CYPHP Evelina London Evaluation

NCT03461848 | Completed

• 1 other identifier: Version 1.1 26-07-2017
• Study Type: interventional
• Target: 1,731
• Locations: 1 country
• Sites: 1

Brief Summary

The Children and Young People's Health Partnership (CYPHP) Evelina London model is an innovative, evidence-based approach to reshaping healthcare services in Southwark and Lambeth. The model of care is a complex health services public health intervention aiming to integrate care across organisational and professional boundaries. There is a major focus on improving front line care for all children and young people, and comprehensive proactive care for those with common and long-term conditions such as asthma, epilepsy, eczema, and constipation CYPHP Evelina London model of care is being adopted by the Clinical Commissioning Groups of Southwark and Lambeth as part of routine care. Early roll out of the model has already started. However, due to resource limitations, implementation will occur in phases. In the first phase (\~two years), half of GP practices in the Lambeth and Southwark area will implement the full model while others will offer enhanced usual care (EUC). The evaluation team will utilize this staged CCG roll out to evaluate the programme using a cluster randomised controlled trial design. It is expected that all the EUC practices will also adopt the CYPHP model within the next three years. The impact of the CYPHP Evelina London model will be assessed at two levels; at the population level ("Population evaluation") and among CYP with specific conditions ("Tracer condition evaluation"). The tracer condition evaluation will with consent, follow up CYP with tracer conditions (asthma, epilepsy, eczema, constipation) to assess the impact of the new model of care on health service use, quality of care, and child health measures including health-related quality of life. Cost-effectiveness will be assessed for population and tracer conditions.

Conditions

Asthma; Eczema; Constipation

Outcome Measures

Primary Outcomes (2)

• Secondary Care service use

  Population Evaluation: To assess differences in rates of secondary care service use among CYP from GP practices delivering the CYPHP model compared with practices delivering EUC, up to two years' post-implementation of the service.

  Baseline and up to 2 years after

• Health-related Quality of Life, measured by PEDSQL

  Tracer conditions evaluation: To assess differences in health-related quality of life among CYP with tracer conditions from practices delivering the CYPHP model compared with practices delivering EUC, up to two years' post-implementation of the service.

  Baseline, 1 year and 2 years

Study Arms (2)

CYPHP Evelina London Model

EXPERIMENTAL

Practice clusters across Lambeth and Southwark have been randomised to introduce either the CYPHP Evelina London model of care, or Enhanced Usual Care.

Other: CYPHP Evelina London Model of care

Enhanced Usual Care Model

ACTIVE COMPARATOR

Practice clusters across Lambeth and Southwark have been randomised to introduce either the CYPHP Evelina London model of care, or Enhanced Usual Care.

Other: Enhanced Usual Care

Interventions

CYPHP Evelina London Model of care OTHER

Universal services offer, Paediatric hotlines, Education and training for health professionals, Online decision support tools and guidelines, Young people-friendly access to primary care, and Resilience training in schools, Targeted services offered dependent on need. Children with any of the tracer conditions will be offered pathway based care including early intervention for physical and related mental health needs, paediatric nursing support, care plans shared with schools, medication reviews, and peer-led parenting support. Self-management support, social support signposting, and safety-netting are offered to all.

CYPHP Evelina London Model

Enhanced Usual Care OTHER

Universal services offer, Paediatric hotlines, Education and training for health professionals, Online decision support tools and guidelines, Young people-friendly access to primary care, and Resilience training in schools, Self-management support, social support signposting, and safety-netting are offered to all.

Enhanced Usual Care Model

Eligibility Criteria

• Age: 0 Years - 16 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• CYP\<16 years (In 2011, 2 years prior to CYPHP service start)
• Registered with a participating practice in Lambeth and Southwark.
• Registered with a participating practice in Lambeth and Southwark.
• CYP\<16 years (In 2011, 2 years prior to CYPHP service start)
• Diagnosed or identified as having one of the four tracer conditions by the CYPHP/EUC service, according to the service definitions

You may not qualify if:

• If during the course of the evaluation period the patient diagnosis is clarified or changes to one which is no longer included within the tracer conditions studied.
• If the patient ceases to be registered with a participating practice.
• If the patient moves their primary residence outside of Lambeth or Southwark.
• With regards to epilepsy only: if the patient no longer receives treatment for their epilepsy by a consultant working within the Guy's and St. Thomas' NHS Foundation Trust or King's College London NHS Trust.

Sponsors & Collaborators

• Guy's and St Thomas' NHS Foundation Trust: lead
• King's College London: collaborator
• Newcastle University: collaborator
• London School of Hygiene and Tropical Medicine: collaborator

Study Sites (1)

Guy's and St Thomas' NHS Foundation Trust

London, SE1 9RT, United Kingdom

Location

Related Publications (7)

• Satherley RM, Newham J, Cecil E, Forman J, Kelly C, Wolfe I, Lingam R. Implementation of the children and young people's health partnership model of paediatric integrated care: a mixed-methods process evaluation. Arch Dis Child. 2025 Jul 18;110(8):603-611. doi: 10.1136/archdischild-2024-327664.

  PMID: 39904570 DERIVED

• Cecil E, Forman J, Newham J, Hu N, Lingam R, Wolfe I. Investigating a novel population health management system to increase access to healthcare for children: a nested cross-sectional study within a cluster randomised controlled trial. BMJ Qual Saf. 2024 Oct 18;33(11):694-703. doi: 10.1136/bmjqs-2024-017223.

  PMID: 38991704 DERIVED

• Wolfe I, Forman J, Cecil E, Newham J, Hu N, Satherley R, Soley-Bori M, Fox-Rushby J, Cousens S, Lingam R. Effect of the Children and Young People's Health Partnership model of paediatric integrated care on health service use and child health outcomes: a pragmatic two-arm cluster randomised controlled trial. Lancet Child Adolesc Health. 2023 Dec;7(12):830-843. doi: 10.1016/S2352-4642(23)00216-X. Epub 2023 Oct 19.

  PMID: 37866369 DERIVED

• Kelly CB, Soley-Bori M, Lingam R, Forman J, Cecil L, Newham J, Wolfe I, Fox-Rushby J. Mapping PedsQL scores to CHU9D utility weights for children with chronic conditions in a multi-ethnic and deprived metropolitan population. Qual Life Res. 2023 Jul;32(7):1909-1923. doi: 10.1007/s11136-023-03359-4. Epub 2023 Feb 23.

  PMID: 36814010 DERIVED

• Soley-Bori M, Lingam R, Satherley RM, Forman J, Cecil L, Fox-Rushby J, Wolfe I. Children and Young People's Health Partnership Evelina London Model of Care: economic evaluation protocol of a complex system change. BMJ Open. 2021 Nov 24;11(11):e047085. doi: 10.1136/bmjopen-2020-047085.

  PMID: 34819278 DERIVED

• Satherley RM, Green J, Sevdalis N, Newham JJ, Elsherbiny M, Forman J, Wolfe I, Lingam R; CYPHP team. The Children and Young People's Health Partnership Evelina London Model of Care: process evaluation protocol. BMJ Open. 2019 Sep 3;9(8):e027302. doi: 10.1136/bmjopen-2018-027302.

  PMID: 31481367 DERIVED

• Newham JJ, Forman J, Heys M, Cousens S, Lemer C, Elsherbiny M, Satherley RM, Lingam R, Wolfe I. Children and Young People's Health Partnership (CYPHP) Evelina London model of care: protocol for an opportunistic cluster randomised controlled trial (cRCT) to assess child health outcomes, healthcare quality and health service use. BMJ Open. 2019 Sep 3;9(8):e027301. doi: 10.1136/bmjopen-2018-027301.

  PMID: 31481366 DERIVED

MeSH Terms

Conditions

Asthma; Eczema; Constipation

Condition Hierarchy (Ancestors)

Bronchial Diseases; Respiratory Tract Diseases; Lung Diseases, Obstructive; Lung Diseases; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Immune System Diseases; Dermatitis; Skin Diseases; Skin and Connective Tissue Diseases; Skin Diseases, Eczematous; Signs and Symptoms, Digestive; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Ingrid Wolfe

  King's College London

  PRINCIPAL INVESTIGATOR

• Raghu Lingam

  University of New South Wales

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 27, 2018
• First Posted: March 12, 2018
• Study Start: April 9, 2018
• Primary Completion: December 31, 2021
• Study Completion: March 31, 2022
• Last Updated: December 13, 2022

Record last verified: 2021-01

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)