Background The number of children and young people with Long Term Ventilation (LTV) needs accessing hospice services continues to increase. This paper outlines the provision of a hospice-led LTV service initially by specialist nurse roles, evolving further with the development of a novel senior care assistant role (SCA).

The LTV service From April 2020 to February 2021 the LTV service supported 68 children and young people with level 1, 2 or 3 ventilation needs, children and young people with a tracheostomy and those with complex respiratory care needs. The service supports discharge planning, coordinates care outside of hospital, provides specialist clinical education for families and professionals and has supported care at end of life for LTV children and young people. Care is overseen by two clinical nurse specialists (CNSs), two LTV nurses and two SCA. Full theoretical and practical training is in place with education cascaded by specialist team and tailored to individual hospice staff needs.

SCA role development The development of the SCA role was perceived as innovative and cost effective way to support the CNS in delivery of LTV care as the caseload and complexity of LTV children and young people developed. From April 2020 to February 2021, SCAs spent 69% of their time on clinical tasks, 17% teaching and 8% on practice development. Key elements of the SCA role (with CNS oversight) are:

• Teaching/training/mentoring nurses and care assistants. Training and supporting families.

• Developing child specific portfolios.

• Advocating for children and young people in MDTs and professional liaison.

• Sourcing equipment.

• Assessment of stable and unstable children and young people, planning and evaluating care.

Conclusion Developing this innovative SCA role has ensured patients receive increased professional contact, enabled their own personal professional development and makes best use of the organisation’s available workforce in a cost effective way. The SCA acts as role model, demonstrating that safe and effective care is possible with the introduction of a skill mix for children and young people with LTV needs in the region.