A GP drop-in clinic model providing holistic community care in family hubs: Service evaluation findings and next steps.

Objectives: The first few years of life are vital in building the foundations for a child's healthy development, with the needs of the whole family having an impact on how children grow and develop. In addition, many families living in deprived areas face multiple barriers and inequalities in accessing high quality primary care.A new approach to improving access to primary care was developed in the form of a drop-in GP clinic based in a Family Hub. The model allows families with young children to see a GP as a whole family, with no appointment time restrictions, and the ability to see the same GP at every contact. This provides continuity of care and the opportunity to deliver preventative and holistic care in the context of the whole family.This service evaluation aimed to explore the reach and impact of the new service on families and practitioners. Study design: This was a service evaluation based on clinical data and qualitative interviews. Methods: Clinical data from consultations were used to inform the evaluation, and interviews were undertaken with eight parents and nine Family Hub staff members. Codebook thematic analysis was used to summarise the findings. Results: In the first six months, 78 family members used the drop-in service in 135 consultations. Most consultations focused on chronic issues such as gastrointestinal issues, mental health and social and neurodiversity concerns.Four main themes identified from the interview data were: clinical benefits, experiences of accessing and engaging with healthcare, logistics and practicalities, and wider system questions. Families and staff spoke positively about the benefits of the service, including helping to overcome barriers to accessing care, reducing use of emergency services, families having trust and reassurance in the healthcare system, reducing overtreatment, the partnership working with other professionals and families feeling their concerns were taken seriously. Possible limitations included reliance on a single GP, lack of understanding from some families about how to access the service and recognition that the service provided care for pre-school aged children only. Those interviewed felt an expansion of the service into other geographical areas would be beneficial. Conclusions: The interviews demonstrated a range of benefits from the drop-in model and suggested that this helped to overcome some of the challenges and barriers some families face in accessing usual care in a primary care setting, in addition to providing a more satisfying care experience for both families and clinician.The next steps for this work will aim to test the viability and cost-effectiveness of this model on a larger scale, including providing the service in another Family Hub and exploring opportunities to test this model in different settings.