Are virtual wards for children safe and effective? A 3-year retrospective service evaluation of an urban Hospital at Home service for children and young people.

Objective: Service evaluation of an urban 'Hospital at Home' service which provides care in patients' homes that would traditionally be delivered in the hospital setting.

Design: Retrospective longitudinal review of routinely collected data recorded contemporaneously for clinical use, analysed to elicit utilisation patterns and service impact.

Setting: A paediatric 'Hospital at Home' service delivered across two large acute hospitals, treating a total of 4427 patients across both primary and secondary care in South London from January 2018 to June 2022.

Gender medicine and the Cass Review: why medicine and the law make poor bedfellows.

In April 2024, the final report of the Cass Review, an independent review chaired by Dr Hilary Cass, was published, offering recommendations to improve gender identity services for children and young people in the UK. The core purpose of the Review was to improve care for children and adolescents. Commissioned by National Health Service England, the Review identified a weak evidence base for medical endocrine interventions and recommended that these treatments be provided within a structured research framework.

Lower Risk of Multisystem Inflammatory Syndrome in Children With the Delta and Omicron Variants of Severe Acute Respiratory Syndrome Coronavirus 2.

Little is known about the risk of multisystem inflammatory syndrome in children (MIS-C) with different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. In southeast England, MIS-C rates per confirmed SARS-CoV-2 infections in children aged 0-16 years were 56% lower (rate ratio [RR], 0.34 [95% confidence interval {CI}, .

Public health for paediatricians: Fifteen-minute consultation on addressing child poverty in clinical practice.

Paediatricians and other child health professionals have a key role in identifying, preventing or mitigating the impacts of poverty on child health. Approaching a problem as vast and intractable as poverty can seem daunting. This article will outline how social determinants impact child health, and provide practical guidance on how to address this problem through a public health lens.

Developing new models of care at speed: learning from healthcare redesign for children with COVID-related multisystem inflammation.

This article describes the rapid, system-wide reconfiguration of local and network services in response to the newly described paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) (also known as multisystem inflammatory syndrome in children). Developing the model of care for this novel disease, whose natural history, characteristics and treatment options were still unclear, presented distinct challenges.We analyse this redesign through the lens of healthcare management science, and outline transferable principles which may be of specific and urgent relevance for paediatricians yet to experience the full impact of the COVID-19 pandemic; and more generally, for those developing a new clinical service or healthcare operating model to manage the sudden emergence of any unanticipated clinical entity.

Use of age-specific hospital catchment populations to investigate geographical variation in inpatient admissions for children and young people in England: retrospective, cross-sectional study.

Objectives: To develop a method for calculating age-specific hospital catchment populations (HCPs) for children and young people (CYP) in England. To show how these methods allow geographical variation in hospital activity to be investigated and addressed more effectively.

Design: Retrospective, secondary analysis of existing national datasets.

Change in viral bronchiolitis management in primary care in the UK after the publication of NICE guideline.

The aim of this study was to investigate changes in general practitioner (GP) management before and after the publication of the National Institute for Health and Care Excellence bronchiolitis guideline. In March 2015 and May 2016, an electronic questionnaire was sent to GPs. It was completed by 1001 GPs in 2015 and 1009 in 2016.

The team that plays together stays together: the effect of departmental Christmas party attendance on team cohesion within a healthcare setting.

Objectives: To understand the effect of attendance at departmental Christmas parties on cohesion and teamwork within the healthcare setting. METHOD DESIGN/SETTING/PARTICIPANTS/INTERVENTIONS/OUTCOME MEASURES: We used the 'Team Development Measure' questionnaire to assess team cohesiveness among healthcare professionals before and after departmental Christmas parties took place. A pooled mean score (PMS) of responses was used to compare between groups.

Does increased duration of consultant presence affect length of hospital stay for unplanned admissions in acute paediatrics?: an observational before-and-after analysis using administrative healthcare data.

Objectives: This study aims to review whether implementation of increased duration of consultant presence is associated with reduction in length of hospital stay (LoS) in children with an unplanned admission to hospital. METHOD DESIGN/SETTING/PARTICIPANTS/INTERVENTIONS/OUTCOME MEASURES: An observational before-and-after study of all unplanned general paediatric admissions to a UK hospital between 1 September 2012 and 31 August 2015, comparing LoS and readmission rates before and after implementation of a policy mandating consultant review within 12 hours of unplanned hospital admission.

Results: 5367 inpatient admissions were analysed: 3386 prior to implementation of the policy and 1981 afterwards.

The role of paediatricians in public health for children and young people.

There is an increasing awareness among practising clinicians that public health for children and young people has an enormous impact on child health outcomes, and is an intrinsic aspect of the practice of paediatrics. This article, the first in a series, explores the key concepts of child public health, explains why public health matters to clinicians through a series of examples, and outlines opportunities and resources for further learning.

Who comes back with what: a retrospective database study on reasons for emergency readmission to hospital in children and young people in England.

Objective: To determine the proportion of children and young people (CYP) in England who are readmitted for the same condition.

Design: Retrospective cohort study.

Setting: National administrative hospital data (Hospital Episode Statistics).

Integrating primary and secondary care for children and young people: sharing practice.

Objective: To share innovative practice with enough detail to be useful for paediatricians involved in planning services.

Design: A review of practice, adopting a realist approach.

Setting: We collected detailed information about five initiatives which were presented at two meetings in July and October 2014 and telephone interviews between July and November 2014 with key informants, updating information again in February 2015.

Understanding healthcare processes: how marginal gains can improve quality and value for children and families.

Understanding how to identify and improve clinical pathways has proven a key tool in quality improvement. These techniques originated beyond healthcare, but are increasingly applied to healthcare. This paper outlines the history of the technique transfer and how to use in clinical practice.

Contribution of recurrent admissions in children and young people to emergency hospital admissions: retrospective cohort analysis of hospital episode statistics.

Objective: To examine the contribution of recurrent admissions to the high rate of emergency admissions among children and young people (CYP) in England, and to what extent readmissions are accounted for by patients with chronic conditions.

Design: All hospital admissions to the National Health Service (NHS) in England using hospital episode statistics (HES) from 2009 to 2011 for CYP aged 0-24 years. We followed CYP for 2 years from discharge of their first emergency admission in 2009.

Educating future leaders in patient safety.

Education of health care professionals has given little attention to patient safety, resulting in limited understanding of the nature of risk in health care and the importance of strengthening systems. The World Health Organization developed the Patient Safety Curriculum Guide: Multiprofessional Edition to accelerate the incorporation of patient safety teaching into higher educational curricula. The World Health Organization Curriculum Guide uses a health system-focused, team-dependent approach, which impacts all health care professionals and students learning in an integrated way about how to operate within a culture of safety.

Health policy research: successes and challenges.

This review seeks to explore and explain what health policy research is and why it matters, through pooling the evidence and providing case examples. Alongside examining the types of research involved, and their rationale the paper identifies the challenges taking part in this sort of research may create. Finally the paper suggests how to make clinical research more accessible to policy makers.