Our incubator proposal addresses key issues for research in general paediatrics (including community paediatrics) across the multi-disciplinary team (MDT). This includes representative professional groups, CYP and carer groups, and expertise across age groups. We have engaged those with existing incubators to learn from their experience. Our incubator will pull together a large range of stakeholders who already have the knowledge, networks and shared ambition to improve research in general paediatrics, but lack combined resource. Our incubator has equality, diversity and inclusivity as its core value, ensuring we support under-represented groups (including women, ethnic minorities and those from lower socio-economic backgrounds) as well as healthcare professionals under-represented in research, to build capability and capacity in the workforce to engage with, implement, undertake and lead research in practice.

General and community paediatric services provide broad care for CYP in acute and chronic disease encompassing the prevention and management of common conditions. We define general paediatrics as inclusive of community paediatrics including the care of children with disabilities, safeguarding concerns and children in care. General paediatrics covers children from birth to late adolescence in the UK, and accounts for almost 70% of paediatric consultations.

Over the last 30 years, general paediatric care has been particularly challenged to meet the needs of CYP by the growing complexity of disease such as the increasing long-standing nature of illness, multi-morbidity and a transition from communicable to non-communicable diseases. Increasing complexity due to the interaction with social determinants of health, disabilities and mental health (MH) also provide challenges for the specialty. Out-patient attendances (including conditions such as obesity, constipation, asthma) have risen - over 2.5 million in 2022-23. Services at the frontline for delivery of acute care have seen increasing numbers and complexity of emergency admissions, including acute MH crises (12.6% of paediatric admissions in 2022, compared to 7.6% in 2021 with a 600% increase in eating disorder admissions). Waiting times for community paediatric services are growing three times faster than adult community services.

Despite this, research in general paediatrics has lagged significantly behind other child health specialities and CYP cared for in general and community settings remain under-represented in research studies, including trials of new therapeutics. Currently, of 4735 open NIHR portfolio studies, 7% are in a CYP speciality and only 1% are badged as general/community paediatrics and only 5.4% of 2022 RCPCH UK census respondents reported research involvement. A lack of paediatric-specific data means a large proportion of medicines used to treat children are used “off-label” (1.2-99.7%), which is associated with increased rates of adverse drug reactions. The evidence-base for management of some of the most common conditions in childhood remains poor. Given much of adult disease has its origins in childhood and adolescence we are therefore not addressing the unmet needs of future populations.

This incubator aims to inspire and support those interested in research in general paediatrics, with an inclusive and collaborative multi-professional approach. focussing on health from newborn to late adolescence. Our incubator will build on, and go beyond, the strengths of established networks, namely the GAPRUKI network (General and Adolescent Paediatric Research in the UK and Ireland) and BACCH (British Association of Community Child Health) Strategic Research Group (SRG).

Overall the incubator is designed to help ensure the delivery of meaningful research in this underrepresented population and across the lifecourse and settings where CYP are cared for.