SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

AoMRC (2008) Managing urgent mental health needs in the acute trust
NCEPOD (1997) Who operates when
ASGBI (2010)
NCEPOD (2004) The NCEPOD classification for intervention
The Royal College of Anaesthetists: Guidelines for the Provision of Anaesthetic
Services (Chapter 9, section 1.2)
Standards for maternity care: report of a working party. (2008) RCOG, RCM, RCA,
RCPCH
Safer Childbirth - Minimum Standards for the Organisation and Delivery of Care in
Labour (2007), RCOG
Facing the Future: Standards for Paediatric Services, Royal College of Paediatrics
and Child Health, April 2011.
The clinical standards for Paediatric services in NW London (to ensure seven day per week
access to high quality paediatric emergency care across the whole of NW London) were
agreed pre-consultation. Implementing these standards will require closer integration of
paediatric emergency, urgent, short stay and ambulatory care as well as major changes in
working patterns for the medical and nursing workforce. The case for change for paediatrics
is therefore largely driven by the medical and nursing workforce. Across NW London there
are some paediatric units which already run with 20% Registrar / middle grade vacancies,
and in some units, periods of time where there is a lack of Paediatric trained nurses working
in the Paediatric area of the Emergency Department (ref LHP survey in their Case for
change). For high quality care, we need to staff units properly. This could be done by
concentrating emergency paediatric care into a smaller number of units.
Similar staffing issues exist with neonatal care. To ensure that recent improvements in
neonatal care are maintained, we must ensure that we have the appropriate workforce in
place. The medical vacancies for Paediatrics apply equally to neonatology and we also do
not have enough nurses to care for sick babies: NW London has the highest vacancy rate in
London – 22% in 2011 compared to a London average of 14%.
The DH Toolkit for High Quality Neonatal Services, NICE Standards for Neonatal Care and
the British Association of Perinatal Medicine (BAPM) standards are that 70% of the
registered nursing workforce should be Qualified in Specialty (QIS). In NW London this
figure is 62%. NW London has the highest use of bank and agency staff in London - 30% in
2011 compared to a London average of 22%.
7.23 Key messages from consultation
A public Consultation on three options was undertaken during the summer and autumn of
2012. Respondents were asked to indicate the extent to which they supported or opposed
the recommendation that all major hospitals should have inpatient paediatric units.
Of the 4,572 respondents answering this question, just over half support the proposal (54%),
and most of these „strongly support‟ it (33% of all respondents answering the question,
compared with 21% who „tend to support‟ it). Three in ten respondents oppose the
recommendation (28%), giving a net support score of +27 percentage points.
7c. Work of the Paediatric CIG 182