We have devised a system which divides the whole childhood population into six segments: healthy child; vulnerable child with social needs; child with single long-term condition; child with complex health needs; acutely mild-to-moderately unwell child and acutely severely unwell child. For each of these segments, we can envisage a pathway, or more accurately, a team around the child, delivering right care, right place, first time.
How this approach can be used to support commissioning
It makes sense to work through each segment and consider how we can provide the best healthcare resources for those children.
Our segmentation approach starts with healthy children, and suggests that if we want them to stay healthy, we should devote some attention to that. For example, by taking measures to prevent rising obesity.
For many children, social issues are driving their health needs. A child living in temporary bed and breakfast accommodation with limited floor space isn’t going to get the same opportunities to crawl, walk and develop as other children.
Children with long-term conditions need specialist nurses who can go into their school and explain the condition, the treatment and the best way to support that child in the school: immediately the stigma is lifted, and the staff are less fearful.
Children with short-term mild to moderate illnesses should be managed in a community setting, with primary care staff taking the lead, while capacity in the hospital is focused on those children with severe and complex urgent problems.
As commissioning becomes more sophisticated, funding might be allocated to these segments, linked with carefully chosen outcomes and values. If that happens, commissioning will be, at last, well placed to drive up quality of care.
The segmentation tool is gathering interest. The RCPCH has started to re-write its curriculum for paediatricians in training and is using the six segments to define the key topics. This means that the paediatricians of the future will think differently. They will understand better the broader health needs of the population and will be trained to work with the whole network of child health experts. And children won’t need to be on a ‘pathway’ to receive expert healthcare.
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- Last updated
- Author Giuseppe Prima