Our Trust took the view of developing a 'One Front Door' service and instructed our paediatric unit to provide additional staffing support to ED to ensure paediatric provision.
However, due to the nature of our population we soon realised that there were some 'time critical' chronic, long term paediatric patients that the paediatric department knew well and they could ill afford to spend 2-3 hours waiting for treatment in ED.
AS a result of discussing this with our ED colleagues, our Paediatricians and out Ambulance service, the Paediatric Unit have developed a 'passport' card for these individuals and backed it up with an Ambulance Advanced Care Plan for our Ambulance colleagues that details on what occasions these chronic, time-critical patients should be conveyed directly to our Paediatric Ward, bypassing the 'One Front Door' of ED.
These patients include those with diagnoses such as oncology, metabolic conditions, brittle epilepsy and cardiac conditions.
The system has been a huge success with patients and parents feeling that they are being seen by the right clinician in the appropriate timeframe, Paramedics now feel reassured that they are taking the patients to the right department and clinicians are reassured that their time critical patients are being seen and given timely interventions.