Change is coming: developing our recommendations for future models of care

Dr Nicola Jay discusses why and how we are thinking about future paediatric models of care as part of our ambitious Paediatrics 2040 project.

Update Paediatrics 2040 was launched in March 2021 - see our microsite

Well here we are, another decade… what will it bring? One thing for sure – there will be lots of activity to plan for change in the way we offer paediatric services, as future models of care are a key part of the Paediatrics 2040 project.

Facing up to change

This project reminds us of the need to be brave and to face up to doing things differently. It takes courage to admit that perhaps we are not doing things as well as we could. We all work hard, but perhaps just not in the right way.

Change is difficult, both from a personal point of view and from a job structure and organisational perspective, and there are often competing agendas between doctors, managers, politicians. What sometimes feels like a face off between primary and secondary care means that the way we offer services can be incohesive, leaving gaps for children and families to fall into. We offer services that suit us and not what patients are asking for. We are hearing more frequently that young people want to be seen in schools and environments where they feel empowered to be themselves and talk, in the community that is important to them.

There are many external drivers for change in paediatric models of care in the UK:

  • We are not meeting children’s needs, with poorer health outcomes than comparative populations
  • Poverty continues to increase, and although healthcare is free at point of contact, getting to that contact is increasingly difficult for families
  • We need to consider the environmental impact of the way we deliver services

Our models of care workstream

So what have we been doing in our models of care group? We have a vibrant, diverse, geographical spread group of professionals who feel passionately that our job is not just to deliver services but to change those services to meet the needs of children and their families. We have had two meetings and some online contact, with a focus on talking with each other, sharing what we are doing well and what can we let go. 

Our focus has been on getting out and about around the country, mainly in the north (silent cheer and maybe my influences!) to have grass roots involvement, where the action is, to understand and ask three questions:

  • What have you learnt from the past: What changes have happened over the past 20 years that have impacted on the delivery of paediatric models of care? What has worked? What hasn’t?
  • Your vision for the future: What would you like to see change in the delivery of paediatric care in the next 20 years?
  • If I were in charge: What are the major changes that need to happen to achieve this?

What next?

What I have learnt in my career is that my theoretical knowledge is of no use unless the children I see will use it. What determines whether this happens is trust and delivering the information in the correct way - it’s not rocket science. But that’s why the CYP voice we are collecting through our RCPCH &Us network will be so important in determining how we do things in the future. 

Honesty is always the best policy and if you are savvy then you will know that I haven’t really revealed anything apart from change is coming. Join us in developing our vision for the future and embrace it…

[survey closed on 1 March]