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Call for investment in community-based children's nursing services

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Urgent investment is urgently needed in community children’s nursing services so more young patients can be cared for outside the hospital and closer to their home.

A coalition of nursing and medical organisations has warned that an urgent shake up of children’s unscheduled care is needed to tackle UK’s poor child health outcomes.

“Investment is urgently needed in community care, especially in community children’s nursing services”

Peter Carter

The Royal College of Paediatrics and Child Health, the Royal College of Nursing and the Royal College of GPs have launched a set of new standards to improve unscheduled care for younger patients, noting that children make up more than a quarter of emergency department attendances in the UK.

The 11 standards, published in report titled Facing the Future: Together for Child Health, are designed to improve healthcare services for children and ensure that specialist child health expertise and support is available to strengthen primary care services.

The standards include that each acute general children’s service should be supported by a community children’s nursing service.

This service should operate 24 hours a day, seven days a week, providing advice and support, with visits as required depending on the needs of the children using the service, stated the report.

Peter Carter, chief executive and general secretary of the RCN, said: “Investment is urgently needed in community care, especially in community children’s nursing services that can provide crucial support to general children’s services, and offer advice for worried parents.”

He highlighted that there was both a high number of children being admitted to emergency departments and a “worrying variation” in the rates across the country. 

“These standards are important not only to reduce these inconsistencies, but also to make sure children are getting the most appropriate care,” he said.

Dr Hilary Cass, president of the RCPCH, added: “Every attendance means that a parent is worried about their child’s health, and either unable or unsure about how to access a more appropriate service.

“We therefore need to help patients navigate the options available to them and to get the most appropriate care – but also make sure that those services, and the healthcare professionals who deliver them, are fully skilled and best equipped to provide the best possible care.”

 

The full list of standards are:

  1. GPs assessing or treating children with unscheduled care needs should have access to immediate telephone advice from a consultant paediatrician
  2. Each acute general children’s service should provide a consultant paediatrician-led rapid-access service so that any child referred for this service can be seen within 24 hours of the referral being made
  3. There is a link consultant paediatrician for each local GP practice or group of GP practices
  4. Each acute general children’s service provides, as a minimum, six-monthly education and knowledge exchange sessions with GPs and other healthcare professionals who work with children with unscheduled care needs
  5. Each acute general children’s service is supported by a community children’s nursing service which operates 24 hours a day, seven days a week, for advice and support, with visits as required depending on the needs of the children using the service
  6. There is a link community children’s nurse for each local GP practice or group of GP practices
  7. When a child presents with unscheduled care needs the discharge summary is sent electronically to their GP and other relevant healthcare professionals within 24 hours and the information is given to the child and their parents and carers
  8. Children presenting with unscheduled care needs and their parents and carers are provided, at the time of their discharge, with both verbal and written safety netting information, in a form that is accessible and that they understand
  9. Healthcare professionals assessing or treating children with unscheduled care needs in any setting have access to the child’s shared electronic healthcare record
  10. Acute general children’s services work together with local primary care and community services to develop care pathways for common acute conditions
  11. There are documented, regular meetings attended by senior healthcare professionals from hospital, community and primary care services and representatives of children and their parents and carers to monitor, review and improve the effectiveness of local unscheduled care services
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Readers' comments (1)

  • There definitely needs to be an investment in training and developing of childrens nurses to work in community settings. Universities need to provide courses and hospital and community Trusts need to sponsor places and provide community placements so childrens nurses can be skilled up in the 21st century to provide nursing care in out of hospital settings care. In practice CYP and their family prefer care closer to home or at home and high quality care can be provided effectively and safely in community settings by highly skilled specialist childrens nurses

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