Children's home nursing: results of a national survey

A questionnaire survey was undertaken to establish the characteristics of children's home nursing teams in the UK that deal with acute and chronic cases, to assess their impact on hospital referrals and determine whether they are cost effective. The sample consisted of acute and community trusts listed on the Royal College of Pediatrics and Child Health (RCPCH) database. Differences were found in trust affiliation, staffing, skill mix, caseload, procedures undertaken and hours of operation. Variations depend on whether teams had a predominantly acute caseload, dealt with a mixture of acute and chronic cases, or dealt with predominantly chronic cases. Thirty-two per cent of respondents stated that home care replaced inpatient care for the majority of the children. Budgets of home nursing services varied enormously with a very clear relationship between budget and staffing levels. This survey shows that in 2001, many trusts in the UK provide a children's hospital at home or home nursing service, but that the scale and scope of these services vary widely. Further research is needed on several aspects of home care including the relative costs and benefits of different forms of service in comparison to hospital-based care.