Barriers and facilitators to continuity and co-ordination of healthcare for under 18 years old: a systematic review

Abstract

ObjectiveTo determine views and experiences of babies, children and young people relating to continuity of their healthcare.DesignQualitative systematic review.SettingPrimary research from UK settings where NHS-commissioned or local authority-commissioned healthcare is provided. Systematic reviews from UK and non-UK high-income countries.PopulationBabies, children and young people under 18 years old with experience of healthcare. Parental and/or carer perspectives only included if children are under 5 years old or unable to express their own view.InterventionsNot applicable.Main outcome measuresThematic analysis of the benefits and facilitators to continuity of care for babies, children and young people.Results20 047 abstracts were screened; 186 full-text articles were reviewed; 11 papers fulfilled the review criteria. From these, four main themes and 14 subthemes were identified. The theme ‘individuals’ had four subthemes: ‘knowledge of healthcare system’, ‘support’, ‘personal lives’ and ‘results’. The theme ‘healthcare professionals’ had four subthemes: ‘interservice communication’, ‘collaboration with babies, children and young people’, ‘communications’ and ‘relationships with healthcare professionals’. The theme ‘practical’ had four subthemes: ‘colocation’, ‘appointment times’, ‘referrals’ and ‘waiting times’. The theme ‘technological’ had two subthemes: ‘ease of use’ and ‘complements current healthcare management’.ConclusionsContinuity of healthcare for babies, children and young people can enhance clinical outcomes but requires active facilitation by healthcare providers and services, especially in circumstances where individuals or their families are less able to advocate for themselves. A range of barriers and facilitators were identified together with recommendations for enhancing continuity of care.PROSPERO registration numberCRD42019145566.