Integrating community children’s nursing in urgent and emergency care: a qualitative comparison of two teams in North West England

Table 1 Case study population and service characteristics

		Case study
PCT Population		A		B
Population¹	<15 years old, n (%)	34,300 (18.7)		45,100 (18.1)
Deprivation²		17.9		34.5
Child Well-being³		7.5		20.4
Local Healthcare Economy
Services
Hospital		District General		District General
ED		Yes		Yes
OAU		No		Yes
Walk-in Centre (n)		Yes (2)		No
Emergency Admission Rate at Local Hospital^‡4		42.3		52.3
ED attendance rate at Local Hospital^‡5		376.2		385.1
GPs per 100,000 children <15⁶		306.4		295.2
CCNT
Base (Organisation)		Community (PCT)		Hospital (Acute Trust)
Number of years established at beginning of study		3		14
Disease focus		Acute and Chronic		Acute (and End of Life)
Referrals⁷	n	923		3,024
	Source (%)	Ward	77.0	35.2
		GP	7.3	16.0
		Walk-in-Centre	5.2	-
		School Nurse/Health Visitor/Midwife	5.0	-
		Parent/Carer	2.1	1.5
		Other CCNTs	1.7	-
		ED	1.1	26.0
		OAU	-	15.8
		GP out-of-hours	0.2	-
		Out-patients	-	2.1
		Other	0.4	3.4
Workforce⁸ FTE	n		13.8	14.4
	per 1,000 children <15		0.40	0.32
Hours of operation		Mon to Fri 08:00 to 20:00;		Mon to Sun 08:00 to 20:00
		Sat/Sun/Bank Holidays 08:00 to 18:00
CCNT referral rate per 1,000 children <15⁹		26.9		67.1

^‡ Local Hospital is defined as the hospital to which the greatest percentage of children resident in the PCT attend.
¹ Office for National Statistics (ONS) mid-year estimates 2008.
² Percentage of people living in the most deprived quintile of the Index of Multiple Deprivation 2007 (England average: 19.9%) (Source: APHO and DH Health Profile 2009).
³ Percentage of Lower Super Output Areas in lowest quintile of the national distribution (Source: Local Index of Child Well-being 2009).
⁴ Emergency Admission Rate for three commonest medical presentations at EDs (i.e., breathing difficulty, feverish illness, diarrhoea) per 1,000 children aged 0–14 resident in the study area (Source: Hospital Episode Statistics 2006/07).
⁵ ED attendance rate per 1,000 children aged 0–14 registered with a GP in the study area (Source: North West Strategic Health Authority Tactical Information Service 2007/08).
⁶ GPs per 100,000 children aged 0–14 (Source: The Information Centre for Health and Social Care 2009).
⁷ Annual Referrals (Source: CCNT routinely collected data 2009).
⁸ Full-time Equivalent workforce (Source: Service A, December 2009; Service B, March 2010).
⁹ CCNT referral rate per 1,000 children aged 0–14 (Source: CCNT routinely collected data 2009; ONS mid-year estimates 2009).

ISSN: 1471-2431