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Integrating care in a childrens hospital: a qualitative interview study with mental and physical health professionals in England

Por: Morgan · T. · Pilimatalawwe · D. · Mannes · J. · Morse · I. · Folwell · J. · Hain · P. · Walsh · C. M. · OCurry · S. · Duschinsky · R.
Objective

To explore physical and mental health professionals' hopes and concerns around integrating their services in a colocated children’s hospital.

Methods

One-off semi-structured interviews were conducted with 31 participants (16 mental health and 15 physical health professionals). Participants were purposively sampled to ensure representation across each trust and professional background. Participants included allied health professionals, nurses, team managers, paediatricians, psychiatrists and psychologists.

Results

Staff described integration as both promising and ambiguous. While many welcomed the potential for improved collaboration and holistic care, others expressed uncertainty about what integration would entail. Six key themes were identified: (a) siloed and patchy beginnings, (b) one whole child, (c) day-to-day of colocation, (d) the integrated worker, (e) patients not in the same boat and (f) extending integration.

Conclusions

This novel analysis offers insights around the practical and emotional processes involved in integrating care systems. Staff valued the potential for holistic, child-centred care, improved collaboration and shared learning but expressed concerns around ambiguity, shifting professional identities and the practicalities of colocating services. These tensions underscore the need for clearer communication, relationship-building and support structures during service redesign. Our findings also support integrating wider community and social care systems and call for future research involving young people’s perspectives to ensure meaningful, inclusive integration.

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