Context The project was part of a Quality Improvement Fellowship. It worked directly with the local Sure Start children centres. It worked alongside a local strategy to provide paediatric patients with the best care in the most appropriate setting.

Problem The aim was to enable children centre staff to empower parents and provide reassurance on managing everyday childhood illnesses at home.

Assessment of problem and analysis of its causes A Pre-project questionnaire, completed by 85 parents, demonstrated that most take their children to the emergency department seeking reassurance.

The project worked with 2 of 4 local children’s ‘Sure Start’ centres to provide parents with key points to manage 3 commonly seen childhood illnesses at home. The focus was on empowering parents and reassuring them to trust their own instincts.

Intervention A facilitator guide and parent information leaflet was produced using information already in circulation.

Six childhood illness sessions were run, by the author, during parent and children groups in Sure Start. This was both a demonstration to Sure Start facilitators and gained parent feedback.

At the end of each session verbal feedback from facilitators and parents was reviewed and material revised (PDSA cycles). The final version incorporated basic ‘games’ such as true/ false flash cards and question and answer flash cards.

Parents stated they found the information ‘useful’, ‘reassuring’ or ‘helpful’. Facilitators found the material ‘easy to use’ and described the sessions as ‘engaging’. They would be able to run a session themselves.

A working group was set up to embed the sessions into the regular groups.

Strategy for change The material was introduced at the Sure Start Team Lead meetings and parent groups over a 4 month period. The facilitators had opportunity to review the material and observe sessions. They were directly observed and supported when running their first session.

The CCG Lead for Sure Start was involved throughout and was key in helping to support the program.

A working group of experienced staff was created by the Sure Start Team Lead. The current pilot will run over 6 months

Measurement of improvement The material was trialled and reviewed by requesting verbal feedback from both parents and facilitators. The initial three sessions were well received by parents. Facilitators felt apprehensive about responding to medical questions. 7 out of 9 were not confident to run a session alone.

More structure and guidance was added and the information was put into a ‘game ‘format’. 3 revised sessions were run. After observing, 7 out of 7 (100%) group facilitators were confident to run a session.

A further process measure was the numbers of regular sessions run by confident group facilitators within children centres. This is currently 3 a month in one of the local areas.

Effects of changes The parents exposed to the sessions gave positive feedback such as ‘If I had known this before I wouldn’t have worried’ or ‘It’s good to have people coming into groups to talk to parents about things like that’.

The main problem was engaging the Sure Start centre staff to lead a session. They liked the material and the sessions but felt apprehensive about leading a session. It took longer than expected to engage them.

Lessons learnt I have learnt how important engagement is.

Next time I will set up a working group earlier to gain better engagement.

Message for others My project has highlighted how important it is to involve patients in new initiatives.

For paediatric patients it is really important to understand why parents bring their children in as an emergency.

For change to happen it is important to engage and empower parents to make the right choices for their children.