Abstract
Background
The prevalence of Tic Disorders (TD) in Children and Young People (CYP) approaches 3%, indicating TD to be more common than previously believed. However, in the United Kingdom, access to National Healthcare Services (NHS) with a remit for the assessment, diagnosis and management of TD in CYP remains severely limited. The present study aimed to build consensus among healthcare experts to define and characterise a realistic service model of care with a remit of assessing, diagnosing, and treating TD in CYP; and to identify potential obstacles and facilitators to establishing and implementing this service model.
Methods
A panel of experts (N = 10) participated in a three-round e-Delphi study. All surveys were completed online. In Round 1, experts provided free-text responses to 7 open-ended questions. Researchers qualitatively processed responses and generated 28 statements which comprised the Round 2 survey. Participants rated statements on relative agreement and/or importance, items that reached consensus were not included in subsequent survey. Controlled feedback of individual and group responses was displayed for participants in Round 3.
Results
Expert consensus was gained on statements pertaining to; service configuration, constraints and obstacles to service development and delivery, age-range and duration of service input, and interventions for service to offer. A ranking hierarchy identifying prioritised professional roles for newly commissioned services was created.
Conclusions
The present study successfully built consensus among healthcare experts for a specialised NHS service model of care for the treatment of TD in CYP. Findings included identifying potential aids and barriers for implementation and highlight the importance of multi-disciplinary team-working and integrated care. Importantly, the present study further emphasises the need for the systematic development of clinical guidelines for TD by the National Institute of Clinical Excellence (NICE).