This new network is called the General and Adolescent Paediatric Research Collaborative - UK and Ireland and is known by the acronym GAPR-UKI. In developed countries the majority of secondary care of children and young people (CYP) occurs in ‘General and Adolescent’ Paediatric units. In fact in the UK there is an estimate that 80% of all paediatrics is conducted by General Paediatricians. Much of the care conducted in these busy units has a poor evidence base and is often under-researched. Some common examples include the use of paracetamol and ibuprofen for fever, the management of chronic fatigue syndrome, the treatment and investigation of sepsis in babies, the management of asthma, the treatment of chronic constipation and the treatment and investigation of urinary tract infections.
We have therefore established GAPR-UKI which will be a network of research focused General Paediatricians throughout the hospitals of UK and the Republic of Ireland to overcome the challenges inherent in recruiting and performing research with children with common problems attending General Units. Busy clinicians in District General Hospitals with an over-stretched service are challenged to deliver research. GAPR-UKI has been established to support this process. We plan to commence a series of mixed method research projects, service evaluations, national audits and randomised controlled studies to help develop the evidence base for care of CYP in both District General Hospitals and tertiary Children's' hospital.
General Paediatric research is challenging for a number of reasons:
1. Serious outcomes and adverse events are rare.
2. Data collected in tertiary institutions are not necessarily applicable to other settings.
3. Much acute in-patient children is short term (24 hours or less)
4. Patients are often treated differently according to local policies with the opportunity to learn from these skilled encounters by accumulating treatment episodes frequently missed.
5. Data quality from general out patient care setting can be minimal.
6. Funding for General Paediatric research is limited.
7. Sharing of information between institutions is often restricted.
8. Difficulty in disseminating findings and translation of science into practice.
9. With a research focus on rare and specialist disorders, common conditions can be overlooked.
The structure and governance of GAPR-UKI is based on other national and international research networks such as PERUKI (www.peruki.org) This document outlines the function, structure and processes of GAPR-UKI and its contents should be referred to in order to continue to sustain successful growth and collaboration in all GAPR-UKI studies and governance issues. We acknowledge the start-up help, advice, and support of individuals affiliated with the aforementioned established PERUKI network and key advice we received from the RCPCH, SPARKS and Action Research.