Shift Lead Triage Pathway (.doc)Region: Covers City wide Manchester
Geography: Urban
Estimated local pop. 0-18 years: 120,000
Aims
Deliver nursing care closer to home for children and young people who are acutely ill, have long term conditions or who have complex health needs.
Reduce avoidable hospital admissions of acutely ill children and young people.
Facilitate early discharge from hospital after elective and non-elective admissions.
To improve access to health services for all children and young people according to their needs, particularly by co-locating services and developing integrated ways of working.
To improve health outcomes and life chances for all children and young people.
Objectives
To provide more care closer to home, promoting the shift of service delivery (including staffing resources) from a hospital based to community based model.
Care will be provided from a variety of community settings including the family home.
Offer greater access to high quality child centred healthcare.
Reduce inpatient admissions and length of stay.
Facilitate earlier discharge.
Target patient groups
Age 0-16 years (and up to 18/19 for special needs or complex needs)
The service model
Two interlocking services: home service and community clinic service.
Referrals are triaged by the team leader / shift coordinator. Families are contacted within 4 hours and arrangements made for visit or clinic appointment.
Home service:
- Hours 8am-10pm 365 days a year
- Can be referred once have a diagnosis (IV administration, chemotherapy, wound care, TPN -total parenteral nutrition)
- Seen at home if infected or infectious
- Also seen at school if possible
- Help to train SN e.g. stoma care
- Maximum frequency of visits is 6-hourly (3 times/day)
Community nurse-led clinic service:
- Various community clinics venues across the City of Manchester on a daily basis, Monday to Friday.
- Alongside the acute team, the Community Nursing Service also incorporates complex care team, palliative care team, continence, epilepsy, asthma specialist teams and special needs community and school nursing. All teams are managed by the Head of Service for CCN service.
Opening times
Hours 8am-10pm every day
Staffing
A skill mix of Band 7 team leaders, Band 6, Band 5, Assistant Practitioners, and Band 2 and 3 clinical support workers and administrators
Who can refer
Secondary care wards (ED, clinical decision units, oncology, day surgery, medical assessment unit, paediatric wards) from:
- Local DGH (district general hospital)
- Local specialist hospitals
- GP referrals
- HV referrals
Resources
The acute team are based in a local health centre.
Funding organisation
Funded by CCGs. Run by Central Manchester Foundation Trust
Level of integration in the system
Horizontal linking – we work in collaboration with education and social care.
Evaluation
The CCN acute team use the friends and family test currently, with results of over 90% who would recommend our service.
Challenges, successes, lessons learned and advice
Good communication (via letters) with GP, SN, case workers
No conflict of interest for hospital trust expediting discharge, because it helps to create efficient patient flow
Very helpful to have a co-coordinator who does RAG (red, amber, green) ratings to prioritise patients.
Contact for more information
Heather Sutton
Team leader – Acute team
0161 248 8501
In: Case studies
Tagged: acutely unwell children and young people: compendium of new care models, children and young people
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