Paediatric units ‘under-staffed and under pressure’ – report
MORE children’s doctors are urgently needed in Wales to prevent the workforce from “burning out” and providing an “unsafe” level of care.
That’s according to a major new report which found that paediatric units across the UK are struggling to fill workforce rotas and carry out consultant-led shift handovers.
In Wales it is recommended that the number of full-time-equivalent paediatric consultants be increased by 8.3% from 84 to 91.
That’s compared to 520-540 (3.8%) in England, 84-110 (30%) in Scotland and 30-31 (3.3%) in Northern Ireland.
Dr Mair Parry, the Royal College of Paediatrics and Child Health’s (RCPCH) officer for Wales, says the Welsh Government needs to urgently address this staffing shortfall.
She said: “This audit shows the pressure faced by the paediatric workforce in Wales today with units struggling to safely staff rotas and provide specialist advice.
“In particular, units in Wales struggle to deliver the two consultant-led handovers required in a 24-hour period – just 28% of units do so.
“These handovers help units anticipate any potential changes in staff required and enable patients at risk of deteriorating to be identified much more quickly. Failure to address these issues will put patients at risk.
“Children in Wales deserve the highest standard of healthcare regardless of the time of day or night they need treatment.
“I therefore call on Welsh Government to act quickly and provide the boost our workforce so desperately needs.”
The audit, called Facing the Future, analysed data submitted by paediatric clinical directors on two sets of standards produced by the RCPCH in partnership with children, young people and families.
It found that across the UK, a paediatric consultant is present in a hospital during times of “self-identified” peak activity in 38.7% of units.
The situation is even worse at the weekends, with paediatric consultants being present during peak times in just 28.6% of units.
Dr Carol Ewing, vice-president for health policy at the RCPCH, said: “It is down to the sheer dedication of our doctors that children are being treated as safely as they possibly can on paediatric wards in the UK but the risk of ‘burnout’ is all too real.
“To improve the care delivered by units, it is vital they meet every one of the standards set out in this audit.
“However, as we have seen from our hospital visits, units are only going to be able to do this if they have the resources in place to support them.
“In order to meet three key standards – children seen by a consultant within 14 hours of admission, two consultant-led handovers and presence at peak times – paediatric departments need increased consultant presence from around 8am to 10pm. The growth in the paediatric workforce is crucial if this is to happen.”
In Wales, the RCPCH is calling on the Welsh Government to fund an increase in paediatric trainee places to achieve an expansion in the paediatric consultant-level workforce.
The organisation also wants the Welsh Government to publish a Child Health Plan by 2019 to fully assess how paediatric services can be improved in Wales.
Some hospitals in Wales, including the Royal Glamorgan, near Llantrisant, are reducing their paediatric services and will no longer offer them 24-7.
The current children’s ward at the hospital will be changed to a paediatric assessment unit, which will only open from 8am until 10pm.
As a result the Welsh Ambulance Service will be told to bypass the Royal Glamorgan and travel to either the University Hospital of Wales or Prince Charles if they have critically ill or injured children on board outside these hours.
Any children visiting the new assessment unit who require an overnight stay will be transferred.