Strengthening Care for Rural Children (SC4RC)

Project Details

Across NSW and Victoria, 860,000 children, 30% of the States’ population, live in rural areas. Although 19% of these children live with a chronic illness, there are fewer GPs per capita and paediatric specialty care is often lacking. Strengthening Care for Rural Children (SC4RC), a model where paediatrician and GPs work together in GP practices, aims to deliver and rigorously evaluate a primary health care system strengthening programme that can bridge the gaps in access to health services and health outcomes between children living in rural Australia and their urban peers. It aims to improve the health of children by increasing capacity of the existing rural GP workforce to assess and effectively manage paediatric conditions.



  • Prof Raghu Lingam, co-lead Investigator, University of New South Wales
  • Prof Harrier Hiscock, co-lead Investigator, Murdoch Children’s Research Institute
  • A/Prof John Preddy, Murrumbidgee Local Health District
  • Dr Kylie Vuong, University of New South Wales
  • Prof Michael Brydon, University of Notre Dame
  • Dr James Best, Royal Australian College of General Practitioners
  • A/Prof Peter Hibbert, Macquarie University (Australian Institute of Health Innovation)
  • Prof Faye McMillan, University of New South Wales
  • Dr David Tickell, Ballarat Health Services
  • Dr Kathleen McCloskey, Barwon Health
  • Dr Mike Forrester, Barwon Health
  • Dr Joanne Ging, Sydney Children’s Hospital Network
  • Dr Nan Hu, University of New South Wales
  • Dr Hayley Smithers-Sheedy, University of New South Wales
  • Dr Michael Hodgins, University of New South Wales
  • Dr Maya Eamus, Murrumbidgee Local Health District
  • Murrumbidgee Primary Health Network
  • Western Victoria Primary Health Network


MRFF - 2020 Clinician Researchers: Applied Research in Health

Research Outcomes

Our step-wedge cluster randomised controlled trial aims to determine:

  1. The effectiveness of SC4RC compared to standard GP care, to:
    • Increase the quality of paediatric care for children and young people aged 0-18 years delivered by GPs within 15 common paediatric health conditions during the 10 month intervention period (primary outcome) and up to 12 months post intervention period. Care quality will be measured by standardised best practice care quality indicators developed within the national Care Track Study with the outcome of interest at the indicator level.
    • Reduce GP paediatric referrals to hospital emergency departments (ED) and paediatric outpatient clinics (OP) during the 10 month intervention period and up to 12 months after the intervention.
    • Increase GP confidence in dealing with children and young people in primary care.
    • Increase family trust in primary care, and reduce family preference for paediatric referral.
  2. The incremental cost-effectiveness and cost-benefit of SC4RC compared with standard GP care.
  3. The factors that help or hinder implementation of SC4RC to inform adaptability and sustainability.

Research Publications

Khano S, Sanci L, Woolfenden S, Zurynski Y, Dalziel K, Liaw ST, Boyle D, Freed GL, Moore C, Hodgins M, Le J. Strengthening Care for Children (SC4C): protocol for a stepped wedge cluster randomised controlled trial of an integrated general practitioner-paediatrician model of primary care. BMJ open. 2022 Sep 1;12(9):e063449.

Research Group

Key Contact

For further information about this research, please contact the research group leader.

Department / Centre

General Practice and Primary Care

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