Understanding the influences on the design and delivery of an integrated child health and social care service in underserved communities in the UK: A qualitative exploration using the SELFIE framework

• There are few integrated health and social care services active in the UK • This work describes an example aimed at underserved children and young people • The service increased engagement of families and timely referral to social support • Benefits for effective care of collocation and collaborative working were described • Integrated care appeared not to be a priority by the local health system Background The UK’s National Health Service has provided funds for developing localized services integrating health and social care intended to address the health inequities prevalent in children and young people living in marginalized communities. However, little is understood of the factors that influence their design and delivery, nor which combined health and social care models are most effective. Objective To use evidence drawn from staff delivering a collocated integrated health and social support service for children, also known as the Sparkbrook Children’s Zone, to inform similar care offers. Methods A qualitative exploration of staff experience using a directed content analysis to populate and present the results within the Sustainable integrated chronic care model for multi-morbidity: delivery, financing, and performance (SELFIE) framework. The analysis presented here focusses on the domain of Service delivery , predominantly relating to the content and access of care. Results A total of 14 staff were interviewed: clinicians from primary and secondary care, social care providers, local voluntary groups, and school-based family mentors. Participants described at the Micro- level how the service increased engagement of families and facilitated referral to social support and preventive care; at a Meso- level the benefits of collocation, collaborative working, and community outreach and at the Macro level, improvements to the access and availability of appropriate care. Conclusions The pilot appeared to deliver multiple benefits for both patients and staff particularly through collocating health care and social support. However, sustainable integrated health and social care requires greater institutional commitment and leadership.