Literature Collection

BACKGROUND: The Sparkbrook Children's Zone (SCZ) is an integrated health and social care offer for children and young people (CYP) in an economically marginalised area of Birmingham, UK. This study sought to measure: clinic reach to CYP living in deprivation; proportion of CYP receiving preventive health offers; referral rate to secondary care; proportion of CYP referred to a family support worker. METHODS: Observational study using routinely collected data to evaluate activity and impact of the SCZ. SCZ weekly clinics, embedded in a partner primary care network, are located in Sparkbrook and Balsall Heath East, Birmingham's second most populous ward with a young population, high diversity and high infant mortality. The clinics provide preventive health, clinical care, mental health support and social support to CYP <16 years. UK Health Research Authority approval reference: 25/PR/0168. RESULTS: From March 2022 to December 2024, 2265 CYP were booked into clinics (93.5% slots taken up); 89% of families were from the bottom Index of Multiple Deprivation quintile.Preventive healthcare: immunisation advice increased from 10.7% in 2023 to 40.2% in 2024; oral health promotion from 29.2% to 46.8%; smoking cessation advice from 1.8% to 12.5%; 97% eligible children received Healthy Start vitamins; 83% had body mass index measured.Clinical care: 73.8% of CYP discharged after seeing General Practitioner/paediatrician, 3.8% referred to secondary care, 14.7% patients were not brought to appointments.Social support: 28.2% of CYP referred to a family support worker. Five top reasons for referral: feeding, behaviour, activities, special educational needs and disabilities, parenting skills. CONCLUSION: Initial data suggest preventive health and social support can be successfully integrated in a neighbourhood health offer for CYP living in deprivation, with low referral rates to secondary care.

Alzheimer's disease (AD) is often underdiagnosed, especially at early stages when symptoms are mild, and patients may benefit from new and recently approved anti-amyloid therapies. An updated patient care pathway may facilitate timely diagnosis and intervention. We conducted a scan of published information and convened an expert panel of health care professionals to gain insights on early AD care pathways. We developed an Early AD Patient Care Pathway as an implementation guide that includes new diagnostic and treatment modalities and addresses needs and opportunities. The Early AD Patient Care Pathway focuses on patient identification, assessment, diagnosis, treatment, and management and monitoring. Operational readiness considerations aid pathway implementation and include evaluating and addressing gaps in program and business planning, technology, education and resources, access and reimbursement, and care coordination. The pathway is adaptable to health system needs and may be further tested and refined for sustainability. HIGHLIGHTS: We analyzed published information and insights from subject matter experts on care pathways for early Alzheimer's disease.We identified opportunities to improve screening of at-risk patients, make appropriate specialist referrals, and ensure timely access and care coordination for diagnosis, treatment, and monitoring as a means of incorporating the latest diagnostics and therapy options.We developed a care pathway that promotes an integrated approach to patient care and is adaptable to various healthcare settings with input from subject matter experts.