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North West London Paediatric Critical Care Network.

At present Paediatric Intensive Care (PIC) capacity is being utilised ineffectively with about 10% of PIC capacity being occupied by level 1 or 2 patients (high dependency patients). While sometimes this is appropriate, a proportion of these high dependency patients could be better managed by providing high dependency care closer to home in their local hospital.

Purpose

As the regional Paediatric Intensive Care Unit for North West London, we have been tasked to deliver a CQUIN to aid and improve the ability of local hospitals to provide high dependency care for children when appropriate. The National CQUIN scheme has been modified for the London region for 2018/19, and aligns to the next steps for the National PIC Review. For the year 2018/19, we have been asked to work with our local hospitals to set up a network of care for paediatric critical care, which aligns with a more general piece of work to set up a north London specialist paediatric network.

Objectives

The primary objectives of the North West London PCC Network are:

Safety

Enable the delivery of safe, effective patient care

CO-ORDINATE sERVICE DELIVERY

Identify and pursue cross network opportunities and co-ordinate service delivery

standardised DATA

Provide standardised guidelines & protocols

INFLUENCE POLICY

Act as a voice in Paediatric critical care by informing and influencing national policy

SHARE expertise

Exchange information, expertise and best practice across the network

aSSESS SERVICE DELIVERY

Formally assess services against national standards
Currently up to

10%

of PIC capacity is occupied by level 1 or 2 patients

Approach

The health system landscape is changing, and it is widely accepted that there are benefits of working collaboratively across multiple boundaries to improve health outcomes and deliver child centred patient care.

 

North West London PCC Governance Group

The governance group for the North West London Paediatric Critical Care Network will provide the strategic vision and enable the changes essential for developing services and improving the quality of care for critically ill children.

The group of stakeholders will work across Trusts to improve patient outcome for children across the region. This will be achieved through:

  • A collaborative approach to the assessment of provisions and the identification of opportunities to develop within the network

  • Ensuring that the application of standards set out by specialist commissioning services are monitored and adhered to

  • Enabling opportunities to standardise care/ care pathways, education and training and improve overall quality of care.

 

Key Professionals and the Organisation
Name Position Organisation
Kathy Brennan Regional Programme of Care Manager W&C NHS England
Dr Ruchi Sinha NWL PCCN  Lead Consultant St Mary’s (Imperial) (PIC)
Michelle Pash NWL PCCN  Lead Nurse St Mary’s (Imperial) (PIC)
Margarita Burmester NWL PCCN Lead Consultant Royal Brompton (PIC)
Abhishek Narayanan NWL PCCN Lead Consultant Royal Brompton (PIC)
Eva Zizkova NWL PCCN Nurse Lead Royal Brompton (PIC)
James Woods  NWL PCCN Data Lead Royal Brompton (PIC)
Caroline Scott-Lang Consultant St Mary’s (Gen Paeds)
Claire Murphy Practice Educator St Mary’s (Gen Paeds)
Dr Emily Byron PCC Consultant Hillingdon
Chris Mann Matron Hillingdon
Jas Khalsa Practice Educator Hillingdon
Lynn Sinitsky PCC Consultant Watford
Becky Platt Matron Watford
Samantha Pollard Practice Educator Watford
Priya Kumar PCC Consultant Northwick Park
Jacqueline Waldon Matron Northwick Park
Martin Gray PCC Consultant (Level 2 Lead) Chelsea & Westminster
Anna Miles Matron Chelsea & Westminster
Stuart Adams Practice Educator Chelsea & Westminster
Nour El Hadi PCC Consultant West Middlesex
Tracy Armstrong Matron West Middlesex
Jade Funnell Practice Educator West Middlesex
Cathy Roberts Practice Educator CATS
Mark Clements ANP/NWL Nurse Retrieval Lead CATS
Dr Padmanabhan Ramnarayan NWL Lead Retrieval Consultant CATS
PCCN

Work Streams

The governance group will confirm and prioritise work streams to be developed from subjects highlighted by the Network. Working groups will then be identified to assist with the progression of these tasks.

Using the 2017/18 CQUIN review to identify areas in need of development, the network proposes three areas to standardise the delivery of care across the Network.

 

  • Nurse Education
  • Guideline/Pathway for Children requiring Long Term Ventilation
  • Patient Journey – Communication and patient escalation/de-escalation between PCC units

Network Tools

Tools that can be made available via the North West London PCC Network are:

The North Thames Tool

This tool will allow individual hospitals to capture in a secure and efficient manner, daily intervention data related to Paediatric Critical Care Minimum Dataset (PCCMDS).

Gather – data platform 

The Gather data collection platform allows its users to collect at patient level, fully compliant PBR data in a secure online setting. This tool will allow individual hospitals to capture in an efficient manner, the full Paediatric Critical Care Minimum Dataset (PCCMDS).

Educator – data manager

The Educator platform can transform how nurse educator teams manage and process large amounts of educational based data. Users can record, track and receive alerts on factors such as mandatory study days, internal/external study days, equipment training, competencies and study hours.

Clinical Skills Passport

The RCPCH publication ‘High Dependency Care for Children – Time to Move On’ identifies the clinical skills essential to care for children requiring critical care. We have produced an accompanying Skills Passport for all nurses caring for critical ill children to complete.

PICU Activity Tracker (PAT)

The PICU Activity Tracker (PAT) tool allows users to track and analyse multiple data factors from delayed discharges, refused admissions, cancelled surgical cases and daily capacity figures. National reporting data can be generated with ease using the trackers built-in reporting capabilities.