Evaluation of the PATCH nursing service: partnership and training supporting children with complex needs at home

Abstract

The PATCH project was an intersectoral initiative between health, social and education services in Lanarkshire, Scotland which provided support at home from two experienced children's nurses for parents of children with complex disability. The project was funded by the Scottish Executive Health Department Innovations Fund for Children's Services for two years from April 2000. This article reports results of an external independent evaluation of parents' and agency members' perceptions of the PATCH service. Audiorecorded interviews were obtained from members of eight families and eight agencies. Issues related to the two key aspects of support addressed in the project, carer training and partnership working, are presented. The skilled approach to training adopted was successful in creating a network of carers, both lay and professional, which resulted in improved respite and rest for parents. Effective partnership working resulted in improved communication, the development of an innovative child record, effective help in crises and improved service co-ordination. Together, the training and partnership elements of the PATCH service addressed practical, emotional and social dif. culties experienced by families. The freedom to work flexibly and to approach agencies directly and the ability to cut across established organizational structures were significant factors in improving support for families. A number of key aspects of nursing expertise and possible outcome indicators for such a service are presented.