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Paediatric Permanent Open-Door Service

What is the Permanent Open-Door Service?

Permanent open door is for children and young people with specific medical conditions/needs which require ongoing hospital care. Permanent open door enables children and young people to access care without having to get a referral from their General Practitioner (GP) or the Accident and Emergency Department first. The aim is that these children will receive timely, co-ordinated, high quality care promoting minimal disruption to their daily lives.

The decision to place a child or young person on open door is made by the child or young person’s named consultant.

When do we use the Permanent Open-Door Service?

If your child becomes unwell with their specific condition/need that places them onto the Permanent Open-Door Service for all other concerns regarding your child, we recommend you take your child to their General Practitioner or A&E Department. For example:

If your child is on the Permanent Open-Door Service because they have severe asthma and they have a tummy bug, we recommend you contact your child’s GP


If your child is on the Permanent Open-Door Service because they have severe asthma and they have broken their arm, please take them to the A&E Department.

If your child is seriously unwell, please seek immediate attention by dialling 999, do not wait to call the Paediatric Decision Unit (PDU).

If you are ever unsure as to whether you should use the Permanent Open Door Service or go to your child’s GP/ A&E Department, please telephone the nurse/doctors on the PDU for advice on 01296 315216.

How do we access the Permanent Open-Door Service?

Please telephone the Paediatric Decision Unit (PDU) on 01296 315216 which is open 24 hours a day, 7 days a week or the Children’s Day Unit (CDU) at Wycombe, Monday to Friday between 08.00- 18.00 hours excluding Bank Holidays on 01494 425506.  When telephoning, please tell us that your child is on permanent open door, along with their name, date of birth and if you know it their hospital (MRN) number; these details just make it easier to access your child’s information quickly. Your child’s MRN number should be displayed on any letters you have received from the hospital

One of the nurses or doctors will speak to you and either provide advice over the telephone or ask you to bring your child either to PDU or CDU. Sometimes the doctors/nurses may advise you to call an ambulance or to come in via the A&E Department; this would only be because they feel your child is at immediate risk and needs urgent assessment. If this was to happen, the paediatric team would see you and your child in the A&E Department.

Your child may also be allocated a Community/Specialist Nurse who can also be contacted to give advice or ask you to come to PDU or CDU as appropriate. He/she will give you their contact telephone number when they first make contact with you.

If you are ever unable to get through to PDU or CDU, please contact Ward 3 (the children’s inpatient ward on 01296 315145

Where is the Paediatric Decision Unit (PDU)?

The PDU is based in Stoke Mandeville Hospital within the A&E department. When you arrive please report to the reception desk in A&E.

Where is the Children’s Day Unit (CDU)?

Is located within Wycombe Hospital and is signposted from the entrance to the hospital. Please report directly to the CDU (Ward 11).

Do we need to bring anything to PDU or CDU?

Please bring any medications that your child is taking. It is also advisable to bring an overnight bag with some night clothes, toiletries, nappies etc in case of possible admission.

What happens when we get to PDU?

A nurse will assess your child and then your child will be seen by a paediatric doctor. A plan will then be made with you about your child’s care. Sometimes your child will just be seen by a nurse, for example if they have to come in for a specific procedure for example insertion of a new nasogastric tube. PDU can be a very busy department and children will be seen in order of clinical priority.

If my child needs to be admitted where will they go?

They will be admitted to Ward 3 (the children’s inpatient ward) which is on the ground floor of the hospital.

Does my child still need a GP if they are on the Permanent Open-Door Service?

Yes, it is important that your child does still have a GP.  The Paediatric Team at Stoke Mandeville Hospital and the Children’s Day Unit at Wycombe will work closely with your child’s GP and any other health and social care professionals involved in your child’s care.

As mentioned earlier your child’s GP can be an ideal resource to talk about other childhood concerns not relating to your child’s specific medical need/condition.

If your child is prescribed any medication from their Paediatric Consultant, they will need to get ongoing supplies from their GP.

How long will my child be on the Permanent Open-Door Service?

This is individual to all children and is reviewed regularly by your child’s named Paediatric Consultant. You as parents/carers, will be involved in any decisions regarding your child’s care.

Can other children in my family use the Permanent Open-Door Service?

This service is just for your child who was put onto the Permanent Open-Door Service. However, other children in your family can be seen in the Paediatric Department following a referral from their GP if they become unwell.

We hope this information has been helpful if you have any further questions, concerns please speak to any of the doctors/nurses in the Paediatric Department.