Future vision for child health
Dr Damian Roland, honorary associate professor and consultant in paediatric emergency medicine (innovation co-chair)
Tuesday, March 30, 2021
Royal college sets out health challenges for children by 2040 and what good health and care will look like.
The Paediatrics 2040 report is the brainchild of the Royal College of Paediatrics and Child Health president, Professor Russell Viner, who is just completing his term of office.
He wanted to set up a process whereby paediatricians could examine what needed to happen to ensure that children and young people receive the best possible care and outcomes in 2040.
The report covers four specific areas: data and evidence, impact of innovation, working lives and models of care. The first two work streams inform the latter two.
Predicting the future is fraught with difficulty but the evidence is relatively clear that the continued impact of poverty and inequality on children will create unsustainable healthcare demand, particularly for infants, regardless of the current hiatus in children’s emergency care due to the Covid-19 pandemic.
The pandemic certainly impacted on Paediatrics 2040 – which was started in 2018 well before social distancing was even a consideration. However, it was an important lens with which to understand how uncertain the future is, and in particular what may flourish and what might not.
We are universally bad at predicting how new innovations will transform healthcare by being both overly conservative and optimistic about the speed of change. We expect that new techniques and medications will be implemented with much greater speed than is possible, at the same time being surprised by how quickly others become common practice. Part of the reason for this is a misunderstanding of the term innovation itself. As improvement scientist and surgeon Simon Dodds explains: “Invention, innovation, investigation and implementation are four stages of the ‘improvement’ process but they are different. Invention is when something uniquely new is created – by design or accident. Innovation is when we do something new for us (but may not be new for others). Investigation is when we explore how the new thing fits with the old thing – does it work for us in our specific context? Implementation is when we are past the ‘tipping point’ and the paradigm starts to shift.” Placing innovation in the context of improvement makes it more tangible and better highlights the challenges it takes to transform healthcare.
Increasing demand
The current health system remains in a precarious state, especially in paediatrics, with a challenging workforce situation and increasing demand and expectation. Those working in child health have always been good at maximising what can be done, rather than getting too concerned about what the future may bring.
No immediate cash injection into healthcare looks likely at present. And even if it was to occur, it wouldn’t solve those inefficiencies, bureaucracies and productivity challenges. However, it’s not a sustainable situation to continue in the status quo, so it’s beholden on all working in child health to be able to innovate and implement technologies and practical solutions.
Some of the key findings of Paediatrics 2040 are summarised here (see box) but the report is very accessible online. The project also involved contributions from hundreds of children and young people and provides a template for anyone interested in improving child health to look at what we need to collectively do to improve their healthcare.
FUTURE CHILD HEALTH NEEDS
The innovation theme identified the need for:
- An improved landscape for innovation, with increased capacity for research that is specific to innovation and technology in paediatrics.
- Clinicians to move beyond the digital consultations adopted during the 2020 pandemic and using digital health products to better monitor, care for and treat patients.
- All relevant stakeholders involved in paediatric care, including children and young people, to be involved in the design, development and integration of different innovations and health technologies relating to their care.
The models of care theme identified a need for:
- Enhanced care models for children with long-term conditions that focus specifically on improving quality of care and quality of life.
- More children and families empowered to know when to seek care, with reduced pressure on emergency department attendances.
- Optimisation of technology to support fully integrated systems across paediatric care, allowing remote monitoring and seamless interconnectivity.
- Child and family engagement embedded in every paediatric service across the UK.
The working lives theme identified the need for:
- Stronger links between paediatrics and other specialties, with paediatricians and GPs finding ever closer ways of working together.
- Increased consideration of the whole child and a focus on making every contact count for medical and social care, health promotion and teaching and training.
- Inclusion of different working models within paediatric teams and inclusion of more varied multidisciplinary team members to support patients.
- A workforce involved in and influencing health challenges in the UK and globally.
