The baseline assessment tool for NG61 was applied to our own organisation (Helen & Douglas House), as well as to partner organisations within Thames Valley Paediatric Palliative Care Network, comprising NHS services and third sector charities.
We identified areas for improvement specific to our own service, as well as those that would be best tackled as a regional network (either by the use of referral pathways or joint working on developing written resources for patients). We were able to demonstrate improved compliance between the assessments at Helen & Douglas House conducted in March 2017 and October 2017 (from 84% to 90%).
We now plan to use our learning to support other organisations in the region to adapt their own internal processes by sharing examples of good practice, such as care plans, symptom assessment tools and referral pathways. Our data has also been submitted to Together for Short Lives, who are mapping a national picture of the baseline assessment outcomes for NG61.
This guideline covers recognising and diagnosing autism spectrum disorder in children and young people from birth up to 19 years. It also covers referral. It aims to improve the experience of children, young people and those who care for them.
In December 2017, we reviewed the evidence and added ADHD as a factor associated with an increased prevalence of autism and changed references from DSM-4 to DSM-5.
This guideline covers recognising and responding to abuse and neglect in children and young people aged under 18. It covers physical, sexual and emotional abuse, and neglect. The guideline aims to help anyone whose work brings them into contact with children and young people to spot signs of abuse and neglect and to know how to respond. It also supports practitioners who carry out assessments and provide early help and interventions to children, young people, parents and carers.
Clinical features of abuse and neglect (including physical injury) are covered in NICE’s guideline on child maltreatment. Recommendations relevant to both health and social care practitioners appear in both guidelines.
The technology described in this briefing is Thora‑3Di for assessing respiratory function in children with asthma.
The innovative aspects are that the measurements are taken non-invasively without the need for special breathing manoeuvres, and provide information on right-versus-left lung function.
The intended place in therapy would be instead of spirometry in secondary care in children for conditions such as asthma.
The main points from the evidence summarised in this briefing are from 5 prospective, observational studies including a total of 129 patients and 139 healthy controls (young people and children) in secondary care. They show that Thora‑3Di may be as effective as spirometry in assessing asthma respiratory parameters in children and young people.
Key uncertainties around the evidence or technology are that it is not clear which of the breathing parameters measured by Thora‑3Di are specific to assessing asthma, and that there is limited evidence comparing these measures with spirometry.
The cost of Thora‑3Di is £25,000 per unit (exclusive of VAT). The resource impact is unclear, but using the device could save costs through quicker testing.
A dipstick test offers a quick and painless way to check a child’s urine for signs that their body is fighting an infection.
NICE says children between the age of three months and three years should not be given antibiotics if their dipstick test is negative.
Children over the age of three years may need to be given antibiotics if their urine dipstick analysis shows mixed results and they have other obvious symptoms of a UTI (for example painful urination).
Children under three months of age who are suspected of having a UTI should not have a dipstick test. They should be referred to paediatric specialist care and their urine sent for urgent laboratory analysis.