Rory Farrelly, Director of Nursing at Derbyshire Children's Hospital, part of Derby Hospitals NHS Foundation Trust, talks about the importance of children and young people's emergency services and the development work the children's A&E department has undertaken.
Children's and young people's emergency services are a vital and developing component of health, education and social care. A visit to hospital can be a traumatic experience for a child or young person and their families. It is essential that the best environment and facilities are available to those who attend.
Derbyshire Children's Hospital, which includes the children's A&E department, was built in 1996. Over the last 10 years we have done a great deal of work to develop high standards of care and services. Each patient has a paediatrician taking overall responsibility for their journey through the department, with appropriate members of staff involved with aspects of their care. Qualified children's nurses, registered mental health nurses, paediatric radiologists and pharmacists and play specialists are all crucial parts of the pathway. The play specialists are vital as they assist other professionals in the promotion of play and aid with distraction therapy for difficult situations.
We previously identified high numbers of children attending the department on particular afternoons and evenings. To address this, we provided skilled nurse practitioners and GP clinics in the department during these key times. We identified that children and young people triaged to the primary care professionals or GP could have been dealt with through primary care services if they were available in the community. This demonstrated a clear role for emergency care practitioners (ECPs) from primary care settings and we are now jointly funding a post for an ECP.
We have developed collaborative working between primary and secondary care to provide an appropriate linked service for children, young people and their families. We promoted partnership working to make the best use of staff resources and to ensure that the needs of children and their families were at the centre of services. We are also ensuring that our work links in with the development of a walk-in centre in the area.
We have undertaken a lot of work in the Derby area to develop our ambulatory care service, through the Kids In Their Environment (KITE) team approach. This is supported by a team of qualified nurses who can provide care for life-limiting and life-threatening conditions in patients' own homes, reducing the need for emergency attendance. We encourage nurse-led admissions and discharges to and from the ambulatory care unit.
We have also been looking at developing pathways for patients with chronic conditions, which enable them to complete the pathway supported by relevant nurse specialists. We have extended the role of nurse specialists to work between 8am and 9pm across the full seven days.
