Shared learning database

 
Organisation:
Bridgewater Community Healthcare
Published date:
December 2012

NICE guidance CG72 was used as a tool to compare best practice with current service provided. The views of parents and carers were also used to help identify the gaps in current service. In addition eight families with newly diagnosed Children / Young People were involved in trialling a new care pathway for support to identify areas of good / positive support received and areas where our current service did not meet expectation or best practice as per CG72.

Guidance the shared learning relates to:
Does the example relate to a general implementation of all NICE guidance?
No
Does the example relate to a specific implementation of a specific piece of NICE guidance?
Yes

Example

Aims and objectives

- To evaluate current practice within Warrington Division in relation to CG 72 (Appendix 1) to determine compliance with this guidance
- To work closely with parents /carers and other professionals to identify their main concerns and issues with respect to ADHD
- To work together with families and professionals to identify the best manner to address the issues identified
- To create a proposal to address gaps in compliance

Reasons for implementing your project

NICE guidance CG72 was used as a tool to compare best practice with current service provided. The views of parents and carers were also used to help identify the gaps in current service. In addition eight families with newly diagnosed Children / Young People were involved in trialling a new care pathway for support to identify areas of good / positive support received and areas where our current service did not meet expectation or best practice as per CG72. This input from families has greatly influenced the recommendations for the type of support that has been recommended. Views from professionals in relation to areas of good and weak practice were extremely helpful in determining future direction of a new service.

Warrington was only compliant with guidance on assessment and diagnosis.

How did you implement the project

The project set out to evaluate compliance with NICE guidance CG72 and to determine what steps could be taken to achieve full compliance and provide the children and young people of Warrington with a quality service.

The project included accessing training, research; study time and liaison with professionals in other geographical areas to ensure that the pilot service was founded on evidence based practice and followed NICE guidance. Consultation with parents/carers/children with ADHD played a large part in the project, as did discussion with Community Paediatricians of all grades and other health professionals within Warrington division of Bridgewater Community Healthcare NHS Trust.

Care pathways and documentation for assessment visits, initial consultations and recording interventions was developed for trial to ensure standardised documentation was used throughout the project.

The cost has been 1 full time band 6 nursing post that has been divided between two members of staff job sharing the position, one member of staff was an existing member of the special needs nursing team who has increased her hours to cover the post.

8 newly diagnosed children (ranging in age from 6 to 15) and their carers were involved in this pilot project.

Key findings

The ADHD nurse posts commenced in September and the new clinics will commence in January, offering clients to be seen more frequently ie: three monthly, offering more ongoing support to clients and families than is presently being offered.

The nurses have began to see an increase in contact from parents, families and health professionals seeking support and advice on ADHD management. Parents are commenting that they are so pleased to see the service being offered and are welcoming the extra support at the end of the telephone or from a home visit.

A care pathway has been established that will give clarity on the referral process to our service and our involvement with clients and families.

An audit of our service will be established to monitor its effectiveness with our clients, families and other professionals.

Key learning points

Our specialist nursing team identified the need and gaps in our service and following the NICE guidance it was evident that Warrington was compliant only with assessment and diagnosis, gaps were evident in support pre and post referral. The non-existence of a team approach was leading families to feel isolated and unsupported. Community Paediatricians and other professionals, families, children and young people identified areas that needed to be improved to provide a quality service to those diagnosed with ADHD. Compliance with CG72 would not be possible without consideration of a new way to address the many gaps that exist between CG72 guidance and the service that was in place. Recognising those gaps was imperative to be able to look from a multi-agency viewpoint at how they could be addressed.

Using this approach and ensuring clients, families and carers were involved in the consultation provided the necessary evidence of the gaps and the needs identified to provide a quality service that the clients and families of Warrington deserve.

Contact details

Name:
Carol Humphreys and Ruth McCormack
Job:
Specialist nurses (ADHD)
Organisation:
Bridgewater Community Healthcare
Email:
carol.humphreys@bridgewater.nhs.uk

Sector:
Is the example industry-sponsored in any way?
No