ArticleBMJ paediatrics open2026
Addressing equity through integration of child health services in North West London disadvantaged neighbourhoods: a mixed-methods evaluation.
Article in BMJ paediatrics open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGeneral Practitioner (GP) Child Health Hubs (CHH) have been established in North West London (NWL), UK, for over a decade, yet gaps remain in reaching underserved families with children aged <5 years. To address this, the Early Years GP CHH Pilots (April 2023-March 2025) were set up in three NWL boroughs (Harrow, Brent and Ealing). Each site aimed to establish hyper-local preventative care teams (HLPCTs), identify their target population and health need, and design their evidence-based intervention programme. Our study aimed to describe the processes each site undertook for programme implementation and identify early impact.
methodsWe focused on Harrow and Brent. Using the Medical Research Council framework and the Capability, Opportunity, Motivation - Behaviour framework for behaviour change, we collected data from each site on workforce engagement, volunteer organisation collaborations, community engagement, case studies and specialist clinics. In addition, we conducted interviews with members of multidisciplinary teams (MDTs). Data analyses are descriptive, narrative and thematic.
resultsBoth sites established HLPCTs. Harrow used the Community Health and Wellbeing Worker (CHWW) model and focused on the first 1000 days and Brent used Family Link Workers (FLWs) focusing on respiratory health. Workforce and community engagement were successful for networking and reaching communities. Collaborations with voluntary services aligned services to local needs and public health priorities. Case studies identified both holistic and medical needs, and specialist clinics increased parent confidence (Harrow) and assessed, diagnosed and prescribed medication accordingly for asthma (Brent). 'Community connectors' (CHWWs, FLWs) were crucial to increase family engagement and brought more urgent cases to MDT meetings. However, a key finding was that engaging with families was complicated and may be affecting reach. Interviews highlighted enablers as well as challenges of MDT meetings.
conclusionCollaborative approaches and community connectors are key to engaging with families but challenges remain. Sufficient maturity of interventions is needed to fully establish impacts.
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