29.04.15
Unscheduled care for children needs reform
Worried parents are putting extra pressure on A&E departments by taking their children unnecessarily as they are unable or unsure how to access more appropriate care.
The statement comes from a trio of medical colleges who also warn that unless there is an overhaul of unscheduled care services, there is a risk that growing demand will result in poorer outcomes for children.
Children make up more than a quarter of emergency department attendances in the UK – and in England alone there has been a 28% increase in admissions for children to hospital over the last 10 years.
But the Royal College of Paediatrics and Child Health (RCPCH), Royal College of Nursing (RCN) and the Royal College General Practice (RCGP) have joined forces to suggest hospitals are not always the best places for children to be seen.
In a new report, Facing the Future: Together for Child Health, the colleges say that in order to deal with these pressures, and to improve child health outcomes, not only do unscheduled care services need more investment but there also needs to be a shake-up of how services are designed, with more children being cared for outside the hospital in the community.
A new set of standards has been developed, which include:
- Every child should have timely access to high-quality unscheduled care services
- No child should be in hospital when care can be provided to an equivalent or better standard outside the hospital
- Service providers, planners, commissioners and users should work together across hospital and community services, primary and secondary care and paediatrics and general practice to design and deliver efficient and effective unscheduled care in a geographical network which is responsive to the needs of local children and their parents and carers
Dr Hilary Cass, president of the RCPCH, said: “The vast majority of children’s illnesses are minor and require little or no medical intervention. So a significant number of these attendances at the emergency department are unnecessary – and putting extra pressure on the system and causing undue distress and disruption for families.
“But of course 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.”
Other standards in the report are:
- GPs assessing or treating children with unscheduled care should have access to immediate telephone advice from a consultant paediatrician
- Each acute general children’s service should provide a consultant paediatrician-led rapid-access service to see any child referred within 24 hours
- Each acute general children’s service should be supported by a 24/7 community children’s nursing service
- When a child presents with unscheduled care needs the discharge summary should be 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
Dr Maureen Baker, chair of the RCGP added: “A quarter of a GP’s patients are under 19 years of age and the best place for children and young people to be cared for, wherever possible, is close to home.
"These standards mark a coming together of professional expertise from across the health service. They will help to break down barriers and encourage us all to work together more closely in the best interests of our young patients."
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