How referrals are made to the team
Referrals are made by any health professional, including GPs, hospital doctors, health visitors and school nurses. The majority are made via a telephone call, although some referrals that are made for routine care, are sent to us as written referrals.
Self referrals are not generally accepted, in accordance with the team's referral criteria.
How long referrals will continue for
CCN will only continue to see a child / young person if they still have a nursing need and/or require ongoing support. If a family is equipped with the skills they need to care for their child, and they are confidently managing this care, CCN do not necessarily need to remain involved.
The routine on a first visit depends on the reason for referral, but as a general rule, there are some activities which the CCN is likely to do during that first contact, or soon after referral:
- Check your demographic details, including religion, ethnicity, family dynamics and contact numbers.
- Ask for your consent to share information within our own organisation and with other external agencies, where this thought to be necessary.
- Completion of some type of assessment – this will involve the nurse questioning you to ascertain the history of the problem, other contributing factors and management so far. It might also involve some clinical measures such as counting a pulse rate, taking a temperature, or carrying out a clinical procedure.
- Provide you with a service leaflet – this explains what to expect from the CCN service and how the service operates.
- Develop a Care Plan – which outlines the care needed to help your child recover or to enable you to manage their healthcare needs. They might leave you with a written leaflet which details this care.
- Health Records are electronic, the CCN might be using their laptop in your home.
- Agree with you the next contact you will have with CCN.
Frequency of contact with the CCN
This depends on the reason for referral, and individual circumstances. Not all children/ young people are seen by the CCN, some might only be referred for a telephone assessment. This will be determined by the CCN from the information given when the referral is made, or following an initial telephone call to the family.
For example:
- A child who is referred because they have a short illness such as a respiratory illness, might only see the team a couple of times, and/or receive telephone reviews, over a very short period lasting from a few days to a couple of weeks.
- A child diagnosed with a condition such as Leukaemia, is likely to see us once a week, most weeks as long as their treatment lasts.
- A child who needs to be fed via a tube in their nose, will probably see us to change the tube and perhaps an occasional visit in-between, for as long as they need to be fed in this way.
Discharge from the service
Where possible, discharge from the service will be discussed and agreed with you. CCN will aim to ensure that you are clear of any ongoing care required, and of any future management plan where this is needed.
You will receive a copy of a discharge letter which has been sent to your GP outlining the referral and the key actions from it. This is for your reference only.
If you have any further problems related to this episode of care, you should seek the advice of your GP or other relevant health professional, and they can advise or refer back to us, where this is required.
Supplies
If the CCN provide you with any kind of consumables to assist you in caring for your child, it is your responsibility to let us know when the supplies are running low.
If we are visiting regularly, we will aim to keep an eye on stock levels and intervene in advance. If this isn't done, please contact us as soon as you are starting to get low, as products might need to be ordered in, which can take an additional couple of weeks.
Prescriptions
A number of our Nurses are Non Medical Prescibers, they may be able to provide you with a prescription for certain items.
If your child has items on repeat prescription, we will expect you to manage your stock of these items.
Any information you give to us will be treated confidentially, although it is likely to be shared across the team to enable us to provide the care and support you need. However, as we work within the wider NHS, there will be health professionals in other agencies who we might need to liaise with or speak to along the way.
For example: On discharge, we write to your GP. If your child is very young and is likely to have ongoing healthcare problems, it is useful to communicate with their health visitor. If your child is school age and the reason for referral could affect their schooling, we are likely to liaise with the school nurse.
Where possible, CCN will always try to gain your permission prior to speaking with other agencies about your child.
In the event that there are any concerns as to your child's welfare, whilst we will always try to discuss this with you or advise you that we will be liaising with social care, it is not essential that we gain your permission where it is viewed as in your child's best interests from a Safeguarding perspective.
Accessing Health Records
In the first instance please speak with your CCN who will support you with the process.
All formal access to record requests are forwarded to the Trust Health Records Manager. The information will be supplied within 30 days of receipt of a written request, the relevant fee (if applicable) and proof of identity.
It is our aim to work in partnership with you. We therefore encourage you to contact us if you wish to query anything, to report any problems, or simply to notify us of any progress or changes in treatment.
We regularly have student nurses on placement with the team.
Where possible we will obtain your consent before a CCN visits with a student. If you do not wish a student to be present, please let your CCN know.