We are a multidisciplinary team made up of Specialist Children's Nurses, Dietitians, Community Matrons, Specialist School Nurses and a dedicated Transition Nurse.
Our team work in partnership with children and young people, their families, carers, schools, tertiary hospitals, primary care settings and community services to deliver expert care for children and young people with complex health needs.
We play a vital role in bridging hospital to home care. Ensuring children and young people's continuity of care is safe, compassionate and supportive in their everyday environments.
The service is offered to children and young people aged between 0-19 with acute and/or complex health needs who are either residents in Hillingdon or attend one of the Special Schools within the Hillingdon Borough.
The service is not available to patients with mental health issues, enuresis (bedwetting), or requiring home ventilation.
The team cannot provide a continence assessment or participate in continuing care assessments if the child or young person is not on our team caseload.
Our Paediatric Nurses provide care and support for children with a wide range of health needs, including:
- Skin conditions, like eczema
- Cancer care (oncology)
- Blood pressure monitoring
- Severe allergies (anaphylaxis) in children under five
- Enteral feeding support (tube feeding, nasogastric tube, naso jejunal tube or gastrostomy)
- IV medicines (such as antibiotics)
- Home oxygen support
- Central line care
- Palliative end-of-life care
- Tracheostomy care
- Wound management
- Training of nursing needs for patients, carers, schools' nurses, etc.
In addition, the team provides education and training for children, patients, families, carers, educational settings and respite care.
The team accepts referrals from GPs and healthcare professionals. Referrals can be made by completing a referral form and returning it by email.
Our service has two paediatric dietitians who support babies, children and young people requiring enteral tube feeding when they can not meet some, or all, of their nutritional needs by mouth. This maybe due to a wide range of medical and developmental feeding difficulties and special dietary needs.
The dietitians assess weight growth, nutritional requirements, feed tolerance then tailor personalised feeding plans for each child and young person. They also provide ongoing monitoring and support families after tube placement and work closely with the wider multidisciplinary teams to ensure each child receives appropriate nutrition.
The Dietitians understand the complexities of enteral feeding tubes and supplies, ensuring safe and easy feeding. Liaising with GPs and delivery services to coordinate ordering of equipment and feed to the home. Referrals to this service can be made by completing a referral form and returning it by email.
Our Hillingdon Transition Service supports young people aged 14-19 with learning disabilities, complex health needs, or those leaving care as they move into adulthood.
The Transition Nurse works alongside the Children’s Community Nursing Team and the Children’s Looked After Team to help young people understand and manage their health needs. They also liaise with families, carers, GPs, social workers, teachers and hospital teams to ensure a smooth transition to adult services.
The Transition Service can:
- Liaise with other health professionals
- Support or assist children and young people at health appointments
- Offer support after hospital visits or admissions
- Help you understand your health conditions
- Signpost you to local support and information
- Jointly support you to develop a health passport outlining your health needs
- Answer questions about your health.
Referrals to this service can be made by completing a referral form and returning it by email.
Patient Information Leaflets:
Our Special School Nurses provide support to these Hillingdon special schools: Moorcroft, Grand Union Village, Pinn River and Eden Pinkwell Satellite sites, supporting children with complex health needs that may affect their education.
They support schools by:
- Ensuring appropriate care plans are in place
- Contributing to annual Education Health Care Plan assessments for Hillingdon children
- Providing training for school staff caring for children and young people
- Liaising with other professionals and wider health and social care teams
- Monitoring health needs in school, including weight and skin integrity
- Completing continence assessments for children who need continence products
- Attending family help meetings where health needs are identified
- Contributing to safeguarding children and young people.
Our Matrons work to a defined scope of practice and criteria, enabling them to assess, diagnose, and treat children presenting with minor ailments.
Our Matrons support GP services with the aim to prevent unnecessary admissions to urgent care and A&E.
Based across four GP surgeries in Yiewsley and West Drayton, they ensure local families have timely access to professional support.
All referrals to the Children’s Community Matron are made through the GP practice on same day of the clinic.
Telephone: 01895 488480
Email Addresses
Paediatric Nursing team and Transition Nurse:
Cnwl-tr.
Dietitians
Cnw-tr.
Special Schools
Cnwl.specialsnhillingdon.nhs.net
The service operates from 8.30am to 4.30pm Monday to Friday.