Staff experiences and perspectives of delivering an integrated child health and social care service in community settings: A qualitative exploration using the SELFIE framework

It’s suggested that integrated care is well-placed to address the prevalence of chronic conditions, obesity, and mental ill health in children and young people living in minoritized and economically-marginalised communities in high-income countries. This work describes staff perspectives of delivering an integrated place-based service providing multidisciplinary clinical care and early intervention social support to children and young people in an ethnically diverse and economically disadvantaged community in the UK.

Materials and Methods

We conducted a qualitative exploration of the experiences of staff delivering the service and used a directed content analysis to populate and present the results within the Sustainable integrated chronic care model for multi-morbidity: delivery, financing, and performance (SELFIE) framework. The first part of the analysis presented here focusses on the domain of Service delivery, relating to the availability and access of care.

Results

A total of 14 staff were interviewed including clinicians from primary and secondary care, social care providers, local voluntary groups, and school-based family mentors. Staff described at a Micro-level how the service increased engagement of families and facilitated referral to social support and preventative care; at a Meso-level the benefits of collocation, collaborative working, and community outreach were described. Finally at the Macro level, improvements to the access and availability of appropriate care were observed despite limited engagement by the local care system.

Conclusions

The pilot appeared to deliver multiple benefits for both patients and staff and the broader health economy particularly through collocating health care and social support. However, to implement truly integrated care, greater institutional commitment and leadership are needed.