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What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?

During the start of the coronavirus pandemic a virtual space was set up a bringing together key stakeholders to help identify innovative ways to facilitate rapid discharge of children with complex medical needs.

Building on this we recognise that staff with skills that cross stakeholder boundaries can facilitate understanding & refining of complex processes that can slow down the discharge of a child with complex needs.

We would like to trial the presence of an innovative role that would be able to cross the boundaries between health, social care & housing sectors to aid in the facilitation first discharge to an acceptable & safely modified location.

What does your project aim to achieve?

We would like to showcase how a health professional, by learning about the processes & language of other agencies and developing relationships with partner stakeholders is able to demonstrate upstream impact on length of stay & quality of healthcare journey in this setting.

How will the project be delivered?

The pilot project would involve recruitment of a band 7 occupational therapist to the current team facilitating discharge of complex patients.

Occupational Therapists are a unique professional group who can work across all sectors of health and social care as well as within third party agencies. They are dual trained for physical and mental health and have a core skill set based on a foundation of holistic assessment which makes them ideally suited to working across a variety of systems and services.

There would be an initial plan of secondment to key stakeholders areas followed by planned focus groups with children with complex medical needs, families and staff around the child to identify areas where this aspect of the journey could be improved.

Data around this is already being collected. In addition the patient story is planned to be captured with further focus groups & qualitative feedback from children, families and staff.

How is your project going to share learning?

Children with complex medical needs are a small but growing group who are high healthcare users. The level of complexity in their care is unparalleled in modern medicine due to the three or four way interaction between healthcare professionals, the child & the caregivers.

Their journey as inpatients is often long & tortuous. Their movement home is often dependent on processes external to health that are constantly changing in & of themselves.

By understanding the blueprint of how we can bridge gaps between agencies we can identify & quantify the impact we can make with this investment for this vulnerable & often invisible group of healthcare users.

How you can contribute

  • Any knowledge and advice around what has worked and suggestions for modifying the bid.

Plan timeline

22 Mar 2021 Funding approved and recruitement
1 Jun 2021 Appointment for 1 year
2 Jun 2021 Secondment to key areas
1 Aug 2021 Starting to look at processes
1 Jan 2022 Starting qualitative data collection
1 Mar 2022 Analysis of quantitative data
1 Jun 2022 Completion of project with subsequent presentation


  1. Important project to do - Children with Medical Complexity are an important group who can really be helped with joined up holistic working. Do you have any pilot LOS data about the magnitude of the problem?

    Good luck!

    1. Thank you Yincent!

      My team & I have been working on improvement for this group of children for over 5 years. I think LOS is sometimes too crude to unpick the problem. We did some work with stakeholders including YP & families a few years ago which split it up (see picture). We have used this to develop a toolkit presented at RCPCH this year (link below).
      We know this is a common & growing problem in the UK. We did a FOI survey of all paediatric units which highlighted this (oral presentation at RCPCH this year).

      We are hoping with this funding we can show improvement with a role that spans 3 of the CANVAS swimlanes and most importantly looks at joining up working between health, social care & housing.

      Will consider your comment in adapting this application! Thank you for taking the time to comment.

      Stay safe!


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