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Over 3 million children to benefit from focus on childrens emergency and urgent care

7th July 2008

Latest research findings relating to best practice in the field of Children's Emergency and Urgent Care have been unveiled at a high profile conference in London. The research project, undertaken by the NHS Institute for Innovation and Improvement (NHS Institute) as part of the successful Focus on: High Volume Care Programme seeks to showcase areas of best practice in an area that represents 25% of all NHS patients seen annually.

With over 3 million children and young people seen in Emergency departments in England each year, it has been recognised that increased efficiencies in this clinical field can represent huge progress in the effectiveness of delivery of patient care across the UK. The research
also identified that the number of children and young people being admitted to emergency departments has risen by 6.8% over three years, and the length of stay in hospital also rising by 15%. In response to these growing trends the release of this major piece of work by the NHS Institute could not be timelier.

The 12 month research has been led by Sarbjit Purewal, Lead Associate at the NHS Institute and Dr Venkat Reddy, Consultant Paediatrician and National Clinical Lead. The research identified a number of systems of best practice already in operation around the country, plus undertook workshops to canvass the opinions of children themselves in order to ensure that the holistic needs of their welfare are met, as well as their immediate clinical needs.

The conference, organised to launch the Focus On: Children and Young People Emergency and Urgent Care Pathway research report was attended by leading Children's Emergency and urgent care stakeholders and high performers across the NHS. The Conference also included a key note address by Sheila Shribman, the Department of Health's National Clinical Director for Children, Young People and Maternity Services.

Delegates were able to gain insight into the research findings which delivered the following recommendations:

  • Empowerment of clinical leadership through an enlightened executive team can help facilitate and can champion clinically led service redesign.
  • Gearing up operations to deliver effective and safe emergency and urgent care without necessarily the provision of on site inpatient beds. This system of care depends on competent decision making by senior clinical staff and local facilities available to transfer children to the nearest children's ward if on site beds are not available.
  • Units engineering a fully integrated children's service to deliver high quality and seamless care for children and ensuring an integrated information provision across the whole system to facilitate patient care and flow.
  • Development of joint children and young people's emergency and
    urgent care clinical networks to span primary and secondary care to provide a seamless high quality service. Enhanced primary services for children's and young people's urgent care will prevent unnecessary attendance at hospital emergency departments.
  • Units to ensure that inclusion of a system to safeguard children from a child protection perspective is mandatory and embedded within Children's Emergency Medicine Pathway.
  • Provision of an integrated common front-of-house emergency and urgent care facility to provide seamless streaming of children and young people to the most appropriate service. The availability of advice whenever needed for primary care professionals from senior medical and nursing staff reduces presentation of children and young people to secondary care and also decreases the chances of admission after presenting through out of hours service.
  • Co-location of emergency department, children's accident and emergency and children's assessment units improves the efficiency of the pathway, and enables skill sharing and joint working.
  • Provision of play specialists within units as the research identified that they are integral to all aspects of children's services. They are vital in providing child friend care environments and to prepare children for examinations and procedures.
  • Provision of community children's nursing teams as an essential part of the emergency and urgent care pathway to prevent admissions, support care at home and facilitate early discharge.

In addition to making specific recommendations, the research programme recognised initiatives undertaken by East and North Hertfordshire NHS Trust, Basingstoke and North Hampshire Foundation Trust, Homerton University Hospital NHS Foundation Trust, The Medway NHS Trust, Liverpool Primary Care Trust and Derby Children's Hospital as beacons of best practice.

Commenting on the launch of the findings of Focus On: Childrens Emergency and Urgent Care document Dr Venkat Reddy commented: "I am delighted with the number of innovative practice ideas we found during our visits to various health systems in England as part of our research.

There is something in this document for every one interested in providing emergency and urgent care for children and young people. The goal is to spread good practice so that all children and young people receive high quality care in child friendly environments delivered by trained and competent staff".

Dr Reddy continued: "We were overwhelmed with the demand for places to attend the launch conference which demonstrates the passion among NHS staff for providing high quality emergency and urgent care services for children. This could be beginning of concerted effort to improve emergency and urgent care services for children."

A full report outlining all of the research findings is available from the NHS Institute, together with support materials which include a DVD information pack and teaching materials.

Commenting on the launch of the NHS Institute's Focus On: Children and Young People Emergency and Urgent Care Pathway research report, Mark Jennings Delivering Quality and Value Priority Programme Head said: "This latest research provides NHS units with real tangible initiatives which are already successfully operating in clinical practice and can make a real and immediate difference to the quality of patient care, plus best use of NHS resource. With the opportunity to make a difference to the lives of over 3 million children and young people we have had a hugely positive reaction from all stakeholders who are keen to consider innovative new initiatives which will contribute to improving patient care.

Download a full copy of the Focus on: High Volume Care report.

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