Specialist Healthcare Tasks

The existing Specialist Healthcare Tasks Service was jointly commissioned in 2003 to ensure that children and young people with identified medical needs access the community and enjoy the same opportunities as their peers. It is expected that the service will be provided to a range of staff working with these young people, including Special Educational Needs School transport providers, identified Essex Social Care staff, short break Foster Carers, Education staff supporting children with medical needs in local schools and settings; and workers supporting young people who access Essex short breaks.

The Specialist Healthcare Tasks Service should deliver good quality competency-based healthcare training, assessment and delegation to support workers in order to meet the bespoke care needs of children and young people that will enable them to access and attend a range of settings and make progress in education.

Staff delivering the training must have the appropriate clinical competence to train, assess and delegate delivery of healthcare tasks to support workers. All training, assessment and delegation should be underpinned by an evidence-based methodology and process which complies with all relevant professional standards. The provider of the service will also ensure there is a robust governance framework in which to deliver all aspects of this service.

(NB: this list is not exhaustive and will be reviewed regularly between provider and commissioners)

• Administering medicine in accordance with prescribed medicine, with pre-calculated dosage provided via naso-gastric tube, gastrostomy tube, orally or applied to skin, eyes and/or ears.
• Injections (intramuscular or subcutaneous). These may be single dose or multiple dose devices which are pre-assembled with pre-determined amounts of medication to be administered as documented in the individual child's care plan (preloaded devices should be marked when to beadministered e.g. for diabetes where the dose might be different am or pm. In many circumstances there may be two different pens, one with short acting insulin and another for administration at night with long acting insulin).
• Inserting suppositories or pessaries with a pre-packaged dose of a pre-prescribed medicine.
• Rectal medication with a pre-packaged dose i.e. rectal diazepam.
• Rectal paraldehyde which is not pre-packaged and has to be prepared - permitted on a named child basis as agreed by the child's lead medical practitioner i.e. Pediatrician or GP.
• Administration of buccal or intra-nasal Midazolam and Hypo Stat or Gluco Gel.
• Assistance with inhalers, cartridges and nebulisers.
• Emergency treatments covered in basic first aid training including airway management.
• Tracheostomy care for a stable stoma including suction using a suction catheter.
• Emergency change of a tracheostomy tube.
• Nasal or oral suctioning and nasal/oro pharangeal suction to a prescribed depth . This should be prescribed by a doctor, children's respiratory nurse specialist or a paediatric respiratory physiotherapist.
• Use of cough assist devices when prescribed as part of a respiratory care plan.
• Assistance with prescribed oxygen administration including oxygen saturation monitoring where required.
• Administration and care of liquid oxygen administration.
• Ventilation care for a child with a predictable medical condition and stable ventilation requirements (both invasive and non-invasive ventilation).
• Blood glucose monitoring and carbohydrate counting as agreed by the child's lead nursing/medical practitioner. E.g. GP, Pediatrician, Children's Diabetes Nurse Specialist.
• Bolus or continuous feeds via naso-gastric tube or gastrostomy.
• Bolus or continuous feeds using a pump via gastrostomy or jejunostomy.
• Intermittent catheterisation and catheter care.
• Supporting a child/young person to access a mitrofanoff.
• Stoma care including the requirement to maintain patency of a stoma in an emergency situation prior to seeking advice from the registered nurse.*

Please note this list is not exhaustive and only includes some of the most common clinical tasks which require competency training