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Abstract

Gerontology & Geriatrics Studies

Learning from 35 Years of Community Child Health Services in the United Kingdom: Reflections for Community Geriatricians

  • Open or CloseFiona Finlay1* and Simon Lenton2

    1 Consultant Paediatrician in Community Child Health, UK

    2 Retired Consultant Paediatrician, UK

    *Corresponding author:Fiona Finlay, Consultant Paediatrician in Community Child Health, UK

Submission: November 19, 2018;Published: November 27, 2018

DOI: 10.31031/GGS.2018.04.000580

ISSN 2578-0093
Volume4 Issue1

Abstract

This article reviews the development of community child health services in the UK over the last 35 years and the role of the community paediatrician and reflects on the issues that had to be addressed to enable the specialty to evolve to the service that it is today. The article considers three areas-clinical practice, local service delivery and the national issues of leadership and policy, all of which may be relevant when developing community geriatric services. Community paediatrics and community geriatrics share many common aspects including increasing numbers of patients, the complexity of providing care for patients with multiple comorbidities, the issues of consent and confidentiality and the involvement of the extended family in care plans.

At a local level organizing clinical care in the community poses many challenges not present in a hospital setting where the multidisciplinary team, investigations and specialist care are all based together. This requires careful organization of time and resources to provide practical holistic care for individuals with complex needs in a number of settings. Developing meaningful working relationships with primary care and hospital teams, as well as with social care and other agencies involved is essential for success. A local champion is often required to negotiate new roles and responsibilities and local commissioning support is required for the development of a competent multiagency team that fits seamlessly between primary care and hospital care. Long-term leadership at a national level is essential to develop relevant health service policy, workforce estimates and training competencies, without which there will be insufficient numbers of appropriately trained geriatricians to work in community settings.

For the long-term viability of both paediatric and elderly care teams in community settings the clinical research base and the health service research base requires investment in order to produce the evidence required for future service development and improved outcomes for patients.

Keywords: Community geriatrics; Community paediatrics; Community child health; Integrated care; Multimorbidity

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