Hospital at Home, referral guidance and service information

• Any child that would otherwise require an acute hospital bed can be considered for the virtual ward. 

• Care is delivered across two pain pathways: 

• Support pathway - (Does not include remote monitoring) 

• Monitoring pathway - (Includes remote monitoring) 

• Care is tailored to the child and may include remote consultations, home visits and face to face reviews. 

• Children are admitted to the Medical Paediatric Virtual Ward on Trakcare (add to your ward preferences by searching ‘VIRTUAL Ward Medical Paediatrics’.  

• A nursing handover for the Virtual Ward will be printed in the CDU doctors office. 

• The Virtual Ward nursing staff operate 8am - 8pm Monday to Sunday. Planned reviews will usually be made during these hours.  

• Outside of these hours, families are given the telephone number for the on-call medical team.  

• Families on remote monitoring pathways are advised not to perform observations or submit readings overnight.  

• Clinical support out of hours will be provided by the on-call medical team. 

• The CDU medical consultant will perform a board round of all patients over the weekend. 

• All children should first meet the primary referral criteria. 

• A traffic light approach should then be used to identify suitable children.  

• See the ‘Common conditions and interventions’ section below for example scenarios which may include specific eligibility criteria.  

• At present, referrals from ED and primary care should be reviewed by a member of the medical paediatric team. This will be reviewed moving forwards.

• Currently, all children on monitoring pathways require medical paediatric consultant review prior to admission to the virtual ward.  

• Well children referred for repeat investigations or intervention can be considered once they have been discussed with the responsible consultant. 

• If this occurs out of hours and the child is medically well then they can be discharged and discussed at the morning handover.  

• Routine medical paediatric care of specialty patients can be provided by the medical paediatric team. (e.g. establishing NG feeding, Faecal impaction) 

• Specialty specific care should still be managed by the specialty team. 

• These patients should be discussed with the H@H consultant at the time of referral. Consultant admitting responsibility will be decided on a case by case basis but will usually remain with the referring team.  

• Call the H@H team to discuss these patients (84467).  

• Introduce the concept with the family. 

• 8am - 8pm - Call the H@H nursing team 0141 452 4467 (84467) 

• Children admitted by the medical team out of hours should be discussed with the H@H nurses in the morning. Place these children on the CDU handover.  

• Complete the Hospital at Home referral form for all referrals. 

• For common conditions, families will be given a Patient Held Plan which outlines the goals for care on the ward.  

• Clinical care should follow the appropriate local or national guideline.  
• This list is not exhaustive, and other referrals will be considered. Call the Hospital at Home nursing team to discuss: 

Please note that this list is evolving and further Patient Held Plans will be added. 

Patient information resources

• Patient information leaflet <LINK>
• H@H contact information <LINK>
• Patient declaration <LINK>
• Patient feedback form <LINK>

• To attend medical handovers (CDU & 2C) to identify other appropriate patients.  

• To process referrals including issuing Patient Held Plans (PHPs) and patient information resources. PHPs should be discussed with the admitting medical team. 

• Ensure all eHealth processes are completed. 

• Conduct day to day nurse lead care on the virtual ward.  

• Review and manage the Doccla dashboard. 

• Escalate any concerns to the appropriate medical team. 

Currently, dedicated medical cover is provided from 1pm - 5pm on most week days. 

• Conduct a daily board round with nursing staff.  

• Perform any planned medical reviews. Respond to any unplanned reviews.  

• Ensure discharge letters are completed at the time of discharge from the H@H service.  

• Ensure inpatient discharge letters are completed at the time of transfer to the H@H service. 

• Respond to any concerns from families or the H@H nursing staff. Document any remote consultations on Clinical Portal.  

• Support with any unplanned attendances when no member of the H@H medical team is available. 

• The CDU medical consultant will perform a board round of all patients over the weekend. 

• Children should be admitted under the referring medical paediatric consultant.  

• Clinical care and planned medical reviews will usually be conducted by the H@H medical team. If the child is admitted from an outpatient clinic, then ideally this should be with the named clinic consultant (where possible). 

• Any clinic follow up required will usually be with the admitting medical paediatric consultant. This will be discussed on an individual basis.  

• Any child on a remote monitoring pathway should be added to the bottom of the CDU handover.  

• The H@H nursing team will print a copy of the H@H handover each evening and place in the CDU doctors office. 

• The virtual ward patient list can be found by accessing the Virtual Ward on Trakcare (add ‘VIRTUAL ward Medical Paediatrics’ to your preferences). 

• Clinical details of all children on the virtual ward can be found in the patient notes section on Clinical Portal.