Hospital service form
A separate hospital services questionnaire needs to be completed for each of the hospitals
within your trust providing a paediatric service (inpatients, short stay paediatric assessment
unit (SSPAU), neonatal care or tertiary services). You do not need to include hospitals which
only have some paediatric outpatient clinics or an emergency department which sees
children.
The hospital services questionnaire is concerned with basic information such as whether
paediatric in-patient services are provided, the level of neonatal care, the existence of
dedicated paediatric emergency departments and SSPAUs.
1. Hospital information
* denotes required field
1.1. Unit/hospital name *
1.2. Inpatient service? *
Yes
No
1.3. Outpatient service? *
Yes
No
2. Neonatal care
2.1. Level of neonatal unit *
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2.2. Number of days of Level 1 care provided (full intensive care provided
between 1st January to 30th June 2013 - 6 months)?
2.3. How many times has the neonatal unit had to close to new admissions in
the year prior to 30th Sept 2013 due to shortages in nurses and/or doctors?
3. Emergency departments
3.1. Are children seen in the emergency department? *
Yes
No
3.2. Are children seen in a dedicated paediatric emergency department? *
Yes
No
A dedicated emergency department is one with separate waiting, assessment and treatment
areas for children.
4. Short stay paediatric assessment unit (SSPAU)
4.1. Does the unit have a SSPAU? *
Yes
No
4.2. Total hours SSPAU open per week
4.3. Where is the SSPAU located?
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5. Consultant of the week
May also be called “physician of the week” or “hot week”
5.1. Do you operate a consultant of the week system in general paediatrics?
Yes - operating 7 days a week
Yes - operating less than 7 days a week
No
Not applicable
5.2. Do you operate a consultant of the week system in neonates?
Yes - operating 7 days a week
Yes - operating less than 7 days a week
No
Not applicable
5.3. Do you operate a consultant of the week system in general/neonatal combined?
Yes - operating 7 days a week
Not applicable
Yes - operating less than 7 days a week
No
5.4. Are the service consultant's clinics cancelled during the consultant of the week
period?
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6. Staffing
6.1. Are general practitioners employed to work within the hospital setting? *
Yes
No
6.2. Are physician's assistants employed to work within the hospital setting? *
Yes
No