Realist evaluation of the impact of paediatric nurse practitioner clinics, specialist paediatric nurses, and a children’s community nursing team in deflecting attendance at emergency departments and urgent care centres by children with long-term conditions

Abstract

In 2018, the Greater Manchester Children’s Health and Wellbeing Board developed a 10-point strategy to achieve its objectives, the sixth of which was to reduce unnecessary hospital attendances and admissions for children with long term conditions such as asthma, diabetes and epilepsy. Funding was secured from Manchester Academic Health Science Centre to commission an exploration of the impact of the Paediatric Nurse Practitioner Clinic within the context of the Family Services Model and the impact that the service was having on reducing attendance at urgent care centres or admission to hospital. Alternatives to taking children to the ED/UCC can be a preference. An integrated system, with elements able to book directly into others, with rapid access, information, health promotion, and follow-up were essential to success. Extra consultation time for proactive intervention, with sufficient nurses to provide a seven-days service were valued. Advertisement of the service to the public and to professionals is vital for uptake by professionals and the public