Centre for Health Services Studies, University of Kent, Canterbury, UK
Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK.
BMJ Open. 2022 Feb 7;12(2):e056628. doi: 10.1136/bmjopen-2021-056628.
To capture the extent and impact of changes in the delivery of child health services in the UK, resulting from the SARS-CoV-2 pandemic response, from the perspectives of a range of child healthcare providers.
National Health Service commissioned/delivered healthcare services in two regional settings in the UK: North of Scotland (NOS) and North East and North Cumbria (NENC) in England.
Purposive sample of 39 child healthcare professionals including paediatricians, community/specialist nurses, allied health professionals and mental health professionals, from across the two regions (22 in NOS, 17 in NENC).
Semistructured qualitative interviews conducted via telephone between June and October 2020, fully transcribed and analysed in NVivo V.11 using thematic analysis.
Extensive changes across a range of paediatric services were rapidly implemented to support the pandemic response and ongoing healthcare delivery. New ways of working emerged, principally to control the spread of the virus. Keeping users and their families out of hospital was an urgent driver for change. The changes had considerable impact on the health and well-being of staff with many experiencing radical changes to their working conditions and roles. However, there were some positive changes noted: some practitioners felt empowered and listened to by decision makers; some of the usual bureaucratic barriers to change were lifted; staff saw improved collaboration and joint working across the system; and some new ways of working were seen to be more efficient. Interviewees perceived the implications for children and their families to be profound, particularly with regard to self-care, relationships with practitioners and timely access to services.
Despite the challenges experienced by staff, the pandemic provided an opportunity for positive, lasting change. It is vital to capitalise on this opportunity to benefit patient outcomes and to 'build back' services in a more sustainable way.
从一系列儿童保健提供者的角度出发，捕捉英国 SARS-CoV-2 大流行应对措施对儿童保健服务提供方式的改变程度和影响。
英国国民保健系统委托/提供医疗保健服务的两个区域设置：苏格兰北部（NOS）和英格兰东北部和北坎布里亚（NENC）。
来自两个地区（NOS 地区 22 人，NENC 地区 17 人）的 39 名儿童保健专业人员的目的性抽样，包括儿科医生、社区/专科护士、联合健康专业人员和心理健康专业人员。
2020 年 6 月至 10 月期间通过电话进行半结构化定性访谈，在 NVivo V.11 中使用主题分析对全部转录文本进行分析。
为支持大流行应对措施和持续的医疗保健服务，迅速在一系列儿科服务中实施了广泛的改变。出现了新的工作方式，主要是为了控制病毒的传播。让使用者及其家属远离医院是推动变革的迫切动力。这些变化对工作人员的健康和福祉产生了重大影响，许多人经历了工作条件和角色的巨大变化。然而，也有一些积极的变化值得注意：一些从业者感到被决策者赋予权力并得到倾听；一些通常阻碍变革的官僚主义障碍被消除；工作人员看到整个系统内的协作和联合工作得到改善；一些新的工作方式被认为更有效率。受访者认为这些变化对儿童及其家庭的影响是深远的，特别是在自我护理、与从业者的关系以及及时获得服务方面。
尽管工作人员面临挑战，但大流行提供了积极、持久变革的机会。至关重要的是要抓住这一机会，改善患者的治疗效果，并以更可持续的方式“重建”服务。
