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. 2024 May 30;14(5):e081620.
doi: 10.1136/bmjopen-2023-081620.

Access to primary care for children and young people (CYP) in the UK: a scoping review of CYP's, caregivers' and healthcare professionals' views and experiences of facilitators and barriers

Lauren Herlitz  1 , Emily Ashford  2 , Claire Powell  3 , Kevin Herbert  4 , Stephen Morris  4 , Jenny Woodman  2
Affiliations

Access to primary care for children and young people (CYP) in the UK: a scoping review of CYP's, caregivers' and healthcare professionals' views and experiences of facilitators and barriers

Lauren Herlitz et al. BMJ Open. .

Abstract

Objectives: To examine children and young people's (CYP), caregivers' and healthcare professionals' (HCPs) views or experiences of facilitators and barriers to CYP access to UK primary care services to better understand healthcare inequity. To explore differences across CYP subpopulations with greater health needs from deprived areas, identifying as ethnic minorities, with experiences of state care, special educational needs or disabilities, chronic conditions or mental health problems.

Design: Scoping review.

Eligibility criteria: Included studies were in English, published 2012-2022 and reported: the views/experiences of CYP (0-25 years), caregivers or HCPs about accessing UK primary care; using quantitative or qualitative empirical methods.

Data sources: PubMed, CINAHL, Web of Science, PsycINFO and Scopus.

Results: We included 47 reports (46 studies). CYP/caregivers' decision to access care was facilitated by CYP/caregivers' or their family/friends' ability to identify a health issue as warranting healthcare attention. Barriers to accessing care included perceived stigma (eg, being seen as a bad parent), embarrassment and discrimination experiences. CYP and caregivers believed longer opening hours could facilitate more timely access to care. Caregivers and HCPs reported that delayed or rejected referrals to secondary or adult care were a barrier to having needs met, especially for CYP with poor mental health. CYP and caregivers in numerous studies emphasised the importance of communication and trust with HCPs, including taking their concerns seriously, being knowledgeable and providing continuity of care for CYP. Common barriers reported across high-need subpopulations were caregivers needing knowledge and confidence to advocate for their child, gaps in HCP's knowledge and a lack of connectedness between primary and secondary care.

Conclusions: Connecting general practices and community health workers/services, improving CYP/caregivers' understanding of common childhood conditions, addressing HCP's knowledge gaps in paediatric care and integrated approaches between primary and secondary care may reduce inequity in access.

Keywords: adolescents; health equity; health services accessibility; paediatrics; primary care.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
PRISMA flow diagram. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2
Facilitators and barriers to CYP access to primary care. CYP, children and young people’s; HCP, healthcare professional; YP, young people.
See this image and copyright information in PMC

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References

    1. Levesque JF, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health 2013;12:18. 10.1186/1475-9276-12-18 - DOI - PMC - PubMed
    1. Gulliford M, Figueroa-Munoz J, Morgan M, et al. . What does ‘access to health care’ mean J Health Serv Res Policy 2002;7:186–8. 10.1258/135581902760082517 - DOI - PubMed
    1. Harnden A, Mayon-White R, Mant D, et al. . Child deaths: confidential enquiry into the role and quality of UK primary care. Br J Gen Pract 2009;59:819–24. 10.3399/bjgp09X472520 - DOI - PMC - PubMed
    1. Royal College of Nursing . Safeguarding children and young people: roles and competencies for healthcare staff: Intercollegiate document. London: Royal College of Nursing, 2019. Available: https://www.rcn.org.uk/professional-development/publications/pub-007366
    1. Cecil E, Bottle A, Cowling TE, et al. . Primary care access, emergency department visits, and unplanned short hospitalizations in the UK. Pediatrics 2016;137:e20151492. 10.1542/peds.2015-1492 - DOI - PubMed

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