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Alternative acute out-of-hospital models of care for children and young people

This report is aimed at commissioners interested in developing new models to deliver out-of-hospital healthcare services for children and young people.

The document describes the audit that was carried out across six London emergency departments during a two-week period in February and March 2016. During the audit, clinicians reviewed 3,020 children and young people attendances from 10am to 10pm and considered whether the child could be managed in one of the proposed out-of-hospital models.

The report is designed to help commissioners evaluate whether an out-of-hospital model would work in their area and which one could work best.

The report considers

1) Three community models treating illness but not injury

  • Nurse-led acute illness team for children and young people
  • Nurse-led walk-in centre for illness in children and young people
  • Multi-speciality community provider for children and young people

2) Enhanced primary care models i.e. enhancement of paediatric expertise

  • Enhanced GP practice
  • GP confederation children and young people service

3) Comprehensive models

  • Community walk-in centre for children and young people
  • PACS acute health centre for children and young people

Two current primary care models were also comparatively assessed:

  • Community pharmacy
  • Current GP practice.

The results demonstrated the proportions of children and young people presenting to emergency departments that could be appropriately managed within each new model. Financial data was also collected for each attendance.

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