Aims

• To share with the audience the process of identifying all the areas in a large acute trust that children attend for either outpatients, diagnostics or clinics, which are outside of child health services.

• To demonstrate how a RAG rating tool can be used to improve the quality standards of these areas

Methods Following a recent CQC visit, it was identified that there are significant amounts of children being cared for and seen for procedures/investigations that currently are not overseen or managed by child health services. Whilst there was an understanding of some of the key issues this project highlighted 28 areas that required review. These areas consisted of predominantly OP areas, interventional radiology and therapy areas. Once these areas were identified, walkabouts conducted by the lead nurse for children in the trust. These walkabouts were to assess areas against the NSF Standards for Hospital Service (2004) for children were RAG rated. All children’s services outside of child health services were given a link matron and improvements notice if rag rating was poor. Finding presented to trust safeguarding child strategy group.

Results This table shows the improvements made between the first and second RAG rating assessments.

Conclusion This exercise has demonstrated the importance of having a lead nurse for children in the trust. This allows for outreach to all the small specialty clinics which are predominately adult focused. This has also identified areas off excellent practice that required no input, as many were rated green on first assessment. Simple steps such as involving the play service and scrutinising safeguarding training levels can make a big difference to services. Through RAG rating and action planning, assurances can be given about the quality of children’s care, wherever they attend within the trust.