We’ve got a great opportunity to think really differently about how we approach health and
wellbeing for children and young people in this country.
If we want the best start in life we want healthcare professionals to work in a more
integrated way around the health of our children and their families
I think it’s really clear to me that as paediatricians we need to think and behave
differently about the way we work. We need to connect with other professionals we work
with. The GP and the GP practice is a really key locus of that for us as a great place
for us to build relationships and in doing that what we’ve found is it brings in other
colleagues so, health visitors, school nurses, colleagues who work in a mental health setting,
community based dietitians and indeed colleagues who work in a third sector setting can come
together around the GP practice to work together, to think together and to learn together for
the benefit of children. We work in a really vibrant part of west London
very multi-cultural, multi-ethnic; brings its challenges but also has so many advantages
as well with lots of different communities coming together and supporting each other.
Actually this particular part of town is the most deprived in London itself so clearly
brings its challenges. Child obesity is a growing problem. In North West London, one
in five children are overweight. We are now working in hubs which brings together
professionals from primary care, the hospitals in the community and we are looking at all
aspects of our children’s needs and able to find and create support for all of those
needs and that’s naturally going to have a really tremendous benefit
I’ve seen patients care transformed by the GP hub, children that were coming into A&E
once a week who having one appointment in the hub stopped coming. If you look at outpatient
activity we’ve taken 80% of hospital appointments out of the hospital. About half of those are
being seen in the GP practice face to face and about half don’t need to be seen at
all. What we see is that families feel much more able to look after conditions themselves
and GPs feel much more confident and able to manage patients themselves.
I used to work as a local authority social worker and something I’ve found really frustrating
in that role was the lack of information sharing between professionals. We’re all there trying
to safeguard children and families and it’s really great to have a space where people
feel comfortable to share information. The child health hubs are a really really
good place to discuss your concerns about specific paediatric patients that belong to
the GP surgery. In turn with all the other health professionals that are there you can
have more integrated care and a better outcome for the child.
An example is say a child with maybe epilepsy. I see that child with the GP I might then
find out that there is another problem. Maybe the child is living in temporary accommodation
or the mother has a mental health issue. Things that I wouldn’t know if I was seeing the
child in the hospital and because I have that added insight I can provide advice and guidance
about managing the epilepsy that is very tailored to that child’s individual needs. It’s
much more personalised and therefore much more effective for that individual child and
family. For me I feel like I’m the link between
the professionals, health professionals and my community. I became a practice champion
for White City after one of my children became seriously ill, ended up in hospital but I
didn’t tap into the emergency care that he needed when I should of. It hit me I wasn’t
educated enough I didn’t know much about his asthma and what hit me hardest was when
he was taken into hospital that I was actually using the inhaler incorrectly.
We are now focussing on the whole child, looking at prevention and early intervention and helping
patient and families better manage the child’s health not just from the medial aspect but
also their emotional health and mental wellbeing As people who work in the NHS and work in
healthcare we’ve got to start to behave very very differently about the way we interact
with our communities. We need to make sure that our hospitals are very good and that
when people are seriously unwell that they get great care in that setting but we have
so much more to offer that really reach out to people’s lives in a meaningful way and
that’s about thinking and working differently. Our normal starting point in a consultation
used to be ‘what’s the matter with you’ and now we can ask ‘what matters most to
you’. This model gives us a really good example
of that. We need to get on and scale it up this needs to become the way we work.