Commissioning a good child health service

Child with doctor

Joined puzzle piecesIntroduction

When a child becomes ill, the first clinician they meet is most likely to be their GP. This report is the result of a collaboration between the Royal College of General Practitioners, the Royal College of Paediatrics and Child Health, the Royal College of Nursing, and the Department of Health to identify how to commission the best possible service for children. It is particularly aimed at primary care, general practitioners, school nurses, health visitors, and commissioners, but also paediatric services in secondary care and social care. The main aim of the report is to develop the relationships between staff working in primary and secondary care, so that services to children and their experiences can be improved.

Key on a bookKey principles

By working collaboratively, these organisations have been able to come up with nine key principles to help commissioners deliver robust and good quality health services to all young people, especially those who are vulnerable and at risk and who might slip through the net, as has happened in the past. The report covers:

  • Governance and accountability
  • Context
  • Collaborating in care
  • Multidisciplinary teams
  • Mental health
  • Safeguarding children and young people
  • Competencies and training issues
  • Health inequalities
  • Non-registered families
  • Adolescence

An essential part of ensuring these principles are applied, is to make sure reliable communication channels are in place between everyone involved in delivering child health services, including GPs, health visitors, and schools. All parties must also understand what their responsibilities, and this is where commissioners play a vital role. They must ensure that adequate support is provided in terms of training and making sure that everyone understands what is required of them.

People from different disciplinesActions for multidisciplinary teams

The report asks multidisciplinary teams to address:

  • What they can do to encourage young people to make more use of primary care services?
  • How they access and share information amongst each other, and what good information sharing means?
  • How they can organise regular practice meetings where they can discuss and review cases of young people with “complicated and complex needs.” Appendix 1 is particularly useful as it contains a ‘checklist’ that practitioners and commissioners should apply when treating a child or young person.

The report provides details of existing programmes, such as the Health Child Programme, 0-5 years and 5-19 years, concludes with a set of recommendations relating to each chapter, for health and social care practitioners, and commissioners.


Well-provided integrated care means that young people will receive safe and seamless health services. This can only be done if good communication channels are in place so that information can be shared securely and teams work together, so that everyone knows what is going on, including the young person involved. This report provides a wealth of advice on what teams need to do to achieve strong partnerships and service improvement.

The starting point would be for teams to meet and establish how they will address the questions raised above. How will they make services more accessible to young people? How will they share information, making sure the right people have the right information at the right time? And most importantly, how will they make sure that there are no gaps for children at risk to fall through?


Commissioning a good child health service (PDF)
CIRC – Clinical Innovation and Research Centre
Royal College of General Practitioners, Royal College of Paediatrics and Child Health, Royal College of Nursing
April 2013

Supporting material

Royal College of General Practitioners: child and adolescent health

Royal College of Paediatrics and Child Health

Royal College of Nursing

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Caroline De Brún

Caroline De Brún

Caroline has been a medical librarian in a variety of NHS and academic roles since 1999, working in academic, primary and secondary care settings, service improvement, knowledge management, and on several high profile national projects. She has a PhD in Computing and currently develops resources to support evidence-based cost and quality, including QIPP @lert, a blog highlighting key reports from health care and other sectors related to service improvement and QIPP (Quality, Innovation, Productivity, Prevention). She also delivers training and resources to support evidence identification and appraisal for cost, quality, service improvement, and leadership. She is co-author of the Searching Skills Toolkit, which aims to support health professionals' searching for best quality clinical and non-clinical evidence. Her research interests are health management, commissioning, public health, consumer health information literacy, and knowledge management. She currently works as a Knowledge and Evidence Specialist for Public Health England, and works on the Commissioning Elf in her spare time.

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