Addressing equity through integration of child health services in Northwest London disadvantaged neighbourhoods: a mixed-methods evaluation
File(s)
Published version
Author(s)
Ram, Bina
Blair, Mitch
Type
Journal Article
Abstract
Background
GP Child Health Hubs (CHH) have been established in Northwest (NWL) London, 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) was set up in three NWL boroughs (Harrow, Brent, 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.
Methods
We focused on Harrow and Brent. Using the MRC framework and the COM-B Behaviour Change framework, 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 multi-disciplinary teams (MDTs). Data analyses are descriptive, narrative and thematic.
Results
Both 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” (CHHWs, FLWs) were crucial to increase family engagement, and bought 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.
Conclusion
Collaborative approaches and community connectors are key to engaging with families but challenges remain. Sufficient maturity of interventions is needed to fully establish impacts.
GP Child Health Hubs (CHH) have been established in Northwest (NWL) London, 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) was set up in three NWL boroughs (Harrow, Brent, 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.
Methods
We focused on Harrow and Brent. Using the MRC framework and the COM-B Behaviour Change framework, 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 multi-disciplinary teams (MDTs). Data analyses are descriptive, narrative and thematic.
Results
Both 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” (CHHWs, FLWs) were crucial to increase family engagement, and bought 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.
Conclusion
Collaborative approaches and community connectors are key to engaging with families but challenges remain. Sufficient maturity of interventions is needed to fully establish impacts.
Date Issued
2026-05-25
Date Acceptance
2026-05-03
Citation
BMJ Paediatrics Open, 2026, 10 (1)
ISSN
2399-9772
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Paediatrics Open
Volume
10
Issue
1
Copyright Statement
© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.
License URL
Identifier
10.1136/bmjpo-2025-004079
Publication Status
Published
Article Number
ARTN e004079