The provision of support and education from the team is based upon respect for the child / young person and their family. Each child / young person and their family have individual needs which will be assessed and a jointly agreed, appropriate plan of care will be offered to them in partnership with the family.

Principles of Service Delivery and Key Aspects of Care:

  • To assess and plan care in conjunction with the child / young person and their family
  • To facilitate early discharge through inter-agency and multi-disciplinary liaison
  • To reduce unnecessary hospital admissions and provide co-ordination and continuity of specialist paediatric care
  • Provide continuity of care at home for children / young people with additional and complex health needs
  • Teach and support children / young people and their families, enabling them to become as independent as possible
  • Offer co-ordination and collaboration of care
  • Continuously assess and evaluate care delivery to meet the individual needs of the child / young person and their family

The CCN service is provided in the family’s home, or in a community setting for children / young people requiring:

  • Wound care, post-operative care, support and advice on discharge from hospital
  • Support of oncology children / young people and their families in Fife
  • Support of enterally fed children / young people in collaboration with the multi-disciplinary team
  • Support of preterm infants and children / young people on home oxygen
  • Support children / young people at home with compromised airways requiring assisted support with NP airways or tracheostomies
  • Support, advice and co-ordination of care for children / young people with complex health needs. This role encompasses that of the key-worker and links closely with education, social work and voluntary services
  • Care and support for children / young people with chronic illnesses and their families
  • Teaching and education for children / young people, parents and staff
  • Additional support and education for schools and other professionals involved in the child / young person’s care
  • Palliative and end of life care at home


Children up to the age of 16 years, or young people who still receive extended education up to the age of 18 can be referred to the team by any professionals working with the child / young person and family. We would not consider any new referral to the team if they were over 16 years of age and not already on the CCN caseload. Each child / young person will be individually assessed by the receiving Community Children’s Nurse and parental or legal guardian consent is always required before a referral can be accepted.

Your support team

Team is lead by Nurse Manager – Joanne Bruce

Working hours are Monday – Friday 9am-5pm

You can reach us on 01383 565499