30 oktober 2019

Children’s Health Scotland surveys quality of care in Scottish hospitals

Since 1985, Children’s Health Scotland (CHS, formerly Action for Sick Children Scotland) has carried out periodic surveys of Scottish NHS hospitals admitting children. Its eighth survey, in 2018 – 2019 assesses current parental access and family facilities provision, and the implementation of child healthcare policies and procedures. On October 30 the results were presented.

Its purpose is to highlight good practice and progress and to identify where improvements need to be made. Survey results have been benchmarked against the ten articles of the European Association for Children in Hospital (EACH) Charter, key standards for paediatric care.

The survey has been carried out in paediatric wards, neonatal units and hospitals with adult wards that admit children and young people in hospitals across Scotland.Additionally questionnaires have been sent to health board catering managers, lead paediatric dieticians and child health commissioners.

Results

Speaking about the research Professor Richard Olver, Chair of Children’s Health Scotland said: “Since our last survey in 2012-13, it is pleasing to note that progress has been achieved in the provision of hospital services for children and young people such as open visiting and the provision of overnight and on-ward facilities for parents or carers.”

“However, there are still areas for improvement particularly with reference to the standards set out in the EACH Charter. It is a fact that all children have an explicit right to achieve their developmental potential and to sustain the highest possible standard of health, with a right to appropriate health services to facilitate attainment of these goals”

“On analysis of the findings more needs to be done, especially in relation to admission to adult wards, the provision of healthcare rights information, and compliance with Scottish Government guidance on the provision of education and on the nutritional content of food in hospital. We now look forward to working with those in the sector to implement the recommendations within the report.”

Trends: Some key findings: comparison with 2012/13 survey

FACILITY/PROCEDURE
2018/19
PARENTAL ACCESS
  Paediatric Neonatal Adult
Provision of open visiting for parents/carers 89{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 100{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}  ↔ 88{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} ↔
PARENTAL FACILITIES AND ACCOMMODATION
Parents’ overnight accommodation at bedside in a bed or chair 90{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} ↑ 87{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} ↑ 100{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} ↑
Availability of a sitting room for parents/ carers 86{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 93{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a 86{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}  ↑ 80{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}  ↑ n/a
Self-catering facilities for parents/carers 86{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 80{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a 86{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}  ↑ 80{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}  ↑ n/a
Showering/washing facilities for parents/carers 80{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 80{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a 80{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}  ↑ 80{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} ↑ n/a
FAMILY SUPPORT
Access to a social worker 77{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 67{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 100{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 77{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}  ↑ 67{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 100{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}  ↑
Young people’s services
14-16 year-olds accommodated in a specialist unit or ward 15{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a n/a 15{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} ↑ n/a n/a
Choice of children’s or adult wards for young people 9{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a n/a 9{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a n/a
CHILDREN ADMITTED FOR SURGERY
Dedicated surgery lists 75{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a n/a 75{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a n/a
Allowing parents to stay with child until anaesthetised 100{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a n/a 100{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}  ↑ n/a n/a
Allowing parents to be with their child in recovery 61{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a n/a 61{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a n/a
INFORMATION, RECORDS AND FEEDBACK
Information for parents on reimbursement of travel costs 49{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 93{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a 49{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 93{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}  ↔ n/a
Availability of written information for families about ward procedures on admission 34{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 53{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a 34{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 53{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a
Young people given information about consent 74{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a 56{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 74{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a 56{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}
Young people given information about confidentiality 76{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a 44{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 76{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a 44{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}
EDUCATION
Compliance with Scottish Government guidelines on education1 36{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a n/a 36{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} ↑ n/a n/a
Provision of teaching for children from other local authority areas 45{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a n/a 45{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a n/a
CATERING
Specific menus for children and young people 83{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a 43{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} 83{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} n/a 43{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} ↑

Research design

Children’s Health Scotland carried out a survey of: pediatric wards (35 wards responded, a response rate of 97{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}), neonatal units (15 units; 100{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} response rate), and hospitals with adult wards that admit children and young people (19 hospitals; 95{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}4 response rate), along with catering managers and lead paediatric dieticians (17; 89{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393} response rate), and Child Health Commissioners (13; 93{60f83d427fa1bd0581e14e00752abb5a0f338dfffd4223419b474e528bcb0393}5 response rate).

The topic areas covered were informed by the EACH Charter and the UNCRC and included:

information about the ward or unit admissions;

parental access, including visiting arrangements;

family facilities and accommodation, including sleeping arrangements, family support, refreshments and meals;

young people’s services, including facilities for young people, the provision of information and access to technology;

acute assessment for ill children admitted for less than 24 hours (excluding surgery);

children admitted for surgery and care on operating day;

children and young people admitted to paediatric wards with mental health conditions;

arrangements for providing feedback and accessing records;

any recent or planned changes in service provision;

travel, including provision of information relating to travel costs and car parking;

education, such as the provision of staffing and facilities for education; and

play, including workforce provision, play facilities and equipment.

The survey opened at the beginning of October 2018 and closed in early December 2018. Reminder emails and telephone calls during the survey prompted people to take part.
Following the completion of the online survey, several children’s hospitals and two district general hospitals were visited to explore some of the issues in greater detail with staff, parents and carers. Information from these visits are presented in the report ‘Children in Hospital 2018/19 Survey.

 

 Questionnaires used

Children’s Health Scotland used four separate questionnaires:

Click to view / download the questionnaires.
We include these because we trust they can be an inspiration and a practical help for others elsewhere.