The ARC researchers tested a new integrated model of care designed to improve care delivery for all children and young people living in Lambeth and Southwark, called the Children and Young People’s Health Partnership (CYPHP).
The CYPHP was co-designed by local clinicians, parents, carers, children and young people, researchers, commissioners and providers. The model includes enhanced primary care clinics, targeted biopsychosocial early interventions for children with long-term health conditions, and population health initiatives to identify children with unmet health and care needs. The CYPHP is hosted by Evelina London Children’s Hospital and King’s College London.
In a three-year pragmatic clinical trial involving nearly 100,000 children recruited from across 70 general practices in Lambeth and Southwark, the research team compared the CYPHP integrated care model to enhanced standard paediatric services. Trial findings have been published in The Lancet Child & Adolescent Health.
The trial showed meaningful improvements in care quality and health status for children receiving CYPHP interventions for existing long-term conditions, including asthma and eczema. However, there were no significant reductions in overall paediatric health service use across the population. The researchers suggest this is likely due to the limited reach of services during the study period, which coincided with service disruptions caused by the Covid-19 pandemic, and an important aspect of the model which is the ability to identify and deliver care for children with unmet needs.
While our integrated care model shows real promise, particularly for children with complex health needs, broader system-wide change and increased population coverage is still needed to drive measurable impact on service use
The researchers point to ongoing service performance monitoring which demonstrates increasing population-level impact as the CYPHP model expands across the community. “Major health system interventions take time to embed,” Professor Wolfe said. “We’re encouraged by the clinical improvements so far, and ongoing expansion of the CYPHP model creates opportunities to further study its system-wide effects.”
Forthcoming publications from the study will provide further insights into the substantial unmet physical and mental health needs among children and young people – highlighting the value of early intervention approaches tailored to local contexts. “Integrated services like CYPHP are an important step towards refocusing children’s healthcare on proactive, holistic models that enhance lifelong health,” says Professor Wolfe.
Professor Wolfe says that while the findings underscore challenges in rapidly demonstrating system-level impact, the pragmatic research approach “provides real-time insights to guide implementation and inform local health commissioners”. Ongoing service monitoring in Lambeth and Southwark will enable the research team to understand emerging effects of the CYPHP model across the local population.