Evaluating the feasibility, acceptability and healthcare impact of a GP-integrated paediatric developmental clinic model for children aged 0–16 years in rural Western Australia

The intervention is a GP-integrated developmental and behavioural paediatric clinic model designed to improve access to assessment and care for children in rural and remote communities while awaiting specialist paediatrician review. The model is delivered by participating rural general practitioners (“Study GPs”) who receive targeted training in developmental and behavioural paediatrics, supported by specialist paediatricians and clinicians with expertise in developmental paediatrics, rural child health and developmental assessment, including administration of the Griffiths-III developmental assessment. For children aged over 6 years, developmental and behavioural assessment is undertaken by trained rural GPs with paediatrician support and case review, while children under 6 years are assessed by a rural general practitioner undertaking additional child health training (“RG-Paed”). The intervention is delivered through a combination of face-to-face clinic appointments, telehealth-supported case conferencing, supervised clinical learning and multidisciplinary collaboration. Eligible families are invited to attend an individual assessment appointment with a participating Study GP while awaiting paediatrician review. Initial GP appointments are anticipated to last approximately 60–90 minutes depending on clinical complexity and available prior assessments. The assessment includes detailed developmental, behavioural, psychosocial and medical history-taking; review of prior medical and allied health reports; physical examination where indicated; identification of safeguarding or behavioural concerns; and preparation of a structured management summary for discussion with the supervising paediatrician. Paediatrician involvement occurs through existing outreach clinics and/or telehealth case conferencing with the GP. The intervention is delivered within participating rural general practice and outreach paediatric clinic settings, with telehealth support provided through videoconference platforms including Teams and Zoom. Participating clinicians undertake approximately 10–20 hours of initial training delivered over several weeks prior to clinic commencement, followed by ongoing mentoring, supervision, case discussion and telehealth-supported learning throughout the study period to support fidelity to the intervention model and clinician skill development. Attendance at appointments and completion of assessment documentation and paediatric case discussions are monitored through clinic booking systems, attendance logs, and study records to assess adherence to the intervention. Please note that the initial GP assessment will involve a comprehensive developmental and behavioural review conducted by a participating Study GP. This assessment will include collection of a detailed medical, developmental and psychosocial history; review of previous medical records and allied health reports; assessment of developmental concerns raised by carers, schools or other healthcare providers; physical examination where clinically indicated; and identification of any immediate health, behavioural or safeguarding concerns. The GP will document findings and prepare a structured summary and management plan for discussion with the supervising paediatrician. Training will include education in paediatric developmental and behavioural assessment, developmental surveillance, neurodevelopmental conditions, structured history-taking, formulation of differential diagnoses, referral pathways, and multidisciplinary management planning. Participating clinicians will also undertake specific training in the administration and interpretation of developmental assessment tools including the Griffiths-III developmental assessment, as relevant to their clinical role. The educational program will incorporate existing RACGP paediatric and child health educational resources, structured teaching sessions, supervised practical learning, and case discussion activities. Training will be delivered through a combination of online learning modules, videoconference teaching sessions (including Teams and Zoom), self-directed learning, and supervised clinical experience within developmental paediatric services