Further to my post earlier this week about Paediatric Care at Bassetlaw Hospital, apart from writing to Mike Pinkerton, the outgoing CEO at Doncaster & Bassetlaw NHS Trust, I also wrote to Idris Griffiths, the Chief Officer of Bassetlaw CCG who commission and pay towards the Paediatric Services in our area,  and here is his response in full.

Dear Mr Duveen

Re: Paediatric Care at Bassetlaw Hospital

Thank you for your recent email with regard to the paediatric care at Bassetlaw Hospital.

The CCG wishes to maintain services as close to peoples’ homes as possible and we have been in close contact with Bassetlaw Hospital regarding the paediatric ward.  However, first and foremost we must ensure that services provided are safe and reliable.

The changes being made are as a result of significant medical and nursing workforce shortages and as such are required on safety grounds.  Every reasonable effort has been made over the last six months to maintain inpatient services but short term closures have been necessary on a number of occasions.  These changes  are not being implemented to reduce costs.  The CCG has invested additional funds to maintain inpatient paediatric care at the hospital for a number of years and the hospital has recently invested £278,000 in a new paediatric outpatient facility on the site.  The CCG has worked closely with the hospital to ensure that the best possible urgent paediatric care can be provided at the hospital and that this will benefit as many children as possible.  Therefore, despite the closure to overnight stays for children at Bassetlaw hospital, there are a number of positive developments that are being implemented that will benefit the majority of children who attend Bassetlaw hospital for urgent care.

 The number of children who stay overnight in hospital has fallen over recent years, with ward A3 caring for an average of six children at any one time and data shows that almost 85% of all patients stay just one night or less. The new model of care is consistent with Royal College of Paediatric and Child Health guidance, and most children will therefore benefit from the enhanced assessment and treatment services that are being put in place.

 Ward A3, will close to admissions from 7pm each day from 30 January 2017. Although the overnight service cannot be maintained, acute paediatric services at Bassetlaw are being enhanced and a consultant lead assessment service on A3 will be available from 8am to 10pm, seven days a week.  This specialist service will deliver urgent assessment, diagnosis and treatment.  This should reduce the amount of time children have to spend in the hospital and decrease admissions.  Any child requiring an overnight stay will be transferred to Doncaster Royal Infirmary, or Sheffield Children’s Hospital as appropriate.

 In addition to the new assessment service, and following investment of £278k, there will also be a new facility to provide ‘hot outpatient’ clinics 7 days a week.  These clinics will be able to follow-up patients who have been discharged, will provide assurance to parents and support more children’s care being provided at home.  All outpatient care for children will now be provided in a purpose-built children’s outpatient facility which has its own entrance and is separate from the adult outpatient clinics.  This new facility is adjacent to the new assessment unit on A3.

 Not having overnight stays means that resources can be targeted at the majority of children that require care.  These changes will also help maintain middle grade paediatric medical support to the A&E department.  Whilst the ambulance service may take some patients directly to Doncaster or Sheffield (as in some cases they already do) the A&E department will continue to be able to provide care and treatment for children in the department.

 The hospital is looking on a case by case basis at how best to provide care for individual patients who have high rates of overnight admissions.

The CCG will continue to review the situation to ensure that the changes being made are effective in providing high quality care.  Whilst the availability of specialist staff is unlikely to change in the near future we will be carrying out a review of the situation at the end of the summer.

 I hope that the above information is helpful, however, if I can be of any further assistance, please do not hesitate to contact me.

 Yours sincerely

Idris Griffiths

Chief Officer

I have not received a response from Mike Pinkerton but I will chase this to get a response from him or another senior manager at the Trust.

However, one thing is clear to me.  As when Emergency Surgical Admission were suspended at Bassetlaw Hospital (see my post from last May – Why is Bassetlaw losing Emergency Surgery?), the problem is not finance but staffing.

I have done some research on the web and seen that the lack of trained nurses for Paediatric Care, indeed nurses in general, is not a recent problem but dates back many years (see Thousands of NHS nursing and doctor posts lie vacant from last February).  Training a Paediatric Nurse can take between 8 to 10 years so there will be not quick solution to the problem od getting the staff the Trust would need to keep the Children’s Ward at Bassetlaw open  safely.

Given this, what is preferable? Keeping A3 open without the correct number of staff or to transfer the children who need to stay overnight in Hospital to a safe environment in Doncaster or Sheffield?

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