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16 February 2011, 16:29
From Monday, 28 February 2011, the QEII’s children’s A&E will close to walk-in patients from 8.00pm every evening, reopening at 8.00am the next morning
Changes are being made to times when the children’s A&E and assessment unit are open at the Queen Elizabeth II (QEII) hospital. From Monday, 28 February, the closing time will be at 8.00pm daily, instead of 11.00pm. The service will reopen every morning at 8.00am, instead of 7.30am. Outside of these hours, all children needing to attend a specialist children’s emergency service, whether by ambulance or as a walk-in, will need to go the 24/7 service based at the Lister hospital in Stevenage, or to another nearby hospital if that is considered the preferred option.
The Trust had been planning to introduce these changes from November 2011 to coincide with the move of all remaining neonatal services at the QEII up to the new maternity unit that is being created at the Lister. Specific problems with recruiting sufficient specialist paediatric doctors, as well as children’s nurses, to maintain clinically safe rotas became apparent during January 2011. Whilst this problem might have been possible to resolve through additional spending on expensive locum cover, although it is exceptionally hard to find due to a national shortage of such specially trained staff, this is no longer an option given the budgetary pressures facing the NHS.
The Trust’s divisional chair for children’s services, Dr Andy Raffles, said: “With the longer term plan being for all emergency children’s services to be based at the Lister within the next few years and with the QEII’s special care baby unit due to transfer across to new Lister-based service before the end of 2011, maintaining clinically safe staffing rotas for both specialist doctors and nurses is a real challenge. Even if locums were available, which is rarely the case, the even tighter management being placed on NHS budgets means that the ensuing overspend caused to our budgets is no longer possible. While we’ve just about managed up until now, the position from March 2011 means that we have to make changes to the opening times of the QEII’s emergency children’s services a few months earlier than we had planned originally. Whilst the number of children who overnight will now need to use either the Lister’s emergency children’s service, or that of another nearby hospital, is relatively small, the change in opening times makes a significant difference in the ability of my colleagues to provide a consistently safe and high quality service. Indeed if we had not made this change, we risked an increase in the number of ad hoc closures, which would become inevitable given the staffing position.”
According to the latest figures available to the Trust, which is for the whole of 2010, the changes being made will affect, on average, some 22 children every week who need to attend children’s A&E at the QEII between 8.00pm and 11.00pm (this equates to three to four children on a daily basis). Of these 22 children, just one or two will need to be taken in to the hospital’s children’s assessment unit for further observation or treatment.
Once these changes are made, children needing to travel to hospital in emergency ambulances will be taken directly to the Lister during the hours that the QEII service is closed. Where clinically it is the right thing to do, these children may be taken to other nearby hospitals. The Trust is also putting special arrangements in place for GPs who are considering referring their patients directly in to the QEII’s children’s assessment unit, with the aim of increasing the options available to them.
For children who arrive at the QEII after the children’s A&E has closed for the day, they will be assessed in the main adult emergency department initially. If they need to be transferred to the Lister, this will be discussed with them and their parents/carers, with transport being arranged if needed. In other cases, the child may just need to be seen by the out-of-hours GP service located nearby.
Commenting on the changes, the Trust’s chief executive, Nick Carver, said:
“While the full extent of the staffing challenge facing our children’s team only became clear a few weeks ago, they have worked hard to bring forward their planned change to the QEII service. In doing so, we have consulted widely already – especially with GP leaders locally, as well as our ambulance service colleagues. We are now working with a wide range of individuals and organisations to make sure that the message about the changes is known by as many people as possible.”