GPs to set up special children’s clinics to help ‘increase’ school attendance

NHS England is expecting to see ‘increased’ rates of school attendance for children as a result of its ‘neighbourhood teams’ strategy, it has revealed in new guidance.

The commissioner has said that special ‘multidisciplinary’ clinics should be set up for children and young people, to provide ‘direct care’ in primary care settings including GP practices.

It follows separate guidance on the development of neighbourhood health services, with a focus for 2025/26 on those with the most complex health and social care needs who make up almost half of hospital costs.

As part of this, ICBs are expected to develop plans for specific groups, prioritising children and young people.

The new guidance said that ‘neighbourhood multidisciplinary team (MDT) clinics’, located in GP practices or other community settings, will allow ‘direct care’ to be delivered to children and young people who need it, and one of the measurable outcomes of this will be ‘increased rates of school attendance’ and ‘readiness’.

NHS England’s expectation is that MDT clinics will take place at least once a month and ‘ideally’ be delivered jointly by a GP and a paediatrician.

According to NHSE, the ‘core’ clinical workforce for every neighbourhood MDT for children and young people should include:

• a GP
• a paediatrician
• mental health professionals with specialist clinical supervision and consultation

‘For those who require specialist input from a general paediatrician, MDT clinics may replace the need to travel to the local hospital for a paediatric outpatient appointment,’ the guidance said.

As a result of this strategy, NHS England would ‘expect’ to see:

• increased rates of school attendance and readiness
• reduction in subsequent GP appointments for children and young people who have been discussed in the MDT
• increased patient satisfaction (via Friends and Family test or other qualitative measures)
• reduction in outpatient referrals for certain specialties, such as general paediatrics
• reduction in waiting time for certain outpatient appointments, such as general paediatrics
• reduction in number of A&E attendances and re-attendances
• reduction in number of acute mental health presentations in crisis
• reduction in non-elective admissions

It said: ‘This approach will enhance the current primary care offer for children and young people who might otherwise require referrals to secondary care, community services or other health and social care support.

‘It also increases the opportunities for early intervention and prevention support, especially for children in their early years.

‘Implementing these models of care will reduce pressures on secondary care services by reducing both outpatient referrals and A&E attendances.’

However, the commissioner stressed that this guidance is not a service specification, and that service design and implementation will depend on local factors.

It comes after the Government promised to ‘reform’ primary care, trialling ‘neighbourhood health centres’ which would have GPs and other community health staff ‘under one roof’. It is currently working on a new 10-year NHS plan, expected to be published in the ‘spring’.

Professor Claire Fuller’s landmark review in 2022 had already recommended the creation of integrated neighbourhood teams, as well as ‘single urgent care teams’ which would ‘offer their patients the care appropriate to them when they pop into their practice, contact the team or book an online appointment’.

Last year, an independent investigation into the NHS, led by Lord Ara Darzi, found that neighbourhood working and multidisciplinary teams will be the way forward for the system.

And ICBs around the country have already started overhauling their model of care following this, including North West London ICB where health bosses drew up plans to introduce integrated neighbourhood teams and  Cambridgeshire and Peterborough ICB, where the radical overhaul is going to cost £205m.