{
  "abstract": "Why did you do this work? The Darzi review shows A&E services are overstretched and at breaking point. 1 Integrated models of care aim to reduce reliance on unsolicited emergency hospital attendances and provide comprehensive and timely care. New models of integrated care, often composed of multi-disciplinary teams (MDTs) play a unique role in delivering holistic and convenient care in paediatrics by bringing secondary paediatric expertise into primary care settings. However, it is often difficult to assess the optimal makeup of an MDT, due to limited data on the case mix. This study aims to describe the typical cases seen and discussed and offer a model of auditing case mix which can be used more widely to inform future local service development.What did you do? Baseline data was collected over a 14-month period from a GP Child Health Hub (also known as an Integrated Neighbourhood Team) in North West London between April 2022 and February 2024. A total of 108 cases were recorded, analysed, and categorised into three case types: a) Paediatric medical/surgical case (pathway, diagnostic, investigation, treatment query); b) Interface interagency case- who should do what, when and where, and in what order; and c) Simple referral on to other agencies as appropriate.What did you find? 58/61 (95%) of the cases were interface agency cases between April 2022 to November 2023 however, only 15/58 (26%) of the interface agency cases were aged 5 and under. Data is missing on the case mix between December 2023 to February 2024, highlighting data limitations on MDT case mix.71/108 (66%) cases were of children aged over the age of 5 years from April 2022 to November 2023, whilst 37/108 (34%) cases were of children aged 5 years and underAll cases were medical staff referrals between April 2022 – January 20231 social nurse referred a case under 5 (3-year-old) in February 20231 key worker (family solutions) referred a case for a child over 5 years in August 2023What does it mean? This typology helps describe the case mix in terms of MDT decisions and actions taken on referred cases and acts as a baseline for further involvement of professionals in a particular locality. This could help further develop integrated neighbourhood team development for babies, children and young people in the future.Reference Darzi A. Independent investigation of the NHS in England. 2024. GOV.UK. [online] Available at: https://www.gov.uk/government/publications/independent-investigation-of-the-nhs-in-england.",
  "authors": [
    {
      "affiliations": [
        "Mohn Centre for Children’s Health and Wellbeing, School of Public Health, Imperial College London"
      ],
      "name": "Kajl Ahmad"
    },
    {
      "affiliations": [
        "Department of Primary Care and Public Health, School of Public Health, Imperial College London"
      ],
      "name": "Bina Ram"
    },
    {
      "affiliations": [
        "The Willesden Medical Centre – North West London"
      ],
      "name": "Tess Lindog"
    },
    {
      "affiliations": [
        "Gladstone Medical Centre – North West London"
      ],
      "name": "Neel Trivedi"
    },
    {
      "affiliations": [
        "Department of Primary Care and Public Health, School of Public Health, Imperial College London"
      ],
      "name": "Mitch Blair"
    },
    {
      "affiliations": [
        "Mohn Centre for Children’s Health and Wellbeing, School of Public Health, Imperial College London"
      ],
      "name": "Dougal Hargreaves"
    }
  ],
  "title": "8316 A suggested typology for describing case mix of an integrated GP child health hub",
  "uid": "7704848b-c711-5391-b0b4-6ba780b8c62d"
}