http://www.cypnow.co.uk/bulletin/cypnow_daily/article/1066930/royal-college-call-overhaul-hospital-care-children/
By Lauren Higgs Thursday, 21 April 2011
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Children's hospital care must be radically redesigned to make it safe and sustainable, a report by the Royal College of Paediatrics and Child Health (RCPCH) has warned.
RCPCH president Terence Stephenson acknowledges some of the recommendations would be unpopular. Image: RCPCH
The report outlines how underinvestment and an increase in demand for children’s hospital services has resulted in dangerously low levels of staff and situations in which trainee doctors are left to manage wards due to a shortage in senior-level consultants posts.
To remedy this "huge pressure across paediatric care", RCPCH is recommending reducing the number of inpatient sites for children to create larger centres, significantly expanding the number of registered children’s nurses and boosting the number of GPs trained in paediatrics.
The college also believes there is a need for at least a 50 per cent increase in the number of consultant paediatricians, combined with a decrease in the number of paediatric trainees from 2,929 to 1,720.
To help health professionals provide better continuity of care, the college believes hospitals should adopt a "consultant of the week system", so that each week a named consultant is freed from other clinical duties so they can be completely available for the management of acute admissions.
This is because the implementation of the European working time directive and the consequent transition to shift patterns of working has made it harder for professionals to provide such continuity for patients.
Professor Terence Stephenson, president of RCPCH, admitted that some of the college’s recommendations would be unpopular, but he argued that radical action is necessary to safeguard health outcomes for children and young people.
"There are huge pressures on paediatric services and it is crucial that standards of care for children are not compromised," he said. "The alternative, of making small, piecemeal changes, is simply not viable. If we are to have any prospect of making sure children in this country have the same health outcomes as other leading Western nations, it is time to face the future and redesign children’s health services so they meet the standards that children and their parents rightly expect.
To remedy this "huge pressure across paediatric care", RCPCH is recommending reducing the number of inpatient sites for children to create larger centres, significantly expanding the number of registered children’s nurses and boosting the number of GPs trained in paediatrics.
The college also believes there is a need for at least a 50 per cent increase in the number of consultant paediatricians, combined with a decrease in the number of paediatric trainees from 2,929 to 1,720.
To help health professionals provide better continuity of care, the college believes hospitals should adopt a "consultant of the week system", so that each week a named consultant is freed from other clinical duties so they can be completely available for the management of acute admissions.
This is because the implementation of the European working time directive and the consequent transition to shift patterns of working has made it harder for professionals to provide such continuity for patients.
Professor Terence Stephenson, president of RCPCH, admitted that some of the college’s recommendations would be unpopular, but he argued that radical action is necessary to safeguard health outcomes for children and young people.
"There are huge pressures on paediatric services and it is crucial that standards of care for children are not compromised," he said. "The alternative, of making small, piecemeal changes, is simply not viable. If we are to have any prospect of making sure children in this country have the same health outcomes as other leading Western nations, it is time to face the future and redesign children’s health services so they meet the standards that children and their parents rightly expect.
