New standards set for emergency care of children and young people

From mental health, substance and alcohol abuse to major incidents involving serious injury or death, thousands of children and young people pass through the NHS each day needing emergency care.  Now, a new series of standards set out minimum requirements for how children in emergency settings should be treated - covering areas from service design and environment to staff training and safeguarding.

The standards appear in the third edition of a publication formerly known as the ‘Red Book’, which is widely used by healthcare professionals in the UK to improve care of children in emergency settings. This latest edition, renamed ‘Standards for children and young people in emergency care settings’, is unique in containing not only guidance, but also specific standards against which healthcare providers can be measured.

The standards have been developed by the Intercollegiate Committee for Standards for Children and Young People in Emergency Care Settings led by the Royal College of Paediatrics and Child Health and are designed to help service planners overcome some of the key challenges in emergency healthcare – including the impact of the European Working Time Directive which sets maximum daily and weekly working hours and increased public expectation of immediate access to care.

The standards stipulate that:

• initial clinical assessment occurs within 15 minutes of arrival
• at least one clinical cubicle or trolley space is designated for use by children  for every 5,000 annual child attendances
• emergency departments seeing more than 16,000 children a year employ a consultant with sub-speciality training in paediatric emergency medicine
• all staff in emergency care settings are able to access child protection advice 24 hours a day from a paediatrician with child protection expertise
• all emergency departments receiving children have a lead Registered Children’s Nurse and sufficient Registered Children’s Nurses to provide one per shift
• emergency clinicians with responsibility for the care of children and young people receive training in how to assess and manage their mental health needs and support their family/carers
• regional critical care networks are in place to develop protocols to stabilise and transfer children to specialist centres
• injury surveillance data is collected and accessible as appropriate
• all emergency care attendances by children and young people are notified to the primary care team (GP and school nurse/health visitor)

Professor Terence Stephenson, President of the Royal College of Paediatrics and Child Health, said:

'There have been significant changes to how urgent healthcare is provided to children in the UK, with care provided in a range of settings – from minor injury units, walk-in centres and pharmacies as well as in hospital emergency departments.

'It’s therefore important that to ensure consistency in the level of service, there are clear standards that providers must meet to ensure all children, wherever they are treated and whatever the emergency, receive the highest quality of care. 

'This publication is key to setting – and raising – standards; providing practical guidelines and, for the first time, measurable targets.'

Royal College of Nursing Chief Executive and General Secretary, Dr Peter Carter, said:

'Nurses in emergency care settings are the first clinical point of contact for children and young people. They must have the right level of skills and knowledge to ensure that the child’s care is passed on to the right clinician in a timely manner.

'We urge healthcare organisations across the UK and those planning services to play close attention to these standards as they face challenges including the impact of financial constraints.'

Ends.

A copy of Standards for Children and Young People in Emergency Care Settings can be downloaded here: www.rcpch.ac.uk/emergencycare

The Intercollegiate Committee for Standards for Children and Young People in Emergency Care Settings comprises:

Royal College of Paediatrics and Child Health
British Association of Paediatric Surgeons
College of Emergency Medicine
Joint Royal Colleges Ambulance Liaison Committee
Royal College of Anaesthetists
Royal College of General Practitioners
Royal College of Nursing