NHS service standard - designing services for children and young people

[georginaplatt]

What

There is no specific NHS service standard or service design consideration for designing services used by children and young people aged 5-16.

Why

By and large, because we design for everyone, we don't tend to design differently for 5-16 year olds. That said, there are a few principles we bear in mind:

• Clinical advice for children is sometimes different to clinical advice for adults.
• 5-11s are very unlikely to be reading information themselves so the user is reading on behalf of someone else (same as if you were looking for info on behalf of anyone you care for).
• 12-17s are more likely to be looking for information for themselves, although it may still be a parent looking on their behalf.

What evidence do you have that services across the NHS need it?

What evidence do you have that it meets the needs of the users of those services?

Have you checked that it doesn't already exist in the NHS digital service manual?

This could be a new standard for health and care or update to point 16 'Make your service clinically safe' : - https://service-manual.nhs.uk/standards-and-technology/service-standard-points/16-make-your-service-clinically-safe -->

Anything else

[georginaplatt]

Rob Mccarthy (Interaction designer - NHS Pathways) - "Yes to this point - "Clinical advice for children is sometimes different to clinical advice for adults." On the Streaming & Redirection product, most sites (90%+) do not allow under 16's to use the product due to clinical risk. I don't understand the ins-and-outs of the clinical risk but can put you in touch with a Clinical Author to discuss further".

[georginaplatt]

Clinical informatics manager/ Clinical Author/ paramedic (NHS Pathways) advice: -

"The Streaming and Redirection product has been created to be used for those aged 5 years and over and has had clinical sign off by NHSD. This includes a clinical safety case and hazard log which has been through a rigorous medical device audit.

For the management of child illness presentations, a self-triage child illness pathway was created and is being developed in stages. It is currently used as a streaming tool to identify children presenting with symptoms of serious illness requiring immediate or very urgent assessment.

The design principle is to identify serious illness at the beginning of the algorithm. High acuity presentations such as reduced conscious level, markers of sepsis and severe pain are triaged first and given a high priority level.

Clinical guidelines used currently in widespread practice including NHS Pathways have been used to determine these symptoms and appropriate priority levels. Outcomes based on presenting complaint and main symptoms gives sites an overview of patients waiting to be seen and their corresponding priority levels. Presentations that may pose an increased clinical safeguarding risk have had triage cut to reflect this risk for example burns and bites.

The current iteration of the streaming and redirection product intends for all children to remain within the department. Further development will aim to further triage select presentations that may be suitable for primary care streaming such as sore throat, ear problems etc. This will allow for redirection to other departments within the hospital.

Some sites have chosen not to use the tool to triage children which is down to their own personal choice and governance, but from an NHSD perspective, the tool is safe to be used within this age group with higher dispositions than the adult populations".