Redesign Urgent Care: paediatric pathway to flow navigation centres - review

7. Key Considerations

• If a proportion of children who would normally self-present to ED go through this new pathway, when safe to do so, there is an opportunity to reduce the impact of paediatric attendances at ED by both NHS 24 provided self-care and referral to the RUC flows locally.
• The facility is still there to send the unwell <12s either direct to ED or in 999 ambulances, and will continue to be used by NHS 24 as appropriate.
• Robust public and child protection processes and mechanisms are and will remain in place to ensure children attend ED.
• If the recommendation is to include <12s then all boards would simultaneously go through the readiness assessment process prior to Go Live as per the original rollout.
• Should this be rolled out to all <12s or consider applying a lower age limit of 18 months before rolling out to all ages? For example many minor injury units follow strict protocols and generally will not see children under two. All under 2s currently require a face to face response from SAS and are conveyed to ED
• This is a new system still in development and is untested at volume. The NHS Ayrshire & Arran pilot managed the RUC calls in conjunction with GP OOH and COVID-19 calls and so a proportionally senior and well-resourced workforce was available. The concerns are about the system, not individual clinical decisions that are made, and the way it will perform under stress. The potential impact on children pertains to the impact of a possible delay for an unwell child, where the parents would otherwise have attended ED.