Strengthening Care for Children (SC4C) Project

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The Sydney Children's Hospital Network, Murdoch's Children's Research Institute, UNSW and Central and Eastern Sydney PHN have partnered to deliver the Strengthening Care for Children project.

The project will trial an integrated model of care that aims to:

  • strengthen the paediatric care skills of GPs.
  • increase knowledge of child health and management in general practice.
  • reduce the need for referrals to hospital services.

  • Why do we need this trial?

    Australia’s paediatric population has grown by 19% in the last two decades, with 53% of this growth in NSW and Victoria. However, Medicare data indicates that the proportion of child visits to primary care is steadily decreasing.

    Children also comprise the largest proportion of all emergency department attendances. At Sydney Children’s Hospital Networks (SCHN), there has been a 26% increase in the number of children attending outpatient clinics over the last three years. This has led to a significant increase in wait times.

    Many children who present to hospital services are attending for conditions such as upper respiratory infections, asthma and low severity behaviour problems. These conditions have the capacity to be well managed in primary care, which can result in improved health outcomes.

    A well trained and supported primary care workforce underpins the universal provision of equitable and comprehensive health care for children. This trial aims to determine if this can be achieved by integrating an educational relationship model between GPs and paediatricians in primary care.

    About the Strengthening Care for Children Project

    The current trial within CESPHN is an expansion of the project that was successfully piloted with general practices in the NWMPHN catchment between 2017-2019.

    Following the successful pilot, the project partners received a grant from the National Health and Medical Research Council. The Royal Children’s Hospital, Murdoch Children’s Research Institute, Sydney Children’s Hospital Network and UNSW have partnered to conduct a multi-site stepped wedge cluster randomised control trial. The trial is simultaneously being implemented in the North West Melbourne PHN region with the Royal Children’s Hospital 

    More Information about 2017-2019 pilot 

    Five general practices in the NWMPHN region were recruited and supported to take part in the pilot study between 2017–19.

    Participating practices gained weekly access to an experienced Royal Children’s Hospital paediatrician for patient co-consultations. The paediatrician also gave a monthly case conference for health professionals at the practice. Practices were also able to access the paediatrician by phone and email for same-day advice.

    Sustainability planning was completed in partnership between NWMPHN and the practices. Two practices have hired paediatricians, while others are exploring options for access to paediatric support and learning (for example: a webinar program).

    Read our case study of Neal Street Medical Centre.

    Watch the video below for more information.

    The integrated GP–paediatrician model

     

    The trial will test a model of care that gives GPs onsite access to a paediatrician from theSydney Children’s Hospital Network . This model will run for 12 months in each general practice. It involves weekly GP–paediatrician co-consulting sessions for six months, followed by fortnightly co-consulting sessions for another six months.

    The GP leads the co-consulting sessions, with the GP and the paediatrician providing shared care to paediatric patients. In addition to participating in these sessions, the paediatrician leads monthly 60-minute case study discussions within the general practice. They also provide email and phone support to GPs when they are not onsite (Monday to Friday).

     

    Benefits for families and paediatric patients

    The trial aims to provide better paediatric care by:

    • providing paediatric support for families in their regular general practice 
    • reducing the burden on families (of having to seek, wait for, travel to and pay for specialist paediatric care outside of general practice).
    Benefits for general practices

    The trial aims to support general practices by:

    • helping GPs to participate in research and provide better, patient-centred paediatric care
    • giving GPs an opportunity to contribute to and influence an emerging evidence-based model of care
    • providing collaborative professional development opportunities including education and training in paediatric care, and RACGP-accredited CPD points
    • practice incentive payments to support practice participation and quality improvement.
    • dedicated support from the CESPHN and Murdoch Children’s Research Institute project team.

    Contacts:

    Karen Wheeler
    Project Officer, CESPHN
    E: k.wheeler@cesphn.com.au

    Tammy Meyer Morris
    Project Manager, UNSW
    E: tammy_meyers.morris@unsw.edu.au