11.04.13
‘Too many’ paediatric units – RCPCH
Current configuration of paediatric care is unsustainable, the Royal College of Paediatrics and Child Health has warned in a new report, ‘Back to Facing the Future’.
It measures the results of an RCPCH audit of acute paediatric units in the UK against the 10 minimum standards set out in a blueprint two years ago. The standards include every child admitted with acute medical problems to be seen by a senior paediatrician within four hours; at least one medical handover in every 24 hours; and specialist paediatricians available for immediate advice via telephone.
77% of units meet the standard of every child seen by a senior consultant within four hours and 88% were seen within the first 24 hours of admission.
However, RCPCH raised some concerns over consultant presence during the evenings and found that immediate telephone advice was not always available. The report also highlighted a shortfall of staff across all rotas.
Dr Hilary Cass, president of the RCPCH, said: “These standards have gained a great deal of currency within the paediatric community and it’s encouraging that many units are meeting the standards well. There are countless examples of paediatricians going beyond the call of duty to deliver out of hours care – and it is thanks to the diligence and dedication of these doctors that most of the standards are being met and the level of healthcare delivered to children remains high.
“But perhaps the most concerning area is the consultant presence at times of peak activity. When units are at their busiest, it’s crucial that the most experience and skilled members of the team are present – and currently this isn’t happening in too many services.
“Acute paediatricians are under significant pressure within the current structures and we have to be prepared to re-examine the way in which we deliver care because this way of working is not sustainable.
“There are too many units in the UK to provide a safe and sustainable service; health services can’t continue in their current form. Reconfiguration needs to happen to deliver the best possible care to children and young people. We also need to look at more innovative models of service provision, providing more care in the community. But it’s going to take bold and brave leadership to make it happen.”
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