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01.11.12

Heart ward staffing levels ‘unsafe’ – CQC

A CQC inspection of a ward at Bristol Children’s Hospital showed that staff shortages are having a “major impact” on patients, with not enough checks or observations, and too many medication errors, equipment failures and generally “unsafe staffing levels”. 

The hospital – one of the seven where paediatric heart surgery is being centralised following the Safe and Sustainable review – has been forced to restrict the number of operations being carried out there until its high dependency unit is in place. 

The unannounced CQC inspection, on September 5, was prompted by complaints from families of children who died there following heart surgery. 

The CQC report says: “We found that ward 32 admitted children from the paediatric intensive care unit who were in need of high dependency care. We observed during our visit that this was not reflected in the actual staffing level. Ward 32 was staffed as a paediatric general ward and not as high dependency care.” 

University Hospitals Bristol NHS Foundation Trust has now cut the number of heart operations being carried out at the hospital, until it has set up a dedicated high dependency unit.

Chief executive Robert Woolley said: “No family should leave the Bristol Royal Hospital for Children believing that we did not provide the best care possible for their child. I am deeply concerned that some families believe that we have let them down and will continue to ensure that we address their concerns and bring forward our plans to develop a high dependency unit.”

Bristol was recently named as one of the units that would stay open following the Safe and Sustainable review into children’s heart surgery. That process is now on hold again due to a judicial review and strong campaigns run by staff and families who use the units earmarked to close at the Royal Brompton in London, and at Leeds and Leicester. 

Anne Keatley-Clarke, chief executive of the Children’s Heart Federation, said the issues at Bristol uncovered by the CQC “are sympatric of a wider problem in children’s heart care services across the country”. 

She explained: “Due to the long delays in reaching a decision about the future makeup of services, and now further hold-ups due to referrals to the secretary of state and a judicial review, necessary investment in to services and staffing is on hold”. 

“We are extremely concerned about the planning blight which has resulted from uncertainty over which units will continue to provide surgery. Hospitals uncertain about their futures are reluctant to make the necessary investment and to recruit additional staff, which are greatly needed. Until there is some clarity we fear possible other cases like this and deteriorating care.”  

The Safe and Sustainable review included a requirement that each surgical unit has four surgeons conducting between 400 and 500 operations per year. 

Keatley-Clarke added: “Parents, national charities and professional associations involved all agree that that the changes planned are necessary to improve the quality of care and outcomes for children.” 

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