Advances in paediatric care mean that more children with complex medical problems (heart disease, neurodevelopmental problems and so on) are surviving their early years. This has important implications for the design and delivery of healthcare given their extensive multidisciplinary requirements and susceptibility to poor outcomes when not optimally managed. Importantly, their medical needs must also be understood and addressed within the context of the child and family’s life circumstances. There is growing recognition that many other factors contribute to a child’s complex health needs (CHNs), for example, family problems, fragmentation of health and care provision, psychological difficulties or social issues.To facilitate proactive care for these patients, we must develop accurate ways to identify them. Whole Systems Integrated Care—an online platform that integrates routinely collected data from primary and secondary care—offers an example of how to do this. An algorithm applied to this data identifies children with CHNs from the entire patient population. When tested in a large inner-city GP practice, this analysis shows good concordance with clinical opinion and identifies complex children in the population to a much higher proportion than expected. Ongoing refinement of these data-driven processes will allow accurate quantification and identification of need in local populations, thus aiding the development of tailored services.
included a discussion on risk assessment and management, signposting to appropriate resources and sharing learning points. Confidence in history-taking, psychosocial assessment and management were assessed by self-report before and after the simulation. Results Following both the self-harm and anorexia nervosa scenarios respectively, there were increases in clinician-reported confidence in history taking (37% vs. 85.2%; 41.7% vs. 70%), psychosocial assessment (34.6% vs. 67.8%) and management (37% vs. 60.7%; 58.3% vs. 63.7%). Thematic analysis of qualitative feedback highlighted the desire for further training as well as various benefits of simulation. Conclusion As the mental health needs of CYP continue to rise, it is clear that there remains an urgent and unmet need for mental health training for paediatric clinicians. This data suggests that low technology high fidelity simulation is a feasible method of improving clinician confidence in the assessment and management of CYP with mental health presentations. It is hoped that by developing such programmes, clinicians will be helped to cultivate the necessary skills to appropriately assess and manage patients presenting with mental health concerns.
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