Gloucester Big 6

Background / Motivation

There had been an increase in paediatric emergency admissions to the local Foundation Trust (FT) of 15% over the previous 3 years. Benchmarking data suggested that the rate of admissions for respiratory infections, bronchiolitis and gastroenteritis for under 2s were higher than other comparable demographic areas and Gloucester consistently has the highest rate of emergency admissions per 1000 practice population.


Preventing emergency admissions due to the six common conditions for children within Gloucestershire

Target patient groups

Children with the six target conditions

The service model

Clinical guidelines and assessment tools within the big 6 have been developed for the six high volume conditions (bronchiolitis/croup, fever, gastroenteritis, head injury, wheezy child/asthma, abdominal pain). Assessment tools were developed using NICE (National Institute of Health and Care Excellence) and SIGN (Scottish intercollegiate guidelines network) publications alongside local policies and protocols and were subject to clinical scrutiny. Patient information leaflets produced, online tool and clear red/amber/green system with clinical parameters


Information has been shared with all GPs, practice nurses, GP trainees, minor injury and illness unit nursing staff, junior ED staff and paramedics (SWAST). They have set up a series of educational events to share use of the guidance and clinical cases.

Contact for more information

Jeremy Welch


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