Barriers to accessing paediatric critical care and surgery: A qualitative study

Area of Science:

• Pediatric Critical Care
• Health Services Research
• Health Equity

Background:

• Children and young people (CYP) in North East and North Cumbria (NENC) experience delayed access to paediatric critical care (PCC) and surgery in children (SIC) services.
• Late presentation is linked to poorer clinical outcomes, suggesting potential inequities in service access.
• Factors influencing this inequitable access remain unclear.

Purpose of the Study:

• To investigate the barriers contributing to inequitable access to PCC and SIC for CYP.
• To provide evidence-based recommendations for enhancing service delivery and improving access.

Main Methods:

• A qualitative study was conducted using semi-structured interviews.
• Participants included CYP with experience of PCC/SIC, their caregivers, healthcare professionals, and charity staff.
• Data analysis employed a combined deductive-inductive approach, referencing UK Paediatric Critical Care Society Quality Standards.

Main Results:

• Barriers to accessing PCC and SIC were categorized into communication, system-level, and socio-economic factors.
• Communication and system-level barriers were consistent with existing quality standards.
• Socio-economic factors, though not explicitly addressed in current standards, significantly impact access for certain families.

Conclusions:

• Access to PCC and SIC is a complex interplay of communication, system, and socio-economic factors, potentially delaying critical care.
• Integrating recognition of socio-economic influences into service standards and policies is crucial for promoting equitable access.
• Future research should prioritize strategies to enhance engagement with underrepresented CYP and caregiver groups.