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Seriously ill children face 'post code lottery' for out of hours care

Seriously ill children face 'post code lottery' for out of hours care

Children with serious and terminal illnesses face a postcode commissioning lottery, meaning they are missing out on out of hours care and support, according to a children’s charity.
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Children with serious and terminal illnesses face a postcode commissioning lottery, meaning they are missing out on out of hours care and support, according to a children’s charity.

Together for Short Lives asked CCGs and local authorities about the care packages they offer to children who need palliative care. It said: ‘Children’s commissioning in England is patchy and inconsistent.’ 

A spokeswoman for NHS Clinical Commissioners said CCGs were ‘working hard to make sure that children receive the palliative care they need’ but had to make tough choices about allocating funds.

'Major descrepancies'

Fewer than half the CCGs and under a quarter of local authorities assess how many children in their area need palliative care and their requirements, according to the charity. Only 4% of CCGs provided the number of seriously ill children in their area.

Researchers found that 46% of CCGs are not following government policy to prioritise children’s palliative care in their strategic planning.

The research also highlighted a ‘major discrepancy’ between weekday 8am to 6.30pm care and out of hours services and said that commissioners were failing to plan and support 24/7 care for sick children.

Just 29% of CCGs commission out of hours community paediatricians, despite 64% offering weekday services. While 93% have community children’s nursing teams in core hours, only 67% provide them out of hours.

The charity also found that fewer than a third had adopted National Institute for Health and care Excellence (NICE) guidance on ‘End of life care for infants, children and young people with life-limiting conditions: planning and management'.

Just over a quarter said their plans were ‘in development’ whilst 29% are already commissioning a palliative care team which meets the NICE guidance.

'Postcode lottery' of bereavement care

The charity highlighted a ‘postcode lottery of bereavement care across England for parents whose child has died.’

Nearly one in five do not commission bereavement support and nearly half have no out of hours offering. Voluntary sector children’s palliative care is only commissioned by 22% of CCGs.

Just one in six commission age and developmentally appropriate services, according to the report  

The NHS Clinical Commissioners spokeswoman added: ‘It has to be acknowledged that they are doing this while working in a very challenging context, along with the rest of the NHS and care sector.

'Clinical commissioners have a responsibility to consider the needs of the whole populations they serve.

‘Given the growing population and spiralling demands on the NHS, this means commissioners are having to make really difficult decisions on a daily basis about how to use the finite funding they have been allocated.’

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