The Joint Paediatric Clinic was created in response to the year-on-year increase in the number of referrals from Primary Care (principally GPs) to Secondary Care (principally hospitals) services. Following a scoping exercise, it was identified that children under four years old were among the highest number of children referred to a paediatrician and discharged after their first initial appointment. In light of this, it was proposed that the initial test-and-learn phase of the new Joint Paediatric Clinic project would focus on children under 4 years old.

The clinics are held monthly at a host GP surgery within an A Better Start Southend ward, and children who are not likely to require ongoing secondary care following a Paediatric assessment are offered an appointment at the community Joint Paediatric Clinic. All appointments are a joint consultation with a paediatrician and a GP, with the GP retaining clinical responsibility, acting on recommendations from the paediatrician. At the end of each clinic there is a one hour shared learning event between the clinicians to discuss a specific topic. On average, between 6-10 clinicians attend these, and it provides an opportunity for shared learning, education and upskilling of the workforce.

The Joint Paediatric Clinics has been well received by both Paediatricians and GPs, and feedback from the participating GPs has been very positive.

One GP said: “It was a great experience having a Joint Paediatric Clinic. We encountered common paediatric problems. I learnt a lot from the history taking, examination and management. We had opportunities to discuss each case after the consultations and other relevant topics.”

Another said: “I will strongly recommend this experience to my GP colleagues. This could provide enormous confidence to my colleagues when dealing with common paediatric problems in the community. It will also effectively reduce the referrals to secondary care.”

Collaborative working has been key to the smooth running of this project, with one GP adding: “It has definitely helped improve my confidence in dealing with paediatric issues – fantastic to have joined up working”.

Evaluation of the first six months showed a ‘Did Not Attend (DNA)’ rate of 13%, 84% of patients required no prescription, and advice and guidance was given to the GP, patient and family in all instances (100%). 87% required no onward referral or follow up.

When setting up a project of this nature, there are a number of challenges and factors that impact on the pace and success. The project was initiated at the same time as the Primary Care Networks (PCN) were being established, and PCN engagement was critical to the success of the project.

Initially, the Joint Paediatric Clinics was not the key focus of PCN, and coupled with Southend Hospital’s capacity challenges, the project was difficult to roll-out at the pace initially agreed.

However, the six-month pilot has been a fantastic success, and delivery is being expanded to other localities. The second phase of delivery will focus on areas where there are a high number of referrals, low attendance rates at appointments and places where residents may have difficulty in accessing a service. It’s definitely something to look out for!