COMMUNITY CARE CHILDREN’S ADMISSIONS
VIEW FROM THE FRONTLINE I spoke to a nurse working in an emergency department and admissions unit in an inner city children’s hospital in the Midlands (who wished to remain anonymous). In her experience, there is definitely an alarming number of children brought into hospital unnecessarily. “We get many referrals to the emergency department for children who don’t need emergency treatment,” she says. “The most common conditions I have seen lately are diarrhoea and vomiting and bronchiolitis. These could both be managed at home with advice from the GP.” If these conditions can be managed from home, why aren’t
parents doing this? “This is probably due to the fact that parents do not have a clear idea of what services are available, for example out of house services or utilising the health visitors/GPs within working hours,” she says. “Parents just need to be well educated on when/if the child’s condition deteriorates enough for them to need hospitalisation. For example with diarrhoea, as long as the child is still eating and drinking well, the diarrhoea should resolve after 24/48 hours – it’s when the child does not want to drink when problems such as dehydration arise, which is serious and requires immediate hospital treatment. I think people just go to A&E because they think it will be quicker, but it isn’t by far… The wait is commonly over four hours.”
WHO YOU GONNA CALL? The recent roll-out of NHS 111 to some regions proved problematic to say the least, but it is hoped that better use of these kinds of out-of-hours services can go some way towards addressing unnecessary hospital admissions across the board and filling that information gap that seems to contribute to the problem. However, the Archives of Disease in Childhood report does
highlight an increase in the number of parents being advised by NHS Direct to take their child straight to hospital as one of the potential contributors to the problem. Many parents simply don’t know what the correct action to take is, and coming into A&E rather than risking missing something potentially fatal seems like the safest option. For a non-clinically trained health advisor at the other end of the phone, who does not know your child, this too is likely to be their chosen course of action, as the many critics of NHS 111 would suggest.
“These growing numbers are unsustainable. We need to look at offering more services
outside hospitals”
PARENTAL GUIDANCE But are parents simply becoming too paranoid and is our generation’s propensity to mollycoddle partly to blame for the rise in admissions? The Midlands nurse says it’s not as clear-cut as that and can sympathise with anxious new parents who are unsure of what to do: “It’s hard to say that parents are panicking. It’s always better to stay on the side of caution because conditions such as meningitis and bronchiolitis can be life threatening.” She believes that it really does boil down to how much information is available and whether parents are actually making adequate use of it. “It’s about clear education. As nurses, we are always taught to look at the child and decipher what’s normal for them and what’s not – parents need enough information to be able to do the same.”
WWW.COMMISSIONINGSUCCESS.COM | 33
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72