Advancing integrated paediatric care in Australian general practices: Qualitative insights from the SC4C GP-paediatrician model of care

PLoS One. 2024 May 21;19(5):e0302815. doi: 10.1371/journal.pone.0302815. eCollection 2024.

Abstract

The Strengthening Care for Children (SC4C) is a general practitioner (GP)-paediatrician integrated model of care that consists of co-consulting sessions and case discussions in the general practice setting, with email and telephone support provided by paediatricians to GPs during weekdays. This model was implemented in 21 general practices in Australia (11 Victoria and 10 New South Wales). Our study aimed to identify the factors moderating the implementation of SC4C from the perspectives of GPs, general practice personnel, paediatricians and families. We conducted a qualitative study as part of the mixed-methods implementation evaluation of the SC4C trial. We collected data through virtual and in-person focus groups at the general practices and phone, virtual and in-person interviews. Data was analysed using an iterative hybrid inductive-deductive thematic analysis. Twenty-one focus groups and thirty-seven interviews were conducted. Overall, participants found SC4C acceptable and suitable for general practices, with GPs willing to learn and expand their paediatric care role. GPs cited improved confidence and knowledge due to the model. Paediatricians reported an enhanced understanding of the general practice context and the strain under which GPs work. GPs and paediatricians reported that this model allowed them to build trust-based relationships with a common goal of improving care for children. Additionally, they felt some aspects, including the lack of remuneration and the work and effort required to deliver the model, need to be considered for the long-term success of the model. Families expressed their satisfaction with the shared knowledge and quality of care jointly delivered by GPs and paediatricians and highlighted that this model of care provides easy access to specialty services without out-of-pocket costs. Future research should focus on finding strategies to ensure the long-term Implementation of this model of care with a particular focus on the individual stressors in general practices.

MeSH terms

  • Australia
  • Child
  • Delivery of Health Care, Integrated
  • Female
  • Focus Groups
  • General Practice* / organization & administration
  • General Practitioners* / psychology
  • Humans
  • Male
  • Pediatricians / psychology
  • Pediatrics
  • Qualitative Research

Grants and funding

The study was funded by a 4-year National Health and Medical Research Council (NHMRC) Partnership Grant (APP1179176). This includes direct funding from the NHMRC, as well as cash and in-kind support from the following Partner Organisations: RCH, SCHN, NWMPHN, CESPHN, ACI NSW Health. The NHMRC has no direct role in study design; data collection, analysis, and interpretation; or writing of final reports, presentations, or publications. Murdoch Children’s Research Institute research is supported by the Victorian Government’s Operational Infrastructure Support Program. HH is supported by an NHMRC Practitioner Fellowship (1136222). Representatives from each Partner Organisation formed the Advisory Committee for the project; and therefore, have a role in the study and may influence the activities above.