Children s Community Nursing Team Operational Policy

Transcription

1 Children s Community Nursing Team Operational Policy 1 CCNT Operational Policy Sr Joanne Doyle June 2017

2 Policy : Children s Community Nursing Team Operational Policy Executive Summary The Children s Community Nursing Team (CCNT) provides family centred, and associated acute/chronic nursing care in the child's own home for children from birth to documents: 16 years of age (19 years for long term patients with complex needs). The aims and expected benefits of the service are: to reduce the number of children admitted to hospital reduce the length of in-patient stay when admission is unavoidable Reduce the number of acute re-admissions to hospital Promote child and family satisfaction with children's health services as a whole Supersedes: Children s Community Team Operational Policy November 2016 Description of Amendment(s): Revised policy to incorporate changes in working practices and development of service This policy will impact on: All Trust Staff Financial Implications: Policy Area: Paediatrics Document Reference: ECT Version Number: 4 Effective Date: July 2017 Issued By: Sr Joanne Doyle Review Date: July 2018 Authors: Sr Joanne Doyle Impact Assessment Date: July 2017 Consultation: Ratified by Committee/ Executive Director: APPROVAL RECORD Committees / Group CCNT team members, Children s July 2016 Ward Manager, Clinical Manager/Matron, Paediatric Consultants Paediatric SQS July 2017 Date Received for information: Paediatric SQS July CCNT Operational Policy Sr Joanne Doyle June 2017

3 Contents 1. Policy Statement / executive summary 2. Service Accommodation and Management 3. Referral & Admission Process 4. Admission Criteria 5. Workload Planning 6. Documentation 7. Discharge from the CCN service 8. Transition to Adult Services 9. Temporary Closure of the service 10. Roles and Responsibilities 12. Implementation 12. Measuring performance & Audit 13. Review 14. References 15. Appendices 16. Equality Analysis 3 CCNT Operational Policy Sr Joanne Doyle June 2017

4 1. Policy Statement / executive summary The Children s Community Nursing Team (CCNT) provides family centred, acute nursing care in the child's own home for children from birth to 16 years of age (19 years for long term patients with complex needs). Although the CCNT have a caseload of patients with long term, chronic conditions, input is only provided for these patients when they have an acute Nursing need within their condition e.g. IV antibiotics. The aims and expected benefits of the service are: to reduce the number of children admitted to hospital reduce the length of in-patient stay when admission is unavoidable reduce the number of acute re-admissions to hospital promote child and family satisfaction with children's health services as a whole Although the majority of families prefer home-based care, the psychological, sociological and economic reasons why families may prefer hospital admission are not underestimated and the theme of supportive collaboration underpins the philosophy of the CCNT Service. The CCNT service is subject to an ongoing development programme aimed at improving efficiency of the service, improving and standardising patient care, improving safety for both staff and patients and improving and developing links with other services. The eventual goal is to increase capacity thus offering a wider range of services and meeting the aims of the service to a much greater extent. Whilst this programme is active this policy will be reviewed on a yearly basis to ensure it is kept up to date with the development of the service. 2. Service Accommodation and Management The CCNT office is located on the Children s Ward at Macclesfield District General Hospital. Members of the team report to and obtain their work allocation from this office on a daily basis. The CCNT will work in conjunction with and not deviate from all other East Cheshire NHS Trust policies relevant to the service. The CCNT is staffed as follows; Team Leader 1 WTE Band WTE Band WTE HCA CCNT will hold 4-6 weekly staff meetings chaired by the Team Leader to discuss arising issues and ongoing development of the service. The CCNT will also receive team safeguarding supervision every 3 months. CCNT staff members must attend at least 80% of these meetings per annum. These meetings will be indicated on the off duty. Staff members attending meetings outside of a normal CCNT shift may be either paid for the time spent at the meeting or meetings can be rostered in to staff s working hours. This is at the discretion the CCNT Team Leader after negotiation with the team member involved. The above also applies to monthly Sister s Meetings for Band 6 and above and Ward meetings. Members of the CCNT team report directly to the CCNT Team Leader or Clinical Manager/Paediatric Matron. All CCNT staff members adhere to the East Cheshire NHS Trust Lone Worker policy. 4 CCNT Operational Policy Sr Joanne Doyle June 2017

5 Lone Worker Policy ECT2207.pdf The CCNT carry a Trust mobile telephone. The mobile telephone must be carried at all times throughout a shift. The CCNT member carrying the mobile telephone is responsible for it and must sign it out and in at the start and end of a shift. The CCNT mobile telephone must not be taken home by any staff member. If I staff member takes the CCNT mobile telephone home by accident they must return immediately to base to return it. Also, patient identifiable information such as call logs and text messages should be deleted from the Trust mobile telephone immediately. If this process is not followed, disciplinary action may be taken. See CCNT Mobile Telephone Risk Assessment. Mobile Telephone.doc All CCNT members will start their shift at the designated start time at the CCNT office on the Children s Ward and attend the Children s Ward handover. All CCNT members will end their shift at the designated time (see section 5 workload planning) on the Children s Ward and leave with the Children s Ward Nursing Staff. Home visits must not be made on the way into work or on the way home for safety reasons unless approved in advance by the Paediatric Matron. CCNT Staff members will adhere to all other policies and procedures that are relevant to the working area and specific conditions and procedures and will follow all care plans that have been agreed by the team deviating only when agreed by a Middle-Grade Doctor, Consultant or Team Leader. Any deviation from care plans or guidelines must be documented by the professionals in agreement in the child s nursing records. Due to the nature of the service team members mainly work independently in patient s homes. Home visits requiring two staff members should be considered if risks have been identified through discussion with the referring centre and team members. The risk assessment section of the emisweb electronic Children s Nursing Record form must be completed in full prior to all patient home visits. Clinical Supervision is available for all CCNT staff and should be accessed on a monthly basis as a minimum. Under no circumstances will staff transport patients in their own cars. Under no circumstances will staff transport controlled drugs in their own cars. 3. Referral & Admission Process Referrals are received from: Macclesfield Hospital Children s Ward Macclesfield Hospital Accident and Emergency Department Macclesfield Hospital Paediatric Consultants and Specialist Nurses Other local Children s Wards and Accident and Emergency Departments (principally University Hospital of South Manchester and Stepping Hill Hospital, Stockport) Local tertiary centres (Royal Manchester Children s Hospital, Alder Hey Children s Hospital, The Christie Hospital) Other Children s Community Nursing Teams from across the country whose patients may be temporarily residing within East Cheshire. 5 CCNT Operational Policy Sr Joanne Doyle June 2017

6 Referrals are accepted for a large variety of conditions and treatments (see appendix 1). For referrals that do not meet CCNT admission criteria and/or conditions that do not require acute nursing needs CCNT will refer onwards to a more appropriate agency e.g. Health Visitors or will pass the referral back to the original referrer. All relevant referral forms/correspondence is uploaded, scanned or inputted on to the CCNT emisweb electronic diary and caseload system. The CCNT will initially contact parents/carers of a child via telephone. This attempt will be made 3 times, if still unsuccessful a letter will be posted to the child s home address. After 1-2 weeks if the parent/carer has made no contact with CCNT, the child will be discharged from the CCNT service and the original referrer and School Nurse, Health Visitor, Social Worker and GP notified. 4. Admission Criteria Children can be admitted under the care of the CCNT after being an inpatient on the Children s Ward or having been seen in Accident and Emergency if: Patient and family have been assessed as safe for discharge with all safeguarding issues considered and discussed. Patient has a named Consultant. Family has given informed consent for treatments to be carried out at home. Patient is registered with a GP within the East Cheshire Clinical Commissioning Group. Patient or carer has access to a telephone. A Consultant or relevant middle grade doctor has examined the child and documented the plan of care in the integrated medical notes. A member of the CCNT or other appropriately trained Children s Nurse has carried out a nursing assessment of the child and agrees that the plan of care is appropriate for home nursing. At discharge the child's clinical condition meets the relevant discharge criteria. Adequate visiting time is available to complete the prescribed plan of care. The appropriate referral form has been completed in full. A risk assessment has been completed in full. Children who do not fit one or more of the admission criteria should not be accepted by CCNT Once care has been transferred to the CCNT from the MDGH Children s Ward: The Consultant Paediatrician retains overall clinical responsibility for children whose care has been transferred to the CCNT. Surgical and A&E patients remain the responsibility of the admitting consultant. For acute referrals - electrical, medical equipment and consumables will be provided by the Children's Ward, consumables will either be provided through GP prescription or from the CCNT budget as appropriate. Children who require electrical, medical equipment at home must have an insurance letter signed by their parent/carer accepting full responsibility for the equipment while their child is loaning it. Children who require electrical, medical equipment and consumables on a long term, regular basis must have individual request for funding secured by their Paediatrician before any equipment or consumables can be ordered. CCNT are responsible for the maintenance and servicing of electrical, medical equipment and will liaise with parents/carers and medical engineering (EBME) to arrange this. Referrals to relevant Allied Healthcare Professionals/Specialist Nurses and other community services will be made as appropriate by the CCNT. All patients receiving care from the CCNT who have been referred from the Macclesfield Hospital Children s Ward will have Open Access to the Macclesfield Hospital Children's Ward and direct access to a paediatrician for as long as they stay under the care of CCNT. Children 6 CCNT Operational Policy Sr Joanne Doyle June 2017

7 NOT under an East Cheshire NHS Trust Paediatric Consultant do not have open access to Macclesfield Hospital Children's Ward. These children should be referred to the GP or back to the referring centre if a medical review is required. If the need for medical attention is urgent the CCNT has the right to arrange admission to the ward directly. Children admitted on to the CCNT from surrounding hospitals and tertiary centres will remain under the Consultant at the referring centre and the CCNT will refer the patient back to the named consultant if required unless the patient is oxygen dependant. These patients must be referred to a Macclesfield consultant prior to acceptance by CCNT as per East Cheshire NHS Trust policy: Discharge planning for the Neonate: Administration & Management of Home Oxygen (2014) 5. Workload Planning The CCNT uses a paperlite electronic diary and caseload system emisweb. The emisweb system and CCNT function as a collaborative process to ensure efficiency in the running of the service and are reviewed at the commencement of every shift and referred to regularly throughout the shift. All team members are responsible for checking their own NHS and the CCNT generic daily. Nursing visits are planned between the hours of 07:30 and 20:00 Monday Friday and at weekends. CCNT home visit slots are; Monday - Friday Weekends The last home visit of the day must be made no later than giving the team member time to return to the office to complete daily tasks. All team members are responsible for taking their own breaks and must plan their workload around this. Team members cannot claim time back if they do not have a break. If team members come to work late or leave early this must be agreed with the Team Leader and updated by the Team Leader on the online Health Roster. There is no time owing. Visits are planned according to clinical need, to a maximum of three per day per patient. Staff members will undertake up to 10 visits per week day shift and 7 visits per weekend shift depending on the nursing workload and patient dependency. A greater number of visits can be arranged if the team leaders or nurse in charge feels it appropriate and within a safe workload if the visit will avoid a child s admission to hospital. It is against policy and not appropriate for Health Care Assistants to be delegated the following visits unless accompanied by a Registered Nurse: Any first assessments All acute respiratory conditions All patients where there are safeguarding concerns Any visits involving medication including delivery of medications 7 CCNT Operational Policy Sr Joanne Doyle June 2017

8 The HCA must have access to the registered nurse on duty at all times within the working hours of the HCA shift. The RN on duty is legally accountable for the HCA whilst on shift in line with the NMC code of Professional conduct 6. Documentation A comprehensive plan of care will be discussed and agreed with the medical staff and family prior to transfer home or at first contact. This care plan may take the form of a full integrated care pathway for certain condition and treatments. This plan of care will be evaluated at regular intervals and amended after discussion with the CCNT and either middle-grade doctor or Consultant as required. A written nursing evaluation and record of care will be completed at each visit on emisweb. This, along with any clinical observations, will be recorded in the emisweb CCNT electronic nursing care record. Each CCNT member is responsible for their own Trust allocated IPad which must be taken to all patient home visits and is used to timely document in patient s CCNT electronic nursing care records. IPads are also regularly used for wound photography and accessing training material online. Trust IPads are not for staff personal use and may not be taken home by staff unless approved by the Paediatric Matron. IPads must be kept in a locked cabinet when not in use. See Trust IPad Risk Assessment; IPads.doc 7. Discharge from the CCNT service Nursing visits will continue until the prescribed plan of care is complete. At this point the member of the CCNT directly responsible for the child's care will: Complete a discharge summary and distribute accordingly. o GP o Health Visitor/School Nurse o Referring Consultant o Social Services Ensure that any planned outpatient follow up is arranged. Ensure that patient is discharged from emisweb caseload lists. 8. Transition to Adult Services All CCNT staff members have the responsibility to regularly review the emisweb caseload lists and should identify any long term patients who have turned or are about to turn 16 years old (19 years for long term patients with complex needs). 8 CCNT Operational Policy Sr Joanne Doyle June 2017

9 Once a patient is identified CCNT should refer to the East Cheshire Children s Community Nursing Team Transition to Adult Services Policy Temporary Closure of the Service Due to the small size of the team it is occasionally necessary to close the service temporarily due to staff sickness or absence. On these occasions the staff member who is unable to work should contact the Nurse in Charge of the service the day before, or the Nurse in Charge of the Children s Ward overnight to formally notify of the absence and should provide an estimated date of return. This will assist the team in forward planning. The Nurse in Charge of the service or the Nurse in Charge of the ward should then make every effort to arrange suitable cover for the shift(s) that require staffing. If no suitable cover can be arranged the service should be closed for the specific day(s). The staff member who is absent should contact the Nurse in Charge of the service or Nurse in Charge of the Children s Ward as soon as they are fit to return. CCNT may also be closed at short notice to cover the Children s Ward in an emergency staffing or inpatient crisis. See Emis SOP for temporary closure due to Staff sickness/absence guidance. SOP EMIS.doc 10. Roles and Responsibilities Children s Services Manager o The role of the Children s Services Manager is to support and oversee the Ward Manager and CCNT staff members in the management of the service, act as advocate for the service in relation to the service development. Children s Ward Manager o The role of the Children s Ward Manager is to oversee the supervision of the CCNT Team leaders in the day to day running of the service. CCNT Sister/Team Leader o The role of the CCNT Team Leader(s) is to maintain responsibility of the day to day management of the team, oversee activities undertaken, highlight training needs and support staff to access training, engage and the lead the service development plan taking a long term view of service need, provide supervision for the CCNT Nursing Team. CCNT Registered Nurses o The role of the CCNT Nursing Team is to assist the Team Leader(s) in the day to day management of the service, undertake nursing cares within staff members own competencies, highlight own training needs and make effort to access appropriate training, engage in service development and contribute positively this plan, cover shifts on the children s ward as and when requested and required. o All staff members have a duty to ensure the health and safety of themselves and others whilst at work. Safe working practices and health and safety precautions are a legal requirement 9 CCNT Operational Policy Sr Joanne Doyle June 2017

10 o Registered Nurses must work cooperatively within teams and respect the skills, expertise and contributions of their colleagues (NMC, 2008). o Registered Nurses must carry out all first assessment visits. o Registered Nurses must establish that anyone they delegate to be able to carry out their instructions confidently, competently and in line with Trust policies and procedures (NMC, 2008). o Registered Nurses must confirm that the outcome of any delegated task meets required standards (NMC, 2008). o Registered Nurses must ensure everyone they are responsible for is supervised and supported at all times (NMC, 2008). o Registered Nurses have a duty of care and a legal liability with regard to patients and clients. If a Registered Nurse has delegated a task to a HCA they must ensure that the task has been appropriately delegated, that the HCA understands the task and how it is to be performed, has the appropriate skills and abilities to perform the task and has been delegated in line with Trust policies and procedures (RCN, 2011). CCNT Health Care Assistant o The Health Care Assistant (HCA) working within the Children s Community Nursing Team (CCNT) will participate in the delivery of care interventions and delegated tasks often without direct supervision from a Registered Nurse Practitioner. o The range of duties delegated to the HCA must be overseen by a Registered Practitioner at all times and therefore adhere to the policies and procedures of East Cheshire NHS Trust. o The HCA must acknowledge their own limitations, identify risk issues with regards to them carrying out duties, conform to safe and lone working practices, ensure their own actions contribute to the maintenance of a quality service provision and adhere to all Trust policies and procedures. o All staff members have a duty to ensure the health and safety of themselves and others whilst at work. Safe working practices and health and safety precautions are a legal requirement. o HCA must ensure he/she reports completion of any delegated task to the supervising registered nurse (NMC, 2008). o HCA has a responsibility to highlight to supervisory staff if he/she feels he/she is not being sufficiently supervised and supported (NMC, 2008). o For any task delegated to the HCA by a registered nurse, the HCA must ensure he/she understands the task and how it is to be performed, has the appropriate skills and abilities to perform the task and has been delegated in line with Trust policies and procedures (RCN, 2011). o See appendix 1 for HCA appropriate duties. 11. Implementation The policy should be implemented in its entirety by all staff members under the employment of the Children s Community Nursing Team and Children s Ward at East Cheshire NHS Trust. 12. Measuring performance & Audit The effectiveness and performance of the CCNT will be measured through regular staff meetings, feedback from patients and families, and all staff members engaging in the appraisal process. Regular audits will be undertaken to ensure documentation is in adherence with the East Cheshire NHS Trust Clinical Records Management Policy Incorporating Clinical Record Keeping Standards Policies and procedures will be updated as frequently as each policy and procedure document demands. 10 CCNT Operational Policy Sr Joanne Doyle June 2017

11 13. Review This policy will be reviewed yearly as the service continues to develop and expand. The policy will be reviewed by the authors (if applicable) and/or CCNT Team Leaders before being passed for approval by the Children s Ward Manager and Children s Services Manager. The updated policy will then be subject to the usual ratification process. 14. References East Cheshire NHS Trust (no date) Job Description: Health Care Assistant, Community Service Unit. East Cheshire NHS Trust East Cheshire NHS Trust (2017) Standard Operating Procedure: emisweb. East Cheshire NHS Trust NMC (2008) The Code: Standards of conduct, performance and ethics for nurses and midwives. NMC: London. RCN (2011) Accountability and delegation: What you need to know. RCN: UK 11 CCNT Operational Policy Sr Joanne Doyle June 2017

12 15. Appendix 1 Medical Acute conditions e.g. IV antibiotics, D&V, dehydration and pyrexia, Endocrine conditions, Chest Infections, Asthma, o2 dependent children, neonate, feeding issues, Diabetes, Wound management inc burns, Constipation, Epilepsy, HSP, Nephrotic Syndrome, Pylonephritis, Viral Induced Wheeze, Oxygen sleep studies General Surgery Hernia repair, Orchidopexy, Hypospadias repair, Appendicectomy, Circumcision, Wound management, Removal of sutures/clips, Day Surgery follow-up, Myringoplasty, Tonsillectomy, Adenoidectomy Orthopaedics External fixation, Perthes disease, Hip spica care, Plaster care, Clexane injections Complex needs Tracheostomy care, Gastrostomy care, Oxygen dependent, Bronchiecstasis, Cystic Fibrosis Tertiary Care Oncology, Cystic Fibrosis, Rheumatology, Cardiology, Gastroenterology Dermatology Atopic Eczema, Allergy testing, Psoriasis Ophthalmology Administration of eye drops, Follow up of day surgery, Peri-orbital Cellulitis 12 CCNT Operational Policy Sr Joanne Doyle June 2017

13 16. Equality Analysis Equality Analysis (Impact assessment) Please START this assessment BEFORE writing your policy, procedure, proposal, strategy or service so that you can identify any adverse impacts and include action to mitigate these in your finished policy, procedure, proposal, strategy or service. Use it to help you develop fair and equal services. Eg. If there is an impact on Deaf people, then include in the policy how Deaf people will have equal access. 1. What is being assessed? Children s Community Nursing Team Operational Policy Details of person responsible for completing the assessment: Name: Joanne Doyle Job Title: Sister Team: Children s Community Nursing Team State main purpose or aim of the policy, procedure, proposal, strategy or service: (usually the first paragraph of what you are writing. Also include details of legislation, guidance, regulations etc which have shaped or informed the document) The Children s Community Nursing Team (CCNT) provides family centred, acute/chronic nursing care in the child's own home for children from birth to 16 years of age (18 years for long term patients with complex needs). The aims and expected benefits of the service are: to reduce the number of children admitted to hospital reduce the length of in-patient stay when admission is unavoidable Reduce the number of acute re-admissions to hospital Promote child and family satisfaction with children's health services as a whole Although the majority of families prefer home-based care, the psychological, sociological and economic reasons why families may prefer hospital admission are not underestimated and the theme of supportive collaboration underpins the philosophy of the CCNT Service. The CCNT is currently engaging in a significant service development programme aimed at improving efficiency of the service, improving and standardising patient care, improving safety for both staff and patients, improving and developing links with other services. The eventual goal is to increase capacity thus offering a wider range of services and meeting the aims of the service to a much greater extent. Whilst this programme is active this policy will be reviewed on a yearly basis to ensure it is kept up to date with the development of the service. 2. Consideration of Data and Research To carry out the equality analysis you will need to consider information about the people who use the service and the staff that provide it. Think about the information below how does this apply to your policy, procedure, proposal, strategy or service 2.1 Give details of RELEVANT information available that gives you an understanding of who will be affected by this document Cheshire East (CE) covers Eastern Cheshire CCG and South Cheshire CCG. Cheshire West & Chester (CWAC) covers Vale Royal CCG and Cheshire West CCG. In 2011, 370,100 people resided in CE and 329,608 people resided in CWAC. Age: East Cheshire and South Cheshire CCG s serve a predominantly older population than the national average, with 19.3% aged over 65 (71,400 people) and 2.6% aged over 85 (9,700 people). Vale Royal CCGs registered population in general has a younger age profile compared to the CWAC average, with 14% aged over 65 (14,561 people) and 2% aged over 85 (2,111 people). 13 CCNT Operational Policy Sr Joanne Doyle June 2017

14 Since the 2001 census the number of over 65s has increased by 26% compared with 20% nationally. The number of over 85s has increased by 35% compared with 24% nationally. Race: In 2011, 93.6% of CE residents, and 94.7% of CWAC residents were White British 5.1% of CE residents, and 4.9% of CWAC residents were born outside the UK Poland and India being the most common 3% of CE households have members for whom English is not the main language (11,103 people) and 1.2% of CWAC households have no people for whom English is their main language. Gypsies & travellers estimated 18,600 in England in Gender: In 2011, c. 49% of the population in both CE and CWAC were male and 51% female. For CE, the assumption from national figures is that 20 per 100,000 are likely to be transgender and for CWAC 1,500 transgender people will be living in the CWAC area. Disability: In 2011, 7.9% of the population in CE and 8.7% in CWAC had a long term health problem or disability In CE, there are c.4500 people aged 65+ with dementia, and c.1430 aged 65+ with dementia in CWAC. 1 in 20 people over 65 has a form of dementia Over 10 million (c. 1 in 6) people in the UK have a degree of hearing impairment or deafness. C. 2 million people in the UK have visual impairment, of these around 365,000 are registered as blind or partially sighted. In CE, it is estimated that around 7000 people have learning disabilities and 6500 people in CWAC. Mental health 1 in 4 will have mental health problems at some time in their lives. Sexual Orientation: CE - In 2011, the lesbian, gay, bisexual and transgender (LGBT) population in CE was estimated at18,700, based on assumptions that 5-7% of the population are likely to be lesbian, gay or bisexual and 20 per 100,000 are likely to be transgender (The Lesbian & Gay Foundation). CWAC - In 2011, the LGBT population in CWAC is unknown, but in 2010 there were c. 20,000 LGB people in the area and as many as 1,500 transgender people residing in CWAC. Religion/Belief: The proportion of CE people classing themselves as Christian has fallen from 80.3% in 2001 to 68.9% In 2011 and in CWAC a similar picture from 80.7% to 70.1%, the proportion saying they had no religion doubled in both areas from around 11%-22%. Christian: 68.9% of Cheshire East and 70.1% of Cheshire West & Chester Sikh: 0.07% of Cheshire East and 0.1% of Cheshire West & Chester Buddhist: 0.24% of Cheshire East and 0.2% of Cheshire West & Chester Hindu: 0.36% of Cheshire East and 0.2% of Cheshire West & Chester Jewish: 0.16% of Cheshire East and 0.1% of Cheshire West & Chester Muslim: 0.66% of Cheshire East and 0.5% of Cheshire West & Chester Other: 0.29% of Cheshire East and 0.3% of Cheshire West & Chester None: 22.69%of Cheshire East and 22.0% of Cheshire West & Chester Not stated: 6.66% of Cheshire East and 6.5% of Cheshire West & Chester Carers: In 2011, nearly 11% (40,000) of the population in CE are unpaid carers and just over 11% (37,000) of the population in CWAC. 2.2 Evidence of complaints on grounds of discrimination: (Are there any complaints or concerns raised either from patients or staff (grievance) relating to the policy, procedure, proposal, strategy or service or its effects on different groups?) Nil 2.3 Does the information gathered from indicate any negative impact as a result of this document? 14 CCNT Operational Policy Sr Joanne Doyle June 2017

15 Nil 3. Assessment of Impact Now that you have looked at the purpose, etc. of the policy, procedure, proposal, strategy or service (part 1) and looked at the data and research you have (part 2), this section asks you to assess the impact of the policy, procedure, proposal, strategy or service on each of the strands listed below. RACE: From the evidence available does the policy, procedure, proposal, strategy or service affect, or have the potential to affect, racial groups differently? Yes No X Explain your response: This document offers guidance for the management of children being accepted onto the Children s Community Nursing Team. All patients will be considered fairly for acceptance by the CCNT regardless of race. Any explanations to parents and children whose first language is not English will be carried out using the Trust s interpretation and translation policy and/or the picture communications book in the ward communications aids box. GENDER (INCLUDING TRANSGENDER): From the evidence available does the policy, procedure, proposal, strategy or service affect, or have the potential to affect, different gender groups differently? Yes No X Explain your response: This document offers guidance for the management of children being accepted onto the Children s Community Nursing Team. All patients will be considered fairly for acceptance by the CCNT regardless of gender. DISABILITY From the evidence available does the policy, procedure, proposal, strategy or service affect, or have the potential to affect, disabled people differently? Yes No X Explain your response: This document offers guidance for the management of children being accepted onto the Children s Community Nursing Team. All patients will be considered fairly for acceptance by the CCNT regardless of disability. If necessary the Trust s interpretation and translation policy and/or the picture communications aids box can be utilised. For parents with learning disabilities, the health facilitator from CWP can be involved. The Children s ward has an autism link who can support staff. AGE: From the evidence available does the policy, procedure, proposal, strategy or service, affect, or have the potential to affect, age groups differently? Yes No X Explain your response: These guidelines are designed to be applicable for children of all ages up to 18. Positive impact for patients with complex needs as they are able to stay on caseload up to 18 years. LESBIAN, GAY, BISEXUAL: From the evidence available does the policy, procedure, proposal, strategy or service affect, or have the potential to affect, lesbian, gay or bisexual groups differently? Yes No X Explain your response: This document offers guidance for the management of children being accepted onto the Children s Community Nursing Team. All patients will be considered fairly for acceptance by the CCNT regardless of orientation.- RELIGION/BELIEF: From the evidence available does the policy, procedure, proposal, strategy or service affect, or have the potential to affect, religious belief groups differently? Yes No X Explain your response: This document offers guidance for the management of children being accepted onto the Children s Community Nursing Team. All patients will be considered fairly for acceptance by the 15 CCNT Operational Policy Sr Joanne Doyle June 2017

16 CCNT regardless of religion/belief. Drugs will be checked as required with pharmacy re content as required for specific religions. Eg Muslim patients and porcine content. CARERS: From the evidence available does the policy, procedure, proposal, strategy or service affect, or have the potential to affect, carers differently? Yes No X Explain your response: This document offers guidance for the management of children being accepted onto the Children s Community Nursing Team. If any children have carers for whatever reason, the rationale behind these procedures will be explained to them. OTHER: EG Pregnant women, people in civil partnerships, human rights issues. From the evidence available does the policy, procedure, proposal, strategy or service affect, or have the potential to affect any other groups differently? Yes No X Explain your response: No other impacts identified. 4. Safeguarding Assessment - CHILDREN a. Is there a direct or indirect impact upon children? Yes X No b. If yes please describe the nature and level of the impact (consideration to be given to all children; children in a specific group or area, or individual children. As well as consideration of impact now or in the future; competing / conflicting impact between different groups of children and young people: These guidelines are designed to be used for all children up to age 18 and will therefore impact on all these children. c. If no please describe why there is considered to be no impact / significant impact on children 5. Relevant consultation Having identified key groups, how have you consulted with them to find out their views and that the made sure that the policy, procedure, proposal, strategy or service will affect them in the way that you intend? Have you spoken to staff groups, charities, national organisations etc? Groups identified for consultation: Community Service Managers Children s Services Manager Children s Ward Matron Children s Community Nursing Team Children s Ward Sisters Paediatric Consultants 6. Date completed: July 2017 Review Date: July Any actions identified: Have you identified any work which you will need to do in the future to ensure that the document has no adverse impact? Action Lead Date to be Achieved 8. Approval At this point, you should forward the template to the Trust Equality and Diversity Lead lynbailey@nhs.net Approved by Trust Equality and Diversity Lead: Date: July CCNT Operational Policy Sr Joanne Doyle June 2017