Study warns of impacts of GP-commissioning on children’s healthcare

The Health and Social Care Bill in its current form will be a “missed opportunity” to improve children’s healthcare, experts warn.

The Government’s proposals fail to learn the lessons from other European countries whose health systems deliver better outcomes for children, say the team led by Ingrid Wolfe, specialist registrar for public health and general paediatrician at the London School of Hygiene and Tropical Medicine.

They propose a “fundamentally different” approach in their paper, published on bmj.com

They have concerns about fragmented and difficult to access services for treating long-term conditions, and have particular concerns about death rates from illnesses that rely on rapid care, such as meningococcal disease, pneumonia, and asthma.

“If the UK performed as well as Sweden, the best performing country in our sample, as many as 1,500 children might not die each year,” say the authors.

The reforms should address “the dangerous gap” between general practice and specialists, they say, and ministers should avoid further fragmenting of services through competition.

They also warn of breakdowns in information sharing and regional and national planning of children’s services.

The team conclude: “Our analysis leads us to recommend that comprehensive integrated teams in primary care settings should provide the majority of children’s healthcare. These new children’s healthcare teams should comprise general practitioners with dedicated training in paediatrics and paediatricians with dedicated training to provide care for children with conditions that could better be managed in the community than hospitals. We believe such teams stand the best chance of delivering the right care, at the right time, in the right place, and by the right people.

“We believe that the Coalition Government’s proposed changes to the NHS in England do not address children’s needs and, worse, risk exacerbating the problems we have described.”