Childhood long-term conditions in primary care: a qualitative study of practitioners' views.
BACKGROUND
Improving child health and wellbeing in England was the key focus of the Chief Medical Officer's Annual Report 2012, which recommended that all children with long-term conditions (LTCs) have a named GP responsible for their care. Little is known, however, about practitioners' views and experiences of supporting children with LTCs in primary care.


OBJECTIVE
To explore practitioners' views of supporting children with LTCs and their families in primary care.


METHODS
Qualitative interview study in primary care settings in South Yorkshire, England.


METHODS
Interviews explored practitioners' views and experiences of supporting children with asthma, cystic fibrosis, type 1 diabetes, and epilepsy. Interviews were audiotaped, transcribed verbatim, and analysed using the framework approach.


RESULTS
Nineteen practitioners were interviewed: 10 GPs, five practice nurses, and four nurse practitioners. The GPs' clinical roles included prescribing and concurrent illness management; nurse practitioners held minor illness clinics; and practice nurses conduct asthma clinics and administer immunisations. GPs were coordinators of care and provided a holistic service to the family. GPs were often unsure of their role with children with LTCs, and did not feel they had overall responsibility for these patients. Confidence was dependent on experience; however, knowledge of GPs' own limits and accessing help were felt to be more important than knowledge of the condition.


CONCLUSIONS
Primary care has a valuable role in the care of children with LTCs and their families. This study suggests that improving communication between services would clarify roles and help improve the confidence of primary care practitioners.
Academic Unit of Primary Medical Care, Northern General Hospital, Sheffield, UK.
Anna
A
Willis
Academic Unit of Primary Medical Care, Northern General Hospital, Sheffield, UK.
Jennifer
J
Swann
Academic Unit of Primary Medical Care, Northern General Hospital, Sheffield, UK.
Joanne
J
Thompson
D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy; D004739:England; D005260:Female; D058005:General Practitioners / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008134:Long-Term Care / Q000379:methods / Q000523:psychology / Q000592:standards / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000523:psychology*; D010346:Patient Care Management / Q000379:methods; D010819:Physician's Role / Q000523:psychology; D011369:Professional-Patient Relations; D036301:Qualitative Research; D058996:Quality Improvement
child health; chronic disease; long-term conditions; primary health care; qualitative research