Organizing home ventilation

The number of children and young people receiving long term ventilation continues to rise, with increasing survival from intensive care, improvements in equipment and changing attitudes towards providing respiratory support. These children are also now largely at home rather than in hospital. However for those who have complex problems and are most dependent on ventilation, discharge can be a slow, difficult and costly process. There are a number of barriers to discharge for this group of children, including professional attitudes, problems with commissioning and funding, and establishment of care packages, in addition to complex social issues and difficulties with housing. Good discharge planning starts at the outset of establishing a child on long term ventilation, and aims to overcome these barriers, facilitating discharge in a safe and timely manner. A full assessment of a child and family’s needs, having a discharge coordinator and working in partnership with the family and the agencies involved, are all key to the success of this process. Ongoing care after discharge must also allow for changes in a child’s needs and support for the family, including transition to adult services and end of life care planning where appropriate.