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Families caring for a child with incurable cancer require access to support and advice round the clock. In Brisbane, Australia, an after-hours phone service was established to support these families. This service is operated by oncology clinical nurse consultants (CNCs) experienced in pediatric palliative care. This is the first review of 8 years of activity, totaling 106 patients and 1954 calls. The majority of calls were between parents and CNCs (51%). Updating of the patient's condition (18%) was the primary reason for calls, with support and reassurance (16%), and symptom management of pain (10%) being the other frequent reasons. The majority of calls occurred over the weekends in the morning, with only 11% (n = 209) of calls occurring between 10:00 pm and 7:00 am. Of all the calls made, 43% (n = 814) were calls managed by the CNC without requiring further intervention. Calls were received from throughout Queensland, indicating the value of the service in supporting families throughout the state. The after-hours phone service has proven to be a simple, effective, and valuable service, which is consistently accessed by families, regardless of distance from the hospital.

Children with life limiting conditions require intensive, complex management of the physical, psychosocial and spiritual issues that evolve for the child and their family as the focus of care moves from curative treatment to palliation. Optimal palliative care for children can be limited by the lack of health professionals with the necessary skills and experience to confidently and competently manage the care of both the child and the family. The University of Queensland's Centre for Online Health has been working closely with the Paediatric Palliative Care Service (PPCS) at the Royal Children's Hospital (RCH) in Brisbane, Australia, to investigate the potential of telemedicine for the delivery of specialist support in the home or local community. Research conducted in Queensland has shown how telemedicine can be effectively used to link the specialist paediatric palliative care team into the home of families caring for a child receiving palliative care, regardless of their physical distance from the RCH. This qualitative report describes two case studies, each illustrating the value of home telemedicine for families at this vulnerable and distressing time. This work should provide a useful insight for other specialty disciplines contemplating home telemedicine applications.