What are the Barriers and Facilitators to Providing Continuity of Care between Secondary and Primary Care for Children with Long-Term Conditions?

Problem

Previous research from the Academic Unit of Primary Medical Care at The University of Sheffield by Willis et al. found the role of primary care for children with long-term conditions to largely involve coordination of care (2015). However it also identified a need for improvement of the link between services.It would therefore be beneficial to establish how to best provide continuity of care between secondary and primary care for these children.

Approach

This project aims to identify barriers and facilitators to continuity of care between secondary and primary care for children with long-term conditions. It is being undertaken as part of an intercalated bachelor of medical science (BMedSci) degree. A linked project is being conducted on communication between secondary and primary care health care professionals for children with long-term conditions by Elise Peever.Continuity of care is considered in the project in terms of three kinds of continuity described by Haggerty et al.: informational continuity- availability of necessary health information; management continuity- a consistent management plan and relationship continuity- a relationship between the patient and one or more health care professionals (2003).Like the research by Willis et al., the project will focus on four index conditions- asthma, cystic fibrosis, diabetes and epilepsy- which illustrate different degrees to which long-term conditions may be managed in primary or secondary care (2015).Participants will be secondary care doctors and nurses who work with children with the index conditions, recruited via existing networks of health care professionals. This will give the secondary care perspective, complementing the primary care views researched by Willis et al. (2015).Data collection will be first through semi-structured interviews with a topic guide, to focus the discussion whilst allowing new ideas to emerge. Then there will be one or more focus groups involving member checking for triangulation. These will be audio recorded, transcribed verbatim and analysed, most likely using a thematic approach.Although this work involves data collection from secondary rather than primary care, the focus is on bridging the primary-secondary care interface. Sharing the research across this boundary may help bring together ideas on how best to provide continuity of care for children between these services.

Findings

The approval process is complete and data collection is due to begin shortly. The data collection and analysis for this project will be complete by the time of the conference.

Consequences

It is hoped that this research will lead to practical suggestions for how to improve continuity of care between secondary and primary care for children with long-term conditions.