Consultants at St George’s University Hospital in Tooting are helping to transform children’s healthcare in Wandsworth by getting involved in specialist Together Clinics that have been set up in GP practices in the area.

Children are seen by a consultant and their GP – Together – speeding up treatment, reducing follow-up appointments and keeping care close to home.

Dr Tom Coffey, lead GP for children’s services in Wandsworth said:

“This is a really great service and the result of some genuine collaboration that brings specialists closer to patients”.

Tom developed the clinics alongside Dr Marianna Leach, paediatric consultant at St George’s. Marianne said:

“The Together clinics reflect a genuine partnership between primary and secondary care. They improve children’s health and their experiences of paediatric care. We are building relationships and breaking down silo working. They are the future of how we should manage children and young people’s health. I am passionate about developing these further.”

Patients are seen for the same conditions as in the general acute paediatric clinics at St George’s – everything from reflux, weight and concern about head shape in babies, to headaches or abdominal pain in older children. GPs can book children from birth to 18 years directly into the clinic.

For non-emergencies, children are usually seen at the Together clinic within four weeks of first consulting their GP. Appointments take place in their own practice or one nearby. This means the whole process is speedier than the traditional route. In urgent cases, children are referred for further investigations within days and GP involvement means follow-up appointments, provided by GPs who know the patients and family well, can take place at the surgery without waiting for an outpatient slot.

Jennie Rankin attended the Together clinic at Earlsfield Practice with her daughter Grace, aged seven months. Grace has experienced health problems since contracting viral meningitis when she was three weeks old. Jennie said:

“We’ve had two admissions to St George’s hospital with bronchiolitis, which is why we saw the paediatrician today. It has been quite stressful and quite scary but being able to come to our local GP and see a consultant, who we’ve dealt with before at St George’s, has been absolutely amazing. We haven’t had to wait months.

“The GPs at Earlsfield have been amazing too. When you are a mum with a very ill baby it’s great that you can access that extra expertise. Today we went in to get Grace’s breathing checked and a list of other things. Everything was dealt with really well. We’ve got a plan of action and a follow-up in four weeks, so it’s been very positive.”

Patients are also discussed in multi-disciplinary team meetings, either virtually or in-person, twice a month. These involve consultants, GPs and practice nurses, with long-term plans to include health visitors, therapists and other professionals who work with children and young people. The meetings mean some children can be managed by the GP without attending the clinic due to needing an appointment due to needing input from a paediatric doctor.

Dr Khalida Salim, GP at the Earlsfield Practice, works closely in a Together clinic with Dr Marianne Leach from St George’s. She shares:

“This is one of the best changes I’ve seen in general practice over the past few years. It breaks down barriers. Before, just to reach a paediatrician or a consultant at the hospital took a lot of time. Now we just write a short email, asking ‘what advice do you give?’, making it so much easier for us.”

“Children like the clinics because they’re in a familiar environment, parents like them because they don’t have to go to the hospital and GPs and paediatricians love them because they are more efficient, faster and, so much better for the patient.”

The first Together clinic launched in 2017 as a pilot in Putneymead surgery. From that one base, the team upscaled to three locations, then to six. By July there will be eight Together hubs serving nine primary care network areas, with five acute paediatric consultants delivering the clinics.


Notes to editors

St George’s University Hospital FT

St George’s University Hospitals NHS Foundation Trust is the largest healthcare provider, major teaching hospital and tertiary centre for south west London, Surrey and beyond – and one of the largest healthcare providers in the UK – serving a population of 3.5 million.

Its main site, St George’s Hospital – one of the country’s principal teaching hospitals – is shared with St George’s, University of London, which trains medical students and carries out advanced medical research.

St George’s is one of 11 adult and children major trauma centres in the UK, one of eight hyper acute stroke units and one of the biggest and busiest of the eight heart attack centres in London.

It is also an accredited centre of excellence for trauma, neurology, cardiology, cancer and blood pressure services and is the national centre for family HIV care and bone marrow transplantation for non-cancer diseases.

St George’s children’s services are rated outstanding by the CQC.

*St George’s haematopoietic stem cell transplantation team have a 70% survival rate five years after surgery, significantly better than the average in UK.