The Respiratory Surge in Children programme aims to support the national NHS workforce to manage:

• existing demand in children
• potential future spikes in paediatric demand as a result of respiratory syncytial virus (RSV) and other respiratory illnesses in children
• longer-term increasing paediatric acuity and demand in children

• provide engaging and informative content through a digital modular education programme
• promote widespread accessibility and inclusivity through multi-channel delivery
• accommodate different skill requirements across all care settings (home, primary and community care and hospital care) through carefully curated content
• optimise workforce and training innovations
• summarise roles and essential skills required for the NHS workforce to function in a surge model in paediatric care settings through a national digital skills passport

The programme was led by users with both the healthcare systems and future learners actively involved in every stage, from development to delivery. We worked with the Paediatric Critical Care Society (PCCS) and the Paediatric Critcal Care Operational Delivery Networks (ODNs) to ensure programme response to different needs across the nation.

Our aims were achieved through 4 key phases, supported by robust governance and assurance:

1. Understand
   – care standards and competency frameworks (for example, RCPCH, RCN / NMC)
2. Develop
   – co-development of an interprofessional skills matrix that summarises key skills required for different levels of care, with mapped educational resources
   – curation of existing educational resources for learners, trainers and systems onto this elfh microsite, for different levels of care and settings where children are cared for
   – co-design of a national digital skills passport
3. Deliver
   – dissemination of educational resources and digital skills passport at a national level
4. Refine
   – implementation of a feedback mechanism, to enable continued refinement

Paediatric standards for levels of care and competencies have been aligned to:

• High Dependency Care for Children – Time to Move On: A focus on the critically ill child pathway beyond the Paediatric Intensive Care Unit (Royal College of Paediatrics and Child Health, 2014)
  – Appendices: High Dependency Care – Time to move on
• Quality Standards for Care of Critically Ill Children 5th Edition PICS 2015

The content is matched against Royal College of Paediatrics and Child Health (RCPCH), Royal College of Nursing (RCN) and Nursing and Midwifery Council (NMC) professional competencies to aid presentation for revalidation and appraisal.

The Respiratory Surge in Children programme houses free, open access resources.

In order to access the Respiratory Surge in Children programme, you will need an elfh Hub account. If you do not have one, then you can register by selecting the Register button below.

Register >

To view the Respiratory Surge in Children programme, select the View button below. If you already have an account with elfh, you will also be able to login and enrol on the programme from the View button.

View >

Registering large numbers of users

If you are a HR, IT or Practice Manager and would like to register and enrol large numbers of staff within your organisation for access onto the Respiratory Surge in Children programme, please contact elfh directly.

More information

Please select the following link for more information on how to use the elfh Hub.

You can add this programme page on your phone by accessing your browser settings or share settings and selecting “Add to Home Screen”. Please note steps vary between devices. On an iPhone tap the “share” icon  and then “Add to home screen”.

You can add the searchable index web app to your phone home screen by opening it on your phone, accessing browser settings/share settings and selecting “Add to Home Screen”. Please note steps vary between devices and browsers. On an iPhone tap the “share” icon  and then “Add to home screen”.

This domain provides resources that enable healthcare providers and carers across all settings to use a systematic approach to identify deteriorating infants and children. Children with respiratory or circulatory failure become hypoxic and acidotic. Early recognition and treatment of respiratory and circulatory failure can prevent progression to severe illness.

Take me to the Respiratory Surge in Children programme

This domain outlines the pathophysiology, signs and symptoms, and recommended treatment for children with respiratory disease being cared for in various settings including viral bronchiolitis. Most cases of viral bronchiolitis are due to respiratory syncytial virus (RSV). While self-limiting, bronchiolitis can be life-threatening in infants who were premature or have underlying respiratory, cardiac, neuromuscular or immunological conditions.

Looking for resources on respiratory support? Head over to Domain 3 ‘Non-invasive respiratory support’ for all our resources pertaining to oxygen therapy, high flow/high velocity therapy, CPAP/BIPAP, and all things long-term ventilation and tracheostomy related.

Take me to the Respiratory Surge in Children programme

This domain contains resources related to all types of respiratory support, and is organised in a step-wise approach (nasal cannula- face mask- high flow/ high velocity oxygen therapy- acute CPAP/ BiPAP plus tracheostomy and long term ventilation resources).

There are multiple, widely used abbreviations for high flow therapy or high velocity therapy, with little consensus. For clarification, the Respiratory Surge in Children programme refers to these devices as “high flow/ high velocity therapy” to encompass the wide range including specialist devices and ventilators that can provide this support. All can be used with or without oxygen. You may also see these devices referred to as heated humidified high flow therapy (HHHFT), high flow oxygen therapy (HFOT), high flow nasal cannula (HFNC) or simply high flow. These are all referring to same devices, unless otherwise stated.

Take me to the Respiratory Surge in Children programme

This domain provides guides to support safe management of medications for sick children, including opportunities to practice calculations. This is relevant for both paediatric and adult trained staff across a variety of settings. It also includes essential information on physical and psychological differences between adults and children, and critical variations in physiology which are important to understand in all contexts, including when prescribing.

Take me to the Respiratory Surge in Children programme

Family centred care is central to the provision of healthcare for any child in the UK. This domain describes how family centred care is practiced, what this means for those providing care, and essential communication techniques when working with a hospitalised child and their family. This section also explores key information about safely discharging patients, safety netting and approaching conversations about the COVID-19 vaccination in pregnancy.

Take me to the Respiratory Surge in Children programme

Parent / Carer Information Leaflets
This section also contains printable information leaflets for healthcare professionals to share with parents/carers on looking after a child with respiratory illness both in primary care settings and in/on discharge from hospital.

All children’s acute care providers must be able to appropriately assess, treat, stabilise and escalate all critically ill children, including those requiring transfer, to a level 3 unit internally or externally. This domain includes resources to support safe delivery of advanced stabilisation of the critically ill child, covering recognition, monitoring, treatment, escalation and use of transfer equipment as well as regional drug calculators.

The Stabilisation of a Child prior to transfer with a Paediatric Retrieval Team elearning package, developed in collaboration with Embrace, provides a comprehensive introduction to this learning domain through videos and a 180 interactive image.”

Take me to the Respiratory Surge in Children programme

Helpful links: UK Paediatric Transport Networks

1. Scotland Specialist Transport and Retrieval (ScotSTAR)
2. North East Children’s Transport and Retrieval Service (NECTAR)
3. Embrace: Yorkshire & Humber Infant & Children’s Transport Service (Embrace)
4. North West and North Wales Paediatric Transport Service (NWTS)
5. Wales and West Acute Transport for Children (WATCh)
6. West Midlands Kids Intensive Care and Decision Support and Neonatal Transfer Service (KIDS & NTS)
7. Children’s Medical Emergency Transport Service (CoMET)
8. Children’s Acute Transport Service (CATS) | Educational videos from the North Thames Children’s Acute Transport Service (CATS)
9. South Thames Retrieval Service (STRS)
10. Southampton Oxford Retrieval Team (SORT)
11. East of England Paediatric and Neonatal Decision Support & Retrieval service (PaNDR)
12. Northern Ireland Specialist Transport and Retrieval (NISTAR) Paediatric

During patient surges staff may need to flex to support different areas. We have learned from other surges that the better prepared staff are in advance, the easier this is physically, emotionally and mentally.

It is important we check in with each other regularly, so these resources are designed to help us all have honest conversations, defuse and connect with colleagues. Not all people approach wellbeing by the same means; these resources acknowledge those differences and cover a variety of approaches.

Take me to the Respiratory Surge in Children programme

The Royal College of Paediatrics and Child Health (RCPCH) have collated wellbeing materials from across the country.

The Staff Recovery Resources page, curated by the London Transformation and Learning Collaborative, houses resources that were created to support healthcare staff recovering from the COVID-19 pandemic.

Resources cover a range of topics including, developing wellbeing conversations, creative storytelling, moral injury and negotiating brave conversations.

• Adult Critical Care programme
• Digital Skills Passport (project ended)
• Children and Young People with Mental Health needs in Acute Settings

• Julie Combes, Programme Lead
• Lydia Lofton, Governance and Implementation Lead
• Kathy Brennan, Governance and Implementation Lead
• Libby Thomas, Education Lead
• Ella Nuttall, National Skills Passport Strategy and Implementation Lead
• Kulwant Sindhar, PMO Lead
• Chloe Black, Multiprofessional Content Curation and Design
• Francesca Wright, Multiprofessional Content Curation and Design
• Jennifer Broadbent, Multiprofessional Content Curation and Design
• Joanne Broadhurst, Multiprofessional Content Curation and Design
• Laura Lowndes, Multiprofessional Content Curation and Design
• Pooja Bharucha, Multiprofessional Content Curation and Design
• Stacey Bedford, Paediatric Digital Skills Passport Clinical Lead
• Timothy Hunt, Digital Content Creation and Configuration Lead
• Tania Shetty, Project Manager
• Jennifer Yeboah, PMO Support Officer
• Christine Strickett, PMO Support Officer
• Frankie O’Brien, elfh Project Manager
• Bob Smith, elfh Platform Delivery Lead
• Hannah Denness, elfh Communications Officer