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Nurses 'must listen to parents' to spot deterioration in child health

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Nurses and doctors must listen to parents with sick children in hospital and encourage them to raise concerns according to a new national framework to ensure prompt action if a child’s condition starts to worsen.

The Safe System Framework is the first NHS-wide resource of its kind aimed at reducing potentially fatal deterioration in young patients’ health.

Launched by NHS Improvement and the Royal College of Paediatrics and Child Health, it stresses the need to work closely with children’s parents and carers.

”Time and time again we see some children could have received better care if healthcare providers worked with parents to treat deterioration in health”

Dr Mike Durkin

It calls for a “whole system approach” to identifying and responding to deterioration, not just the use of an early warning score or medical observations.

Dr Mike Durkin, NHS National Director of Patient Safety, said parents were currently not actively encouraged to voice concerns about their child’s care or wellbeing and that they worried about potential time-wasting if they made repeated concerns.

“But time and time again – and in some cases tragically too late – we see that some children could have received better care if healthcare providers worked with parents to understand and treat deterioration in health,” he added.

Research has shown more than a quarter of preventable deaths in children and adults were because they weren’t properly monitored, without the right systems in place to quickly spot and act on deterioration.

“Parents can often spot small changes that others may miss”

Fiona Smith

The framework, which was designed with input from nurses, doctors, bereaved parents and patient child health and patient safety experts, highlights the need for staff training in recognising and responding to signs of deterioration.

This should include opportunities to train and learn within multi-disciplinary teams, the framework says.

It also highlights the importance of thorough and timely investigations when things go wrong and ensuring families are supported and kept informed and lesson learned.

Fiona Smith, professional lead for children and young people’s nursing at the Royal College of Nursing, said parents should be seen as “partners rather than bystanders in care”.

“Parents can often spot small changes that others may miss and they should quite rightly play a key role in the care of their child too,” she said.

“When children are ill, it isn’t just about recognising signs. This framework shows how important it is to look at the whole care system rather than just one piece of the jigsaw.

“There are many factors involved in delivering the best outcome for a child, from the patient safety culture of the hospital to the way healthcare teams work together,” she added.

A patient safety alert is being issued across the NHS to raise awareness of the new framework and a range of other resources to support early identification of child deterioration.

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