Project Summary
SUSTAIN: Strengthening paediatric primary care, using an online integrated GP-paediatric care model to deliver equitable, quality care for children close to home and reduce unnecessary referrals.
The main researchers for this project are Professor Raghu Lingam and Dr Annemarie Christie.
What is the issue for NSW?
Within NSW, referrals to the Sydney Children’s Hospitals Network (SCHN) increased by 26% over the past 3 years, with waiting times for many conditions up to 6-18 months. Increases in hospital use are unsustainable.
Nationally, about 60% of medical care for children and youth meets best practice national guidelines. Quality of care paediatric indicators were significantly weaker in primary than secondary care for common medical conditions including; asthma and gastroenteritis, as well as for mental health issues.
Strengthening capacity of healthcare workers at all levels in paediatric care, is an identified priority in the Henry Review of health services for children, young people and families within the NSW Health system. The report recommends upskilling the primary care workforce to improve care pathways especially for children with; behavioural, mental health, and developmental disorders.
What does the research aim to do and how?
SUSTAIN (Strengthening Care for Children) aims to strengthen GP-provided paediatric care closer to home in an equitable and scalable fashion. The intervention, an integrated paediatric-GP model of care, is adapted from the Strengthening Care for Children (SC4C) study. This comprises; virtual fortnightly paediatrician-GP co-consultations, monthly online case discussions, and weekday paediatric email/telephone support. GPs will enrol in the well-established Sydney Child Health Program (SCHP) online child health training program. In this stepped-wedge cluster randomised controlled trial we will evaluate the impact, implementation and cost effectiveness of SUSTAIN across three sites.
The project will assess:
- Change in paediatric GP referrals to outpatient or emergency department (ED) services
- Change in GP Quality of Care, GP confidence in managing children, health-related quality of life and family confidence in GP care
- Evaluation of sustainability and cost effectiveness of this model of integrated paediatric-GP care.