A tool to estimate nurse management hours for commissioners of children's continuing care packages.

Children and young people may be eligible for continuing care at home where their healthcare needs cannot be met solely through existing universal or specialist services. Those assessed as eligible receive a bespoke package of care which may be overseen, managed and coordinated by community children's nursing teams, and which requires a significant amount of nurse management time. This article discusses the provision of continuing care in England and the importance of including adequate nurse management time in commissioned care packages. The author describes the development of a tool by the community children's nursing team in Warwickshire, England, designed to quantify nurse management time based on data from the continuing care assessment decision-support tool, direct care hours and number of competencies required to provide safe care. The outcome, in the form of weekly nurse management hours, is then recommended to commissioners for inclusion in the commissioned care package. Local audit data suggest that the tool can estimate effectively the required number of weekly nurse management hours, particularly for larger care packages. The team has secured positive changes in the commissioning of nurse management time for existing and new patients on its caseload.