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GP care is valuable for children with life-limiting conditions reducing the need for A+E

February 18, 2020

Regular involvement of a GP in the care of children and young people with life-limiting conditions can reduce hospital admissions, a new study has found.

The research - led by the Martin House Research Centre team at the University of York - discovered that children who had less regular contact with a GP had 15% more emergency admissions and 5% more A&E visits than those with more regular consultations.

More than 40,000 children in England live with a life limiting condition. These include conditions for which there is no reasonable hope of cure and from which the child or young person will die, as well as conditions for which treatment is available but not always successful, such as cancer or heart failure. Other conditions include cerebral palsy and severe congenital anomalies.

GPs are rarely actively involved in healthcare provision for children and young people with life-limiting conditions. This raises problems when these children and young people develop minor illness or require management of other chronic diseases.

The study is the first of its type to examine the potential impact of regular GP attendance and continuity of care with a GP for young people with life-limiting conditions. Researchers used the Clinical Practice Research Datalink to analyse attendances at general practices and in hospitals.

Despite the growing number of children and young people living with life-limiting and life-threatening conditions in the UK this study showed that GP attendance rates by them is decreasing. The reasons for this are complex and may include difficulty accessing GP services in a timely fashion and the specialist-led nature of their care.

Study author, Dr Lorna Fraser from the University's Department of Health Sciences, said:" Many of these children and young people have high health care needs and more are now living into young adulthood than ever before.

"The GP can become the main healthcare provider when these young people are discharged from paediatric services. GPs are also in a unique position as a healthcare provider for the whole family which includes bereavement if a child or young person dies."

The study shows there is scope for improvement in communication, including sharing electronic records, between paediatricians and GPs, and for truly integrated care in the community for children and young people with life limiting conditions.

Researchers from Martin House Research Centre, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds and Warwick Medical School were also involved in the study.
The paper, "GPs' role in caring for children and young people with life limiting conditions - a retrospective cohort study" is published in the British Journal of General Practice.

University of York

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