title: Learning Together; part 2: training costs and health gain - a cost analysis.
abstract: Learning Together is a complex educational intervention aimed at improving health outcomes for children and young people. There is an additional cost as two doctors are seeing patients together for a longer appointment than a standard general practice (GP) appointment. Our approach combines the impact of the training clinics on activity in South London in 2014-15 with health gain, using NICE guidance and standards to allow comparison of training options.
  
  
  METHODS
  Activity data was collected from Training Practices hosting Learning Together. A computer based model was developed to analyse the costs of the Learning Together intervention compared to usual training in a partial economic evaluation. The results of the model were used to value the health gain required to make the intervention cost effective.
  
  
  RESULTS
  Data were returned for 363 patients booked into 61 clinics across 16 Training Practices. Learning Together clinics resulted in an increase in costs of £37 per clinic. Threshold analysis illustrated one child with a common illness like constipation needs to be well for two weeks, in one Practice hosting four training clinics for the clinics to be considered cost effective.
  
  
  CONCLUSIONS
  Learning Together is of minimal training cost. Our threshold analysis produced a rubric that can be used locally to test cost effectiveness at a Practice or Programme level.
authors.affiliation: a Independent Health Economist.
authors.forename: Katherine
authors.initials: K
authors.lastname: Cullen
authors.affiliation: b Independent Evaluator for Learning Together South London.
authors.forename: Wendy
authors.initials: W
authors.lastname: Riches
authors.affiliation: c Consultant General Paediatrics , Evelina Children's Hospital , London , UK.
authors.forename: Chloe
authors.initials: C
authors.lastname: Macaulay
authors.affiliation: d GP, Croydon and Head of Primary Care Education , Health Education England , South London , UK.
authors.forename: John
authors.initials: J
authors.lastname: Spicer
mesh_terms: D002648:Child; D003248:Constipation / Q000188:drug therapy; D003362:Cost-Benefit Analysis; D058005:General Practitioners / Q000191:economics / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000191:economics*; D007858:Learning; D000072143:Pediatricians / Q000191:economics / Q000193:education*; D012017:Referral and Consultation / Q000191:economics
keywords: General practice; children; cost; health outcomes; learning together; paediatrics