Integrated 24-hour children and young people's asthma service: Reducing unnecessary hospital attendance

NICE Quality and Productivity Case Studies
South East Essex Community Healthcare
Publication date:
17 January 2014



The service seeks to reduce unnecessary hospital attendance by providing personalised, round the clock access to home nursing support for children and young people from birth to 16 years. It was formed in response to increasing demand for urgent asthma treatment by integrating the existing paediatric asthma/allergy service with the 24 hours Community Children's Nursing Team.

The service is protocol driven and emphasises patient safety. Adherence to protocols is monitored and there have been no ‘near misses’.

Setting up the service involved training the community children's nurses in assessing and treating asthma conditions, and producing a set of highly detailed algorithms and flow charts which the nurses must follow. These are linked to a Patient Group Directive, to enable the nurses to supply and administer medication.

Each intervention incorporates education for the patient and their parents / carer and families about self-management of asthma.

An additional paediatric community nurse was appointed to help meet the overall extra workload.