What is it about?

Considering the collective as well as individual dependency of patients has been shown to improve safety, effectiveness and care delivered in inpatient services. This paper sets out how Martin House Children's Hospice in the UK developed a nursing dependency score to use on the children who use their services. It discussed how the tool was implemented and evaluated, as well as the impact on care provision.

Featured Image

Why is it important?

Bed occupancy, the traditional measure of service use, is no long appropriate, due to the increasingly complex needs and technology dependence of children and young people who use hospice services. A well-designed dependency score, applied to all children on a caseload improves safety, effectiveness and the organisation's ability to allocate resources, improving responsiveness.


Undertaking this piece of work allowed us to explore elements of care that required greater resources. It improved efficiency, equity, and safety, leading to the better allocation of resources. We found that tools used in other organisations did not work 'off the shelf' for Martin House. We hope that this paper helps services to understand how we developed our tool, helping them to develop bespoke dependency scores that meet the requirements of children and young people who rely on their services.

Dr Michael J Tatterton
University of Bradford

The care of children and young people with long term health needs is becoming increasingly complex. This is placing greater demand on the hospice care team as the dependency of these children increases. Traditionally hospice care has been allocated on a one to one basis, however more recently it is clear that there are children requiring more than one member of the care team for some or all aspects of their care. In response to this a focus group from the care team met to explore dependency tools already in use by other clinical areas including hospices. Unable to find a tool to meet our specific requirement, together we designed a bespoke tool for use at Martin House. Hopefully by sharing our process in this paper, others will also be able to adapt and follow the process to develop their own dependency scoring tool.

Catherine Martin
Martin House Children's Hospice

Read the Original

This page is a summary of: Developing a nursing dependency scoring tool for children's palliative care: the impact on hospice care, International Journal of Palliative Nursing, February 2021, Mark Allen Group,
DOI: 10.12968/ijpn.2021.27.1.37.
You can read the full text:



The following have contributed to this page