Abstract
Background and Rationale: Ireland’s healthcare system is undergoing extensive reforms toward universal and integrated care. However, service gaps persist, particularly for children who do not meet criteria for specialist services such as those supported by the Children’s Disability Network Teams (CDNTs). Fragmented primary care pathways disproportionately affect vulnerable children, including those in care and those from minority ethnic backgrounds. To address these gaps, this study aims to inform the development of an evidence-based, child-centred framework for integrated primary care services.
Objectives:
The rapid review aims to:
-Identify and describe global models of integrated care for children delivered in primary and community settings.
-Examine the roles of Health and Social Care Professionals (HSCPs) in these models.
-Explore how integrated frameworks address the needs of marginalised children.
-Provide evidence to guide the development of integrated policies and practices within the Irish context.
Methods: A structured rapid review is underway using the ECLIPSE framework to guide the examination of service models and policies. Five databases (ProQuest, PubMed, Academic Search Complete, Medline Complete, and CINAHL Ultimate) were systematically searched. Initially, articles from 2000 onwards were included; however, the timeframe was refined to 2016 onwards to ensure relevance and manage feasibility. Specific exclusions were added for studies focusing solely on oncology or palliative care, dental/oral health services, vision/optometry services, HIV-specific care, and immunisation/vaccination programmes. Operational definitions for terms such as “primary care/community care,” “integrated care,” “care pathway,” “healthcare service delivery model,” and “framework” were established early to ensure screening consistency. Screening is currently in progress, following a two-phase process managed through Rayyan software, with 20% of records undergoing dual screening. Data extraction and risk of bias assessment will follow, using MetaQAT or CASP tools. Synthesis will be based on a framework synthesis approach, and GRADE will assess confidence in the findings.
Key Insights and Challenges:
Several methodological and conceptual challenges have already emerged:
-Tight timelines required clear task prioritisation and rapid decision-making.
-Broad variability in definitions across studies necessitated operational clarity.
-Post hoc refinements to eligibility criteria were essential to manage scope and maintain relevance.
Preliminary findings highlight key pillars of effective integrated care models, including multidisciplinary collaboration, family engagement, use of digital technologies, and culturally responsive service delivery.
Gaps remain regarding models specifically designed for marginalised or minority children.
Next Steps: Following the completion of screening and data extraction, the findings will inform stakeholder surveys and focus groups with clinicians, service managers, parents, and policymakers. These activities will support the co-production of a practical, evidence-based integrated care framework for children's primary services in Ireland. Piloting and dissemination activities are also planned.
Conclusion: This project addresses a critical gap by synthesising global best practices for integrated primary care models for children. The resulting framework will support the development of inclusive, interdisciplinary, and child- and family-centred service innovations within the Irish healthcare system.