Paediatric 'care closer to home': stake-holder views and barriers to implementation

Gemma Heath, Elaine Cameron, Carole Cummins, Sheila Greenfield, Helen M. Pattison, Deirdre Kelly, Sabi Redwood

Research output: Contribution to journalArticlepeer-review


In this study we explore the views of NHS stakeholders on providing paediatric ‘care closer to home’ (CCTH), in community-based outpatient clinics delivered by consultants. Design: Semi-structured interviews and thematic framework analysis. Setting: UK specialist children's hospital and surrounding primary care trusts. Participants: 37 NHS stakeholders including healthcare professionals, managers, commissioners and executive team members. Results: Participants acknowledged that outreach clinics would involve a change in traditional ways of working and that the physical setting of the clinic would influence aspects of professional practice. Different models of CCTH were discussed, as were alternatives for improving access to specialist care. Participants supported CCTH as a good principle for paediatric outpatient services; however the challenges of setting up and maintaining community clinics meant they questioned how far it could be achieved in practice. Conclusions: The place of service delivery is both an issue of physical location and professional identity. Policy initiatives which ignore assumptions about place, power and identity are likely to meet with limited success.
Original languageEnglish
Pages (from-to)1068-1073
Number of pages6
JournalHealth and Place
Issue number5
Early online date25 May 2012
Publication statusPublished - Sept 2012


  • children
  • outpatient
  • place
  • community settings
  • qualitative


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