677 GP with Extended Remit (GPwER) in Paediatrics-Ensuring children and young people are seen in the right place, at the right time, by the right person

Published Date: 17th August 2022

Publication Authors: Chang R, Abdelaziz M, Barrow A

Aims
The GPwER for paediatrics manages a defined cohort of paediatric conditions in a community setting, ensuring patients are seen at the right time, in the right place by the right clinician. By bringing the skills of a generalist to a specialist area, care is delivered to children & young people closer to home, in a none-hospital setting. This supports primary care with challenging cases, whilst freeing up consultant-led services. This is the first project of its kind in Merseyside, with the aim of improving service quality in St.Helens.

Methods
A service need was identified by St Helens CCG. Collaborative working by myself (GP with previous paediatric speciality training), the Senior Commissioning Manager and STHK Hospital Trust has led to the approval of the GPwER pilot clinic in a Children’s & Families Community Hub. As the clinical lead I devised a robust referral criterion with the Paediatric Clinical Director. This supported the development of electronic triaging for referrals.

Results
The service’s impact has been hindered by launching during the Pandemic. Even so, data in the first 3 months showed that 10% of consultant paediatric referrals were redirected to the GPwER. There were shorter waiting times for GPwER (3-6 weeks) than a paediatrician (12-21 weeks). Children were discharged from the GPwERsooner.

Families fedback using ‘Friends and Family Test’ and a retrospective patient survey with 100% of responses positive. >80% of responses received the highest rating of ‘very good’. Respondents ‘strongly agreed’ the service was appropriate for their child; all felt that the GP was ‘very competent’ in regards to their child’s needs and were ‘very satisfied’ with the outcome.

Conclusion
The significant reduction in waiting times and positive overall experience is important for keeping care in the community and knowledge sharing. This interface for care for children and young people gives prompt diagnosis and management, and has been received positively by families.

Quantitative data has been difficult to interpret (total number of referrals to all services reduced in 2020), but we are now seeing an increase to pre-pandemic levels. This will optimise capacity, with more reflective data by the spring of 2022.

 

Chang, R; Abdelaziz, M; Thong, S; Barrow, A. (2022). 677 GP with Extended Remit (GPwER) in Paediatrics-Ensuring children and young people are seen in the right place, at the right time, by the right person. Archives of Disease in Childhood. 107(Suppl 2), p.A345. [Online]. Available at: https://adc.bmj.com/content/107/Suppl_2/A345.1 [Accessed 22 December 2022]

 

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