1. Learning to Work Together:
The Programme for Integrated Child Health (PICH)
Lisa Collins1, Katie Dharmarajah2 , Melanie Menden3 , Holly Boyd4 , Mando Watson5, Chloe Macaulay6 , Joanna Yong7
1 GP, Camden CCG, 2Paediatrician, London North West Healthcare NHS Trust, 3Paediatrician, Royal Free London NHS Foundation Trust, 4Paediatrician, Barnet and Chase Farm Hospitals NHS Trust, 5Paediatrician, Imperial College Healthcare NHS Trust, 6Paediatrician, Guy's and St Thomas' NHS Foundation Trust , 7GP, Barnet CCG
RESULTS
All participants reported valuable learning and an increase in confidence and knowledge of integrated care.
All respondents agreed with the statement “I now feel equipped to engage others in the integrated care process” .
The programme offers true experiential learning – learning by doing. In addition, many participants completed impressive project work which represents real change for their organisations.
In addition, the GP and Paediatric mentors reported valuable learning from taking part.
Below are some examples of the project work the participants achieved:
Some of the richness of the participants’ learning is demonstrated in the following quotes:
PICH has provided opportunities to develop community networks. As some of the GPs are CCG members, they have incorporated concepts and increased awareness in multidisciplinary facilities such as local Hubs. CCG Child Health pathways are being developed between GP and Paediatric colleagues across London.
AIMS
We know that paediatric care in the community is often disjointed and suboptimal. The Programme for Integrated Child Health (PICH) was designed by members of the London School of Paediatrics’ trainees committee to develop competencies in integrated care. PICH is now integrating with GPs to address the Five Year Forward View’s vision of working differently. It is the first comprehensive integrated child health programme in the UK.
PICH aims to facilitate GP and Paediatric trainees to work collaboratively across boundaries and lead the development of integrated services together with other multidisciplinary colleagues.
METHODS
PICH is a one year educational programme designed to run alongside clinical attachments. Participants work through five key themes by attending monthly seminars and workshops, and completing project work.
21 paediatric trainees were recruited in 2014/2015, 15 GP and 15 paediatric trainees in 2015/2016 and 10 of each in 2016/2017.
Participants are allocated a GP or Paediatric mentor who has particular experience in integrated care to help facilitate and support their work. They have the opportunity to present their projects at monthly “project surgery” workshops and receive review and feedback from the rest of the group.
The monthly PICH seminars are also open to anyone interested. Nursing, managerial and third sector colleagues regularly join the group and contribute to both discussion and project work.
PICH was evaluated by a blinded, externally validated midpoint, and end point questionnaire in the previous years. Current formal evaluation of this year is underway.
Setting up allergy services in community pharmacies as an extension of the “Itchy Sneezy Wheezy” project by Imperial College healthcare NHS Trust
Setting up a Whatsapp group for adolescents with diabetes to improve self motivation and engagement of patients
Conducting a quality improvement project in immunisations as part of CC4C (Connecting Care for Children)
Five key themes of PICH:
What is integrated care?
Patient experience and involvement
Data influencing change
Working clinically in an integrated way
Leadership and development of integrated services
“I felt encouraged and empowered to have authentic patient dialogues”
“I was able to find data through a resource that I never knew existed”
“I learnt that integrated care is only possible with great team work and a good vision of what you want an integrated service to look like”
“Working together improves outcomes. Professionals, parents and patients need to listen to each other”
CONCLUSION
PICH has provided a platform for quality improvement and new organisational structures. Participants reported invaluable learning, and as trainees they have affected change across many domains. PICH prepares trainees to be the future leaders of integrated services. 
The programme has implications for facilitating aspects of the Five Year Forward View. Community health integrated networks are a feature of Sustainability and Transformation Plans (STPs). The Healthy London Partnership (HLP) incorporates the Children and Young People’s Programme. Key focus areas include integrating care across public health and primary and secondary healthcare services and developing innovative access models of care.
PICH has the potential for influencing new organisational structures within Commissioning for Quality and Innovation (CQUIN).
REFERENCES: For more details and to apply to PICH 2017/18:
NB. Applications are now open to First5 GPs as well as AiTs
CC4C:
Itchy Sneezy Wheezy:
Healthy London Partnership: