Making specialist nurses fill rota gaps is a ‘false economy’

Without adequate support, families often feel they have little choice but to take children to hospital at the first sign something is wrong.

Chloe Dawson
29 June 2018
specialist nurses

Specialist nurses are avoiding costs for their Trusts by developing innovative services that keep children with epilepsy out of hospital.

Advice lines and support for families, schools and young people, home visits and specialist clinics make managing conditions such as epilepsy easier for children and those who care for them.


Yet as the nursing shortage continues to bite, managers often think that specialist nurses can be moved to fill rota gaps, but this is a false economy as it deprives patients of their expertise and leads to unintended consequences, claims the Royal College of Nursing.

Not only is this bad for patients, but it could also be putting pressure on other parts of the health and social care system, as well as schools.

Epilepsy can be extremely distressing for children.

Without adequate support, families often feel they have little choice but to take children to a hospital at the first sign something is wrong.

But specialist nurses such as Kirsten Johnson are pioneering ways of helping families manage epilepsy that cause less distress and disruption for children and parents.


Kirsten, who works at Sherwood Forest Hospitals NHS Trust, provides the first point of contact for families with children suffering from epilepsy, giving them access to the support they need to avoid hospital visits.

As part of an RCN leadership development programme, Kirsten undertook an economic assessment of her service which allowed her to demonstrate the value of her role to the trust.

A hotline service she set up to offer parents, young people, carers and schools immediate expert guidance now receives more than 1,200 calls and almost 2,000 texts per year. This alone has freed up almost £85,000 worth of resources in just one year. The hotline allows her to offer help when people need it most, and Kirsten’s timely advice means more episodes can be safely managed outside hospital.

Home visits offer another direct line of support to worried parents, and specialist clinics allow Kirsten to monitor medication and make sure it’s being administered correctly.


Closely managing epilepsy in this way helps to prevent distressing seizures, so Kirsten’s young patients can avoid as many emergency hospital visits.

When patients do have to go to hospital, Kirsten visits them on the wards to let them know about her specialist service and see if they need help.

The condition can be managed.

Kirsten Johnson, a specialist epilepsy nurses at Sherwood Forest Hospitals NHS Trust, said:“Epilepsy can be extremely frightening for children and their parents and often causes a huge amount of distress.

“But it is a condition that can be managed. If parents, schools and carers have specialist help just a phone call away, offering both reassurance and practical help, it gives them the information and confidence to care for a child with epilepsy effectively.

“I really enjoy my job, and seeing the difference it makes to children, young people, their families and the Trust is very gratifying.


“My role is an essential part of the epilepsy service here and would and like to see similar roles in as many Trusts as possible.”

Dr Ann McMahon, research and innovation manager at the RCN, said: “We know specialist nurses play a vital role in managing many conditions such as epilepsy, but this study has revealed the enormous benefits they bring not only to patients, but to the trusts they work for and the wider economy.

“It shows that investment in specialist skills could ease pressure on multiple parts of our health and social care system as well as offering better outcomes for patients.

“By empowering specialist nurses to demonstrate the value of their services in this way, we are in turn helping to secure and develop services for children and their families enabling them to live as full and independent lives as possible.”

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