Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/15754
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Substituting community children’s nursing services for in-patient care: a case study of costs and effects
Authors: Callery, Peter
Kyle, Richard G
Weatherly, Helen
Banks, Michele
Ewing, Carol
Powell, Peter
Kirk, Susan
Contact Email: richard.kyle@stir.ac.uk
Issue Date: Oct-2014
Publisher: BMJ Publishing Group
Citation: Callery P, Kyle RG, Weatherly H, Banks M, Ewing C, Powell P & Kirk S (2014) Substituting community children’s nursing services for in-patient care: a case study of costs and effects, Emergency Medicine Journal, 31 (e1), pp. e55-e59.
Abstract: Objective: To compare children's pathways to and through Community Children's Nursing Team (CCNT) care, and NHS costs, before and after relocation of inpatient services and extension of a paediatric Emergency Department and Observation and Assessment Unit (ED/OAU). Design: Case study. Routinely collected data on activity and staffing were provided by the CCNT. Parents completed questionnaires about their child's use of healthcare services and satisfaction with care preservice reconfiguration (n=221) or postreconfiguration (n=210). The cost of service use was compared prereconfiguration and postreconfiguration. Patients: Children referred to CCNT care. Main outcome measures: Healthcare service use and associated costs, satisfaction with CCNT care. Results: The mean number of services used before referral to the CCNT reduced from 2.8 to 1.6, and the proportion using only one service increased from 26% (n=58) to 61% (n=128). Inpatient admission during CCNT care reduced from 6% (n=13) to 2% (n=4), and ED attendance from 37% (n=79) to 16% (n=31). There was a considerable fall (25%) in the cost of CCNT care, and a sharp fall (55%) in the average overall NHS cost of care. CCNT care was rated ‘excellent' or ‘very good' by 85% of respondents both prereconfiguration and postreconfiguration. Conclusions: A CCNT provided an alternative to hospitalisation when acute general paediatric services were reconfigured to substitute for a relocated hospital. Children's pathways to CCNT care were shortened. The average cost of CCNT care and overall NHS cost were lower following reconfiguration. Satisfaction remained high throughout.
Type: Journal Article
URI: http://hdl.handle.net/1893/15754
DOI Link: http://dx.doi.org/10.1136/emermed-2012-201926
Rights: The publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.
Affiliation: University of Manchester
HS Health - Highland
University of York
University of Manchester
University of Manchester
West Suffolk Hospital
University of Manchester

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