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Stafford hospital suspends 'unsafe' children's A&E Stafford hospital suspends 'unsafe' children's A&E
(about 3 hours later)
A&E services at County hospital in Stafford have been suspended for under-18s because “senior clinicians have advised that the service is not currently clinically safe”. A Staffordshire hospital has suspended its A&E service for children after senior staff said it was “not currently clinically safe”.
University Hospitals of North Midlands NHS trust brought the interim measure into place from 10am on Thursday, owing to a lack of “professionally trained and experienced staff”. The drastic measure, implemented at 10am on Thursday, came after County hospital in Stafford was found to have insufficient staff trained to the required level in resuscitation and life-support for children.
The temporary changes do not affect the adult A&E, which remains open. University Hospitals of North Midlands NHS trust advised parents not to bring their children to the hospital, and instead to take them to a GP or pharmacist in the case of minor illness or injury, or to call 999 in the event of an emergency.
Liz Rix, chief nurse and acting deputy chief executive, said: “I fully appreciate the impact these temporary changes will have on families in Stafford and the surrounding area, and understand that people will be very concerned about this news. It said any sick children brought to the hospital would be cared for by staff until a transfer to another hospital could be arranged.
“However, we cannot and will not continue to deliver services without the confidence that those services are safe. Liz Rix, chief nurse and acting deputy chief executive, said: “I fully appreciate the impact these temporary changes will have on families in Stafford and the surrounding area, and understand that people will be very concerned about this news. However, we cannot and will not continue to deliver services without the confidence that those services are safe.”
“I want to thank my fellow clinical colleagues for reviewing the situation and for their advice, which has led to us taking this difficult short-term decision. Adult emergency services will not be affected at the facility, which was known as Stafford hospital until its name was changed after a scandal over poor care and high mortality rates.
“This allows us the space to examine future options for safe children’s services at County hospital with input from our staff, regulators and partners.” County hospital is not the first to restrict access to its emergency department in recent months. Two weeks ago Grantham and District hospital in Lincolnshire closed its A&E unit overnight because it had too few doctors. In April, Chorley hospital in Lancashire downgraded its A&E unit to an urgent care centre for the same reason.
The trust said a clinical model implemented as part of the Mid Staffordshire NHS foundation trust special administrator recommendations has been deemed “unviable” following a number of safety concerns highlighted in a draft report by the West Midlands quality review service. Dr Anthea Mowat, chair of the British Medical Association’s representative body, said the problems showed a long-term strategy was urgently needed to address workload and funding challenges. “Emergency medicine in particular is experiencing a recruitment and retention crisis,” she said. “This is crippling at a time when we need more of these doctors to keep up with rising demand on services.”
These concerns relate to the “lack of sufficient numbers of staff with very specific levels of paediatric and anaesthetic training, including resuscitation and life-support competencies”. Initial concerns about County hospital, which sees around 30 patients a day in its children’s emergency centre, were raised by the West Midlands Quality Review Service. A subsequent investigation by senior clinicians found those concerns could not be addressed in the short-term, hence the suspension.
Senior clinicians have spoken to staff in detail around the issues highlighted and found the concerns raised by the report “cannot be addressed in the short term”, and have led to the temporary suspension of the children’s A&E service, said the trust. Dr Ann Marie Morris, clinical director and emergency medicine consultant, said: “People view the children’s emergency centre as a safety net, but this is only the case when the right number of professionally trained, experienced staff are in place at all times. This is not currently the case, and as we cannot resolve this in the short-term, the only responsible course of action we can take is to suspend the service.”
Dr Ann Marie Morris, clinical director and emergency medicine consultant, said: “I want to reassure parents that we have taken this decision in the best interests of children. Whilst it is regrettable that some children may have to travel further for care, our first priority has to be providing a safe clinical service. The Stafford MP Jeremy Lefroy said he was “deeply disappointed” by the news. “I am pushing for this matter to be resolved urgently in order that services can be restored,” he said. “In the meantime, it is vital that parents and carers get the correct information, in order that children get to the right place for care.”
“People view the children’s emergency centre as a safety net, but this is only the case when the right number of professionally trained, experienced staff are in place at all times. This is not currently the case, and as we cannot resolve this in the short term, the only responsible course of action we can take is to suspend the service.”
About 30 children are seen at the A&E a day, and local commissioners and the Stafford MP, Jeremy Lefroy, have asked the trust to produce a detailed plan and a timescale for the next steps “as a matter of urgency”.
The hospital, formerly known as University Hospital of North Staffordshire, is not the only A&E to be hit by staff shortfalls.
Grantham and District hospital in the east Midlands had to announce it was to temporarily close its doors at night, owing to a national shortage of emergency doctors. Last month, the Royal College of Emergency Medicine said a gap between supply and demand for emergency doctors was leading to a “real crisis”. But despite shortages in specific A&Es, the Department of Health said at the time that there were 1,250 extra doctors working in emergency departments compared with 2010.
In April, Lancashire Teaching Hospitals NHS foundation trust was forced to temporarily downgrade Chorley and South Ribble hospital to an urgent care unit because it did not have enough doctors. At the time the hospital said that continuing to provide a service without enough doctors would be negligent and put patients at unacceptable risk.
In June, North Middlesex university hospital NHS trust also conceded it was “facing a number of issues” in the A&E department, “particularly around medical staffing”. A Care Quality Commission warning notice said the London A&E department, which sees about 500 patients a day, must make “significant improvements”.
The trust vowed to resolve the staffing issues, flagged up by the body, which focused on a shortage of middle grade and consultant emergency department doctors.