Children and young people living with CHD are at increased risk of neurodevelopmental, psychosocial, and educational challenges. Educational professionals play a key role in supporting these pupils but often receive limited condition-specific information, and little is known about how communication between healthcare services and schools can be improved. This study explored educational professionals’ experiences of supporting pupils with CHD and opportunities to strengthen collaboration between paediatric cardiology services and schools.

Semi-structured interviews were conducted with educational professionals (n = 15) from mainstream primary, post-primary, and specialist schools in Northern Ireland. Interviews explored experiences of supporting pupils with CHD, communication, information needs, and training requirements. Data were analysed using reflexive thematic analysis. Findings were complemented by a pre–post evaluation of an online CHD teacher training webinar.

Four interrelated themes were identified: (1) Desire for structured communication; (2) need for individualised information relating to the educational environment; (3) managing uncertainty in the classroom; and (4) striving for inclusivity via flexibility. Participants relied on parents for clinical information and reported limited direct communication with healthcare professionals. Teachers requested practical, child-specific guidance to support classroom decision-making. Webinar findings demonstrated improved knowledge and confidence following training.

Educational professionals are committed to supporting pupils with CHD but often do so with limited clinical guidance and fragmented communication pathways. Strengthening communication between paediatric cardiology services and schools, alongside practical, child-specific resources, may reduce uncertainty, improve teacher confidence, and promote more consistent educational support for pupils with CHD.

Child sexual abuse (CSA) is associated with substantial psychiatric morbidity, yet the nature and scope of integrated child and adolescent psychiatry within specialist CSA services in Ireland are poorly described.

This retrospective chart review included all children and adolescents referred to an embedded child and adolescent psychiatry clinic within The Alders Unit, a specialist CSA service, between 1 January 2024 and 31 December 2025. Data included demographics, psychosocial adversity, referral characteristics, psychiatric diagnoses, psychotropic prescribing, prior Child and Adolescent Mental Health Service (CAMHS) involvement and onward referrals. Descriptive statistics summarised sample characteristics, and associations between categorical variables were examined using chi-square or Fisher’s exact tests.

Fifty young people (approximately 5% of Alders referrals) were seen by psychiatry (mean age 15.7 years, predominantly female). Nearly two-thirds experienced two or more psychosocial adversity domains, and 58% had a suspected or confirmed neurodevelopmental disorder. Depressive, anxiety and trauma-related disorders were the most common primary diagnoses. Acute risk related to self-harm or suicidality was the leading reason for referral and was associated with onward referral. Most young people required follow-up for more than 12 months. Psychotropic medication was prescribed in two-thirds of cases, largely confined to those with primary Axis I disorders; none were prescribed medication where the primary formulation was emerging emotionally unstable personality disorder traits.

Integrated child and adolescent psychiatry within a specialist CSA service appears to be required for a small but complex subgroup of young people, supporting inclusion of dedicated psychiatry within Barnahus services in Ireland.

In 2020 the Irish Health Service Executive (HSE) shifted chronic disease management (CDM), including COPD and asthma, into primary care via a funded CDM programme. An Enhanced Community Care (ECC) initiative established local clinical specialist teams (CSTs) providing spirometry, nurse-led clinics and pulmonary rehabilitation to support primary care practitioners (PCPs). We explored early PCP experience, diagnostic access, and confidence, to identify improvement priorities.

We sought to evaluate PCPs experiences with the implementation of Ireland’s CDM and ECC programmes for COPD and asthma, focusing on diagnostic access, clinical confidence and priorities for service improvement and professional development.

A semi-structured survey was distributed nationally through PCP faculty meetings, mailing lists and messaging groups. Single- and multi-choice items, Likert scales (1–10) reported as median and interquartile range (IQR), and ranked options quantified satisfaction, access and educational needs; free-text responses underwent thematic analysis.

One-hundred-12 PCPs responded (62% urban; 65% >10 years in practice). Most practices (97%) had adopted CDM and 87% perceived better patient outcomes arising from this, yet only 33% reported a major change in their own practice. Integrated-care hubs were rated good–excellent by 87% and superior to hospital outpatient care by 84%, but limited diagnostics (52%), delayed two-way communication (45%) and inadequate specialist support (50%) persisted. Self-reported confidence in guideline knowledge was modest (asthma 7 (IQR 6–7); COPD 7 (IQR 6–7)) and very low for interpreting pulmonary-function tests and prescribing pulmonary rehabilitation (3 (IQR 2–5) and 5 (IQR 4–6) respectively). Priority topics for continuing-professional-development were: differentiating asthma from COPD, inhaler device choice and PFT interpretation.

Irish PCPs value the CDM/ECC model but highlight implementation gaps. Targeted CPD, faster digital feedback and decision-support tools are needed, alongside longitudinal evaluation against health-service benchmarks and sustainability frameworks.

To examine how co-located community and health services in primary care could support disadvantaged groups.

Co-locating services is thought to improve access, collaboration, and patient outcomes. There are thousands of primary care premises across the UK. At a time of stagnating or widening health inequalities, they present an ideal opportunity to support communities, especially in disadvantaged areas.

We conducted a systematic umbrella review. Articles were retrieved from Ovid MEDLINE and Ovid Embase with supplementary snowball and grey literature searches. Reviews of co-located services supporting disadvantaged groups in primary care between 2010 and February 2024 were included. Quality and risk of bias were assessed using the Joanna Briggs Institute checklist. Two reviewers assessed eligibility, extracted data and assessed quality. Outcomes relating to health, welfare, healthcare utilization, and activity and processes were assessed. Data were narratively synthesized using a convergent integrated approach.

2626 studies were screened, supplemented by snowball and grey literatures searches. Thirteen reviews were included for synthesis. One review included meta-analysis. Three models of care were identified; legal advice, welfare advice, and complementary health care. Data were synthesized according to themes: access and engagement, quality of care, efficiency, improved health, and improved social factors. We found co-located services can improve access to care, engagement in treatment, and quality of care for disadvantaged groups. Improvements to social determinants of health and mental health and well-being outcomes were reported. Findings were inconsistent when considering the impact of co-location on efficiency. We conclude that co-located services in primary care have the potential to improve identification of people most in need and improve their access to high quality health care and social support. Policy makers and practitioners should maximize the use of primary care estates to support disadvantaged groups and communities.

This study aimed to develop a European definition of Community Health Centres (CHCs) as a model of primary care, assess the acceptability and feasibility of this model among experts, and propose a common framework to guide CHC implementation across European countries.

CHCs have existed in Europe for more than five decades and are increasingly recognized as effective models for delivering comprehensive, equitable and integrated primary care. Despite their established global presence, there remains a need to contextualize and define CHCs within Europe’s diverse healthcare systems.

Building on the International Federation of Community Health Centres (IFCHC) definition, a refined version comprising 35 key statements was developed through expert consultations. A two-round Delphi study was conducted with 31 experts from 16 countries, using five-point Likert-scale questionnaires to evaluate the acceptability and feasibility of each statement.

All 35 statements were rated as acceptable and feasible (average value >3 on the five-point Likert scale). The most highly rated elements included respect for human rights, accessibility irrespective of socioeconomic status, interprofessional collaboration, and integrated, people-centred care. Although feasibility ratings were slightly lower than acceptability ratings, they improved in the second round, indicating increased consensus. Statements concerning governance, community participation, and responsibility for specific population subgroups received lower feasibility ratings. Overall, the findings demonstrate broad expert consensus on the relevance and adaptability of the CHC model within Europe. While some implementation challenges persist, particularly regarding governance, interprofessional collaboration, and intersectoral coordination, the proposed definition offers a robust foundation for strengthening primary care across diverse European contexts.

The dual burden of tuberculosis (TB) and diabetes mellitus (DM) presents a growing challenge for health systems in low- and middle-income countries (LMICs), including Pakistan. Despite global and national policies advocating for integrated care, evidence on health facility readiness to operationalize integration remains scarce. This study assessed the readiness of TB basic management units (BMUs) to deliver integrated TB-DM care and explored implementation barriers using the Consolidated Framework for Implementation Research (CFIR).

We conducted an explanatory sequential mixed-methods study from September 2024 to February 2025 across 13 TB BMUs in five districts of Pakistan. Quantitative readiness data were collected using a structured tool adapted from the WHO Service Availability and Readiness Assessment (SARA), generating a composite score across four domains. Subsequently, qualitative data were gathered through multi-stakeholder focus group discussions with healthcare providers, facility managers, patients, caregivers, and policymakers. Reflexive thematic analysis was conducted and mapped to CFIR Inner Setting constructs to contextualize quantitative findings.

Only one facility demonstrated high readiness, while 12 showed low readiness. Facilities lacked routine comorbidity screening, trained staff, diagnostic capacity, and essential medicines. Key barriers included inadequate infrastructure, workforce shortages, fragmented information systems, and low prioritisation of integrated care. Financial constraints and limited coordination further hindered implementation.

This study highlights critically low readiness among TB facilities in different districts of Pakistan to deliver integrated TB-DM care, reflecting systemic weaknesses across core domains. Strengthening systems, building capacity, and improving integration strategies are essential to bridge gaps between policy and practice.

Dual disorder, comprising of substance use and mental health disorders, requires a comprehensive treatment approach. The most effective is integrated dual disorder treatment, which involves addressing both conditions concurrently by the same specialists and in the same setting. This study examines characteristics of integrated dual disorder care offered by treatment services across European countries.

In 2022, representatives of 14 integrated care for dual disorder providers in 10 European countries were asked to respond to a survey about their treatment process, outcomes, barriers and facilitators when implementing dual disorder treatment in respective countries. Thematic qualitative analysis was used to explore closed- and open-ended responses, focusing on commonalities and differences between surveyed services.

Integrated care services varied in treatment settings and structure, but all offered comprehensive support for dual disorder. Among 14 services, half addressed tobacco addiction or provided suicide prevention, three treated cannabis use, and none accepted patients in opioid agonist therapy. Few services reported evaluating treatment outcomes in standardised way. Services supported patients with social security, employment, housing and education, but also noted difficulties in coordinating post-treatment care due to divergent views on dual disorder among specialists from different services.

Integrated care services provide comprehensive and tailored support for people with dual disorder but remain distinct within the healthcare options available to this patient group across Europe. Existing and future integrated care services would benefit from addressing tobacco and cannabis use, measuring treatment outcomes and improving continuity of care.

Randomized controlled trials (RCTs) of the Collaborative Care Model demonstrate strong evidence for effectively managing depression in a stepped-care approach across diverse patient populations. Despite alignment with the American Society of Clinical Oncology guidelines, which recommend a stepped-care approach for managing depression and anxiety in cancer patients, implementation of collaborative care in cancer centers remains limited and sparse real-world data exist. The Supportive Oncology Collaborative, a program integrating behavioral health and palliative care, was developed at an NCI-designated academic cancer center. This study aims to evaluate depression outcomes within this collaborative care program.

A retrospective analysis was conducted on patients with at least 2 Patient Health Questionnaire-9 (PHQ-9) scores recorded within a 12-month period between January 2022 and December 2023 at 1 regional campus. Depression response, defined as a 50% reduction in PHQ-9 scores, was assessed at 12 and 24 weeks. Response rates were compared to those reported in RCTs of collaborative care.

Mean PHQ-9 scores were 17.3 at baseline (n = 47), 11.1 at 12 weeks (n = 43), and 10.1 at 24 weeks (n = 22). Depression response rates were 34.9% at 12 weeks (n = 43) and 54.5% at 24 weeks (n = 22).

We observed depression response rates comparable to those reported in RCTs of collaborative care in individuals with cancer. However, the high proportion of missing data highlights the difficulty of tracking outcomes in real-world clinical settings and the need for further evaluation and strategies to improve data completeness.

To better meet the growing demand and complexity of clinical need, there is a broad international trend towards greater integration of various elements of health- and social care. However, there has been a lack of research aimed at understanding how healthcare providers have experienced these changes, including facilitators and inhibitors of integration.

This study set out to generate new understandings of this from three UK staffing ‘levels’: ‘micro’ frontline workers, a ‘meso’ level of those leading a healthcare organisation and a ‘macro’ level of commissioners.

Using Rogers’ Diffusion of Innovation framework, qualitative analysis of individual interviews from provider staff perceptions was undertaken at these three levels (total N = 33) in London.

English legislation and policy captured the need for change, but fail to describe problems or concerns of staff. There is little guidance that might facilitate learning. Staff identity, effective leadership and culture were considered critical in implementing effective integration, yet are often forgotten or ignored, compounded by an overall lack of organisational communication and learning. Cultural gains from integration with social care have largely been overlooked, but show promising opportunities in enhancing care delivery and experience.

Findings are mixed insofar as staff generally support the drivers for greater integration, but their concerns, and means for measuring change, have largely been ignored, limiting learning and optimisation of implementation. There is a need to emphasise the importance of culture and leadership in integrated care, and the benefits from closer working with social care.

This research aimed to explore the perspectives of primary and community care providers on the challenges that hinder the delivery and uptake of personalized type 2 diabetes (T2D) care, with a focus on the integration of mental health support and care.

The day-to-day burden and demand of self-managing T2D can negatively impact quality of life and take a toll on mental health and psychological well-being. As a result, there is a need for personalized T2D self-management education and support that integrates mental health care. Despite the need for this personalized care, existing systems remain siloed, hindering access and uptake. In response, innovative, comprehensive, and collaborative models of care have been developed to address fragmentations in care. As individuals living with T2D often receive their care in primary care settings, linking mental health care to existing teams and networks in primary care settings is required. However, there is a need to understand how best to support access, adoption, and engagement with these models in these unique contexts.

A cross-sectional survey was distributed to primary and community providers of an Ontario-based smoking cessation network. Survey data were analyzed descriptively with free text responses thematically reported.

Survey respondents (n = 85) represented a broad mix of health professions across primary and community care settings. Addressing challenges to the delivery and uptake of personalized T2D care requires comprehensive strategies to address patient-, practice-, and system-level challenges. Findings from this survey identify the need to tailor these models of care to individual needs, clearly addressing mental health needs, and building strong partnership as means of enhancing accessibility and sustainability of integrated care delivery in primary care settings.