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Meet the team: UK Safety Netting Collaborative

Also:

  • Professor Monica Lakhanpaul, University College London
  • Nic Blackwell, OCB Media
  • Natasha Bayes, University of Northampton
  • Laura Mullins, Parent panel lead
  • Tracey Turner, Parent panel lead
  • Sue Palmer-Hill, Northamptonshire Healthcare Foundation NHS Trust
  • Linda Partridge, WellChild charity

The challenge

More children die of preventable causes, such as meningitis and sepsis, in the UK than elsewhere in Europe. Yet children under 5 years constitute one of the largest proportions of the workload in first contact services such as primary care, urgent/emergency care. Many of these consultations are for non-urgent illness. Parents and professionals find it difficult to identify early signs of serious illness. Safety netting has been repeatedly recommended and evidence from our research programme shows that video-based safety netting tools are needed. Spottingthesickchild.com is available for professionals; this resource, developed by the UK Safety Netting Collaborative of parents and professionals, will provide a spotting the sick child resource for families. This professionally validated standardised safety netting information will help all families spot signs of serious acute childhood illness, including, but not limited to, sepsis. The resource will be useful during consultations to help professionals explain what symptoms to look for, independently at home to help parents decide when to seek help and when negotiating access to health services. This project builds on NICE (2013) fever and sepsis guidelines – our team includes Professor Monica Lakhanpaul who led the development of the first fever guideline and www.spottingthesickchild.com

Our proposal

We have evidenced parent and professional reviewed content for an information resource, with embedded explanatory video showing real symptoms, focussing on the six most common presenting symptoms of childhood illness (temperature, breathing difficulty, dehydration, vomiting, diarrhoea and rash). See the video for an example of a video clip. This content has been converted into a rudimentary webapp, with the help of computer science students, and now needs to be further developed to make it ready to use. The ‘app’ uses ‘traffic lights’ colours to quickly indicate severity of symptoms, includes information on assessment and management of symptoms, an account option for each child, diary space for parents to record events, links to information on services. Without an account parents choose the age of the child and all of the information is then tailored to the age of that child.

The development process will involve:

·         Project setup to include environment creation, package installation, PhoneGap configuration

·         Templating and styling such as page templates, icons, splash screens, wireframing and page layouts/navigation structuring

·         Creation of navigation logic

·         Application build and content input

·         Testing on iOS and Android devices

·         Two feedback cycles and one final review

·         Deployment to Apple Store and Google Play, certificate generation

At each stage the content and format will be reviewed by parents and professionals. We have an existing parent panel composed of parents with children under 5 years of age who have helped us to develop the content so far. We also have a panel of health professionals who are interested in helping to review the tool as it develops.

The benefit for children, families and health professionals

Our vision is for a safety netting resource, showing real symptoms, which is easily accessible for free by parents and professionals across multiple platforms, in all first contact settings such as urgent and emergency care, General Practice, Out-of-hours, ambulance services and independently by parents. Developing this intervention through collaborative co-design, with parents and professionals, means that it is designed to meet their needs: consistent information, professionally validated, presented in a format and language they can understand.

Providing parents with this information will empower them to care for their child safely at home, provide information without needing an appointment and enable them seek help at the right time. The intervention has the potential to reduce morbidity and mortality through increasing recognition of symptoms and access to health care for seriously ill children.

The benefit for the Q community

We will be able to share our experiences of co-developing interventions for the public using the deliberate involvement of both services users and health professionals. Although we work with parents of young children, the methodological learning will be applicable to any situation where interventions are being developed for carers and vulnerable service users and more generally with adult service users.  

How you can contribute

  • Information and ideas to inform integration of our intervention into service systems such as NHS 111 and ambulance services.
  • Suggestions for systems to use to link parents use of our ‘app’ with health service use.
  • Ideas about the best way to deliver the ‘app’ to parents.
  • We would like to ask Q members to join our health professional review panel.

Comments

  1. Agree with the other comments, great idea as it can be truly frightening being a parent in the middle of the night with your unwell child and builds on the great work done locally by West of England AHSN with NEWS and raising the profile of sepsis.

  2. Fantastic idea! This will come in really handy (and links directly to our work)

    1. Many thanks for your support Thomas. Much appreciated. Best wishes Sarah

  3. Many thanks Sebastian. Your support is much appreciated.

    Best wishes

    Sarah

  4. Great idea!

    The future of healthcare will be co-produced and families will provide primary care (supported by tech). We can already see this in banking, retail and other industries that have undergone digital transformation

    Happy to support and help

  5. Hi, I'm very happy to link this into our local learning system for the Maternal & Neonatal Health Safety Collaborative (good suggestion Anna). You may find this guide useful for planning co-production? http://uclpstorneuprod.blob.core.windows.net/cmsassets/DIY%20Health%20Toolkit%20-%20October%202015.pdf

    1. Hi Nathalie

      Many thanks for the offer of linking. Great idea. I hope we will be successful in securing this funding so we can develop what we now have into a launch ready app. Many thanks for sending the link to the DIY project. Monica Lakhanpaul who led it is on our team. She will be delighted that the guide is being shared!

      Best wishes

      Sarah

  6. Like the idea could the app cover allergic reactions anaphylaxis ?

    That could present in different ways  in children for food  more resp  symptoms than but as the UK has the highest figures allergy in Europe might be worth  considering its also multisystemic so linking GI ,skin ,resp etc could be done.Could link in via the redbook as a link ?   links on gumtree lots people look there, local pharmacy support

    1. Hi Elizabeth. Yes we have included anaphylaxis. As the app is focused on symptoms rather than diagnoses it provides parents with information about symptoms of anaphylaxis such as difficulty breathing and rash. The aim is to provide a tool which enables parents to learn about the severity of symptoms and to use this information to inform their decisions about when to seek help.

  7. Great idea! Could you promote through We Midwives and also through the national maternity patient safety collaborative?

    good luck

    best wishes

    Anna

    1. Hi Anna

      That sounds like a great idea. Thank you!

      Sarah

    2. Anna, thanks for this suggestion a great idea

  8. Guest

    Sarah Bridges 2 years, 9 months ago

    Have you seen HANDi Paediatric?

    1. Hi Sarah

      Yes we have seen the Handi app - in fact I think we spoke during the development of the app (unless my memory is failing me!). What we have a rudimentary version of will I think compliment the Handi app as it provides parents with an opportunity to see symptoms for real.

  9. Great idea - marketing, keeping it up to date,etc will be key. Would be good to link with UK Sepsis Trust if not already done so and Patient Safety Collaboratives National Deteriorating Patient Workstream - Alison I know you are already well engaged with this.

    With so may apps out there we need to find a way to highlight those that are endorsed by NHS and signposted on NHS Choices - not sure how the NHS England apps library is going? https://www.england.nhs.uk/blog/apps-library-is-advance-for-a-digital-nhs/

    1. Hi Jo. Yes the updating will be so important. We are linked in with UK Sepsis Trust and a few others too, especially WellChild who have founded some of our prior work. We are hoping we will be able to have the app approved for the app store too.

  10. Hi team excellent idea.

    "Suggestions for systems to use to link parents use of our ‘app’ with health service use" - since all parents of children under 5 have a 'red book' could it low tech and parents enter the hospital number into the app and DOB?

    Delivery of the app I'd assume via android and apple App Store. Ideas for raising awareness of where to go to download; NHS choices website, inclusion of info in hospital bounty packs (? still given), health visitors & children's centres (where still available) as they often support more vulnerable parents, tv ad (maybe get a sponsor to fund), allow all trusts to put a link on their webpage to the app download, info given to parents after any hospital admission, posters in GP surgeries etc. Social media I'd suggest targeting all major platforms eg Facebook, instagram.

    best of luck

    clare

    1. HI Clare. Great ideas - all good places to get information to parents. We hope that NHS Choices will approve it for use and make it available via their website. Love all this other ideas too!

  11. Guest

    Susannah Pye 2 years, 9 months ago

    This is a really great idea. Nurses, midwives and junior doctors are a good place to start for promotion, especially as they can advise parents to download the app as they give safety netting information in A&E/clinic/GP practice/baby check. Thinking slightly outside the box, how about approaching Dr Raj, or asking Blue Peter or Newsround to do a review? Older children/siblings might nudge parents to download the app too.

    1. Thank you for the ideas Susannah. We were involved in the development of the NHS Choices short film on spotting sepsis last year and Dr Raj was out talking 'head' for that so already a link there. Good to think about asking him to help with this.

       

  12. Looks like a great idea. Happy to input from N Ireland Paediatric Collaborative

    1. Hi Sarah

      the collaborative is multiprofessional in nature and has input from Medical, Nursing, Pharmacy and AHP along with managers. We have developed our own regional PEWS chart and are in the process of revising this. I think there would be a good interest to be involved in any app development

      please keep in touch

       

      Levette

    2. Hi Levette. Many thanks for the positive feedback and for supporting us! would be great to have input from the NI Paediatric Collaborative. Please could you let me know the nature of the membership? Is it all Paediatricians or are there other interested professional or other groups as well? Looking forward to hearing from you. Sarah

  13. Excellent idea. You could promote the app by engaging with couples in NCT classes and social media such as Net Mums / Mumsnet.

    1. Many thanks for the suggestions Lucie. Do you have any ideas about which social media groups are best for engaging with families from lower income groups?

      Best wishes

      Sarah

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