To ask the Minister of Health to detail (i) any pathways available for parents of children with complex needs who require urgent clinical advice outside of normal staffing arrangements; and (ii) how his Department monitors whether these pathways are functioning reliably.

(i) In relation to any pathways available for parents of children with complex needs who require urgent clinical advice outside of normal staffing arrangements, Trusts have advised the following:-

Western Trust: Parents access generic emergency services such as A&E; Out of Hours GP or Regional Emergency Social Work service.

Southern Trust: Children with complex health care needs have open access to Acute paediatrics Wards in CAH and DHH. These patients are well known to the nursing and medical teams. Children can also be referred into the ward by the Children’s Community Nursing teams and Community Paediatric colleagues. Families with children with complex needs also will have the ward details and contact numbers and can be reviewed at any time. The families are aware that they should ring the ward in the first instance to alert the team of their concerns/worries. This allows staff to quickly triage the patient’s condition and determine the best area to attend based on clinical need at that time. This arrangement is in place for acute Paediatric wards and works very well for families and the service.

South Eastern Trust: Community Children’s services are available within South Eastern Trust and are provided Monday to Friday 9am-5pm. Additional scheduled support can be provided to meet the assessed need of a small number of children/young people and their families. There is no funded service outside of normal staffing arrangements. Parents are advised to contact the GP out of hour’s service or acute hospital services.

Where a child or young person moves towards end of life care, the South Eastern Trust Community Children’s Nurses work closely with NI Children’s Hospice and Regional Palliative Care colleagues to provide care and support for the child and family.

The Paediatric Physiotherapy service, through Children’s Complex Health will also provide support to those who are approaching end of life, out of contracted hours.

The Child Health Partnership through the Regional Paediatric Palliative Care Network NI; are working to identify needs for Paediatric end of life care provision and agree how this need can be supported and developed across NI.

Belfast Trust: The clinical teams will have formed good relationships with families and parents of children with complex needs and the children will be well known to the service. The specialist nurses are a point of contact by agreement for families and they will organise an admission to the hospital if deemed required/appropriate through patient flow.

Northern Trust: a number of children with complex physical healthcare needs will have open consultation to the acute paediatric wards both in Antrim and Causeway hospitals. The children for direct consultation are determined by the consultant paediatrician managing their care and a flag is put onto Encompass. These children are well known to the nursing and medical teams. They can also be referred in by the Children’s Community Nursing teams and Community Paediatric colleagues. These families have the ward details and contact numbers and can telephone to speak to a member of the medical team for advice at any time. The families are aware to ring the ward in the first instance to alert the team of their concerns/worries which allows medical staff to quickly triage their condition at that time and determine the best area to attend based on clinical need at that time. This arrangement is in place for both acute Paediatric wards and works very well for families and the service.

(ii) how his Department monitors whether these pathways are functioning reliably:-

Pathway Monitoring is through the relevant service with my Department’s oversight.

Pathway reform is now underway to standardise referral pathways via Task and Finish Groups to ensure patients are managed by the most appropriate clinician and to ensure equity of access regardless of where a child presents.

The Department will continue to prioritise this work through close partnership with Trusts and the independent sector to ensure progress is accelerated and that patients across Northern Ireland can access timely, high-quality care.