The paediatric outpatient department at Cardiff and Vale University Health Board faces unprecedented demand. Referrals have increased by nearly 40% in the last 8 years. Many of these children could be managed in primary. A group of paediatricians and GPs in Cardiff and Vale are working together to develop collaborative working practices. The team chose to use an integrated hub model for the new paediatric outpatient service. This involves a paediatrician delivering an outpatient clinic with a GP. Patients are seen in their own or neighbouring GP practice and avoid having to attend hospital. Referrals from the pilot GP practice to paediatrics have reduced since the hub was launched in May 2016. Cumulative referrals to from January to September 2016 are the lowest they have been for 5 years, even though the model was only implemented midway through the year As the model extends, patients from surrounding GP practices will attend the hub practice for appointments and the GPs from those practices will take part in the clinic. For further information, please contact: Dr David Hanna, Welsh Clinical Leadership Training Fellow, email@example.com, Dr Judith Van der Voort, Consultant Paediatrician, Cardiff and Vale University Health Board, Judith.firstname.lastname@example.org, Dr Karen Pardy, Cluster Lead – Cardiff South West Cluster Karen.email@example.com.