G27 Social influences on parents’ health service use when their child is sick: barriers to timely treatment?

Acute childhood illness is surrounded by uncertainty and anxiety about the nature of the illness and when to seek professional help (Neill 2010). Social influences on health service use are complex but need to be understood if services are to address barriers to timely treatment. Aim To explore the impact of social influences on parents' health service use during acute childhood illness. Methods This paper draws findings from 3 projects which explored parents' decision making during acute childhood illness at home. These studies include: a grounded theory study with 15 families (Neill 2008), a social marketing project involving 23 parents in focus groups (Spencer and Neill 2013) and a modified grounded theory study with 27 parents using focus groups and interviews (Jones et al. 2013, Neill et al. 2014). Results Three themes emerged in the data from all 3 projects: Social expectations; Family and social support; and Service design and its impact on access to services. Social expectations shape how parents perceive they are expected to act as mly 'good parents', including an expectation that they will use services appropriately, creating anxiety about attending too soon or too late. Family and social support provides emotional and practical support, not usually advice on how to manage the illness, contrary to professionals' assumptions about the role of extended families. Services are not designed with the child and family in mind: systems create delay, increasing parents' anxiety; difficulties in accessing services; limited continuity; and confusion about which service to use. Conclusion A wide range of social factors influence parents' help seeking in childhood illness. When parents decide to consult they have exhausted their ability to cope with their child's illness independently. Parents need to know where, and when, to seek help and to be able to do so easily, without being judged for doing so. Services face the challenge of reducing barriers to timely treatment within financial constraints, if we are to reduce avoidable morbidity and mortality and improve UK child health outcomes.