Unscheduled Re-attendance to Medical Paediatrics following discharge within previous 72 hours, SOP

GGC Paediatric Guidelines
NHS GGC

Objectives

CDU Unscheduled Re-attendance Guidance

For any child who has an unplanned re-attendance to CDU following discharge in previous 72 hours

Learning from a number of Significant Adverse Event Reviews have identified the need for a formal guidance document to aid resident doctors when assessing children who re-attend the hospital following discharge from the care of medical paediatrics in the previous 72 hours.

Children who re-attend will often be doing so as their illness has followed a standard course and because their care givers are following advice that has been provided by discharging clinicians. Re-attendances are to be expected within acute paediatrics and should not be viewed as a failed discharge.

A re-attendance to medical paediatrics is defined as a patient who re-attends the hospital for an unscheduled review within 72 hours of being discharged from either the Clinical Decisions Unit or inpatient medical paediatric bed. The guidance below describes the expected process that should be followed for all of these patients.

Step 1: Access patient record on Trak Care/Portal, Review following information from previous admission:

1. Discharge letter (if available) – including discharge diagnosis

2. Documented medical notes

3. Results of investigations including : - haematology, biochemistry, microbiology and virology

4.  Available x-ray/imaging reports

5.  Details of past medical history (including previous clinic letters and IDLs)

Step 2: Assessment of patient

1. Take and document full history

2. Perform and document full examination

3. In person review of patient by doctor working on the senior tier rota or ANP

NOTE - If any uncertainty around diagnosis or management, discuss the patient with responsible consultant

Discharge procedure

1. Prescribe medications if required

2. Provide verbal worsening advice to family and clearly document this in the medical notes

3. Provide written worsening advice to family (including links to digital information)

4. Complete fever discharge checklist (if applicable)

5. Complete discharge letter

Editorial Information

Last reviewed: 24/10/2025

Next review date: 31/10/2028

Author(s): Dr Ailsa Winter, Dr Owen Forbes.

Approved By: General Paediatrics Governance Group