Pathway note: the poster describes an A&E triage nurse offer, with the parent self-referring. It does not describe a direct ambulance referral route. Check local arrangements before using as a destination or referral option.
Contact
07974 900 942| Phone lines | Mon – Fri, 08:00 – 20:00 |
| Base | Longsight Health Centre (about 1 mile from Royal Manchester Children's Hospital) |
| Capacity | ACT phones the clinical co-ordinator each morning to confirm capacity |
About ACT
Advanced clinical practitioner (ACP) community service. An alternative to emergency department attendance for parents.
| Offers | Same-day community appointments for redirected patients Targeted parental education Social prescribing Referral to existing community services |
PEWS calculator
NHS England national PEWS (chart CS56015, Sept 2023 v2). Designed for inpatient ward observations, so prehospital use is an approximation. A value sitting exactly on a chart gridline takes the lower score. That is my reading of the chart, so check against the chart if it matters.
Age band
Respiratory rate (/min)
Respiratory distress
Select an age band to see the chart descriptors for each grade.
SpO₂ (%)
Oxygen delivery
Heart rate (/min)
Systolic BP (mmHg)
Capillary refill (central)
Temp °C (not scored)
AVPU (not scored)
Escalation triggers
New suspicion of sepsis
New suspicion of septic shock
Carer says child is worse / concerned
Clinician intuition: "just not right"
Eligibility — all must apply
Aged 0–16 years with an acute illness
Early warning score (EWS) of 2 or less (use PEWS calculator above)
Triage acuity of 4 or 5
Lives in an eligible postcode (check below)
Postcode check
Exclusions — tap any that apply
Injury — burns, breaks, sprains, head injury, lacerations
Testicular pain
Foreign bodies
Complex background
Dental issues
Red flag symptoms
Referral process
A&E triage nurse identifies suitable patient and offers ACT as an alternative
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Parent given ACT contact details to self-refer. ED staff support where possible if language barrier
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AcceptedSafety information, permission to leave and directions to Longsight Health Centre given to parents
RejectedUsual A&E process
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Child seen by ACP in Manchester ACT service
▼ outcomes
DischargedAdvice on self-care ± CCNT follow up
Virtual wardCare for those on agreed step-up pathways (wheeze and fluid challenge)
Gen Paeds contactedExpected admission. Return to ED ± ambulance