Children with MLTCs – South London v-1.0
Research type
Research Study
Full title
A qualitative, multi-perspective assessment of unmet health needs and co-design of care pathways for children with multiple long-term conditions (MLTCs) in South London
IRAS ID
356551
Contact name
Ingrid Wolfe
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
0 years, 3 months, 28 days
Research summary
The prevalence of multiple long-term conditions (MLTC) in children has risen sharply, with evidence showing widespread unmet health needs. In South London, over half of children studied had at least one uncontrolled physical condition, while three-quarters reported unmet needs across physical, mental, or social domains; disadvantaged children faced a 20% higher risk of poorly controlled illness. These findings highlight significant biopsychosocial burdens and complex challenges for families and health systems.
National policy supports integrated care for children with MLTC, but implementation remains inconsistent, particularly in diverse, high-poverty areas such as Southwark and Lambeth. Families often encounter fragmented care pathways, poor communication, and difficulties navigating services, while barriers in these boroughs are underexplored. Quantitative studies provide important epidemiological insights but fail to capture lived experiences, and children’s voices remain largely absent despite their right to participate in decisions about their health. A locally focused, multi-stakeholder needs assessment is therefore crucial to guide solutions.
Local system learning offers lessons. Programmes such as NIHR ARC South London’s CHILDS initiative and neighbourhood Child Health Teams have shown disease-specific gains (e.g., reduced emergency attendances in eczema and asthma), yet population-level impacts were limited in the CYPHP trial. Challenges included reduced engagement among deprived and minority groups, narrow clinical focus, minimal integration of mental health, data silos, digital exclusion, workforce fragility, and weak support for care transitions. These findings suggest that technical integration alone is insufficient, and that solutions must address equity, mental health, and digital barriers through co-design with children, families, practitioners, and community partners.
Aim: To conduct a qualitative needs assessment in South London and co-design an integrated, equity-enhancing care pathway for children and young people with MLTC.
Objectives: (1) Assess lived experiences and unmet needs; (2) Evaluate service access and navigation; (3) Map and appraise care pathways; (4) Identify design requirements; (5) Co-design an intervention with stakeholders.REC name
London - City & East Research Ethics Committee
REC reference
25/PR/1505
Date of REC Opinion
16 Dec 2025
REC opinion
Further Information Favourable Opinion