carers, grandparents – anyone who wants to get involved. They live and work in the community, where they can identify local needs and begin brainstorming possible solutions.

One lovely group identified how sometimes young mothers with new babies can feel very lonely and don’t have a support network. So they developed a group called Chatty prams, where local mums can go for a walk for an hour after their local baby clinic and have an opportunity to talk and support each other. It’s such a simple idea, but it’s made a big difference in that community.

If we’re going to do the right thing for our patients, the best way to know what they need is to ask them. But often if we ask a patient what they want, they’ll tell us what they think we want to hear. That’s why we’re giving practice champions the reins and saying, ‘You’re in control, you’re equal partners in this, we’re doing this together.’ They are more likely to say, ‘This is where the issues are, this is where we need some help.’ It’s fantastic – we’ve had wonderful feedback from our practice champions, patients and GPs. And increasingly, we can see the transferability of CC4C – you can certainly use the same model for all ages, not just children.

At a very basic level, as a professional, you want to do the best for your patients, and this absolutely feels like the best thing to do. You can sense it in your bones.

At a time when healthcare is so precious and so limited and there’s so much to do with so little, it’s fantastic to implement an initiative that improves health, reduces waste, stops duplication and helps everyone to be more proactive about their health.

Find out more about the Connecting Care for Children initiative.