Evidence map›Paper›PMID 42049295›Full record

ArticleBMJ open2026

Development of a tic service model for children and young people in England: a Delphi study.

Sophie S Hall, Nikita R Rattu, Charlotte L Hall, Joseph Kilgariff, Tara Murphy, Nadya James, Emma McNally, Suzanne Rimmer, Louise Thomson, Jaxon H Kramer and 1 more

Abstract read
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sophie S HallNottingham Clinical Trials Unit, University of Nottingham School of Medicine, Nottingham, UK sophie.hall@nottingham.ac.uk.ORCID http://orcid.org/0000-0002-9847-8269
Nikita R RattuAcademic Unit of Mental Health & Clinical Neuroscience, University of Nottingham School of Medicine, Nottingham, UK.ORCID http://orcid.org/0009-0007-5349-4445
Charlotte L HallAcademic Unit of Mental Health & Clinical Neuroscience, University of Nottingham School of Medicine, Nottingham, UK.ORCID http://orcid.org/0000-0002-5412-6165
Joseph KilgariffNottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.ORCID http://orcid.org/0000-0002-7195-7753
Tara MurphyUniversity College London Great Ormond Street Institute of Child Health, London, UK.
Nadya JamesNottingham University Hospitals NHS Trust, Nottingham, UK.
Emma McNallyTourettes Action, Farnborough, UK.
Suzanne RimmerFormerly NHS Healthcare Commissioner, Now Retired, Merseyside, UK.
Louise ThomsonAcademic Unit of Mental Health & Clinical Neuroscience, University of Nottingham School of Medicine, Nottingham, UK.
Jaxon H KramerWandsworth Tier 3 CAMHS, South West London & St. George's NHS Trust, London, UK.
Madeleine J GroomAcademic Unit of Mental Health & Clinical Neuroscience, University of Nottingham School of Medicine, Nottingham, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo develop an evidence-based, consensus-driven service model for the identification, assessment and treatment of tic disorders in children and young people (CYP) in England, addressing the absence of dedicated pathways and national clinical guidance.

designTwo-stage consensus study comprising a Delphi survey, expert/patient and public involvement (PPI) review and regional stakeholder workshops.

settingUK healthcare and community settings relevant to tic disorder assessment and management (primary care, neurodevelopmental services, child and adolescent mental health services).

participantsStage 1: UK-based clinicians, researchers and practitioners with expertise in tic disorders (Delphi panel; n=49; 98% retention across rounds). Stage 2: regional stakeholders including clinicians, commissioners, service managers, third-sector representatives and parents/carers (n=36). Eligibility required relevant professional or lived experience; no exclusions applied beyond this criterion. PRIMARY OUTCOME: Identification of a consensus-based component of a best-practice service model for tic disorders and barriers and facilitators to implementation across regional pathways.

resultsThe Delphi process generated consensus on 40 core components, refined to 43 following expert and PPI review. Agreed features included referral criteria, comprehensive assessment, psychoeducation, behavioural interventions, pharmacological options and integrated cross-service working. Stakeholder workshops highlighted key implementation challenges, including workforce training, funding constraints and coordination across neurodevelopmental and mental health services, informing practical adaptations to the model.

conclusionsThis consensus-informed service model provides structured, UK-specific guidance to support earlier identification, appropriate intervention and improved care coordination for CYP with tic disorders. Future research should assess real-world implementation and impact. CLINICAL IMPLICATIONS: The model offers actionable recommendations for referral pathways, intervention provision and service configuration. Adoption may reduce diagnostic delays, minimise misdiagnosis and strengthen collaboration between primary, neurodevelopmental and mental health services, leading to improved outcomes for CYP with tic disorders.

Indexed as

Mental Health ServicesTic DisordersAdolescentChildConsensusDelphi TechniqueEnglandHumansChild & adolescent psychiatryHealth ServicesMENTAL HEALTH

Identifiers

PMID42049295
PMCPMC13141126

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.