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Acutely ill children waiting nine hours for beds in intensive care Acutely ill children waiting nine hours for beds in intensive care
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Seriously ill children are waiting up to nine hours for an intensive care bed to become available, while others are being transported up to 120 miles from their homes to receive the medical treatment they urgently need, senior paediatricians have revealed.Seriously ill children are waiting up to nine hours for an intensive care bed to become available, while others are being transported up to 120 miles from their homes to receive the medical treatment they urgently need, senior paediatricians have revealed.
In the last two weeks, at least 17 children with acute illnesses requiring intensive care have had to be transported out of their regions because of a lack of beds. Some paediatric intensive care units, treating the most seriously ill children, are worked at 150% of their capacity, such is the level of demand and lack of resources, according to the Paediatric Intensive Care Society. As of Friday night, there were just four beds available in England and one in Belfast. In the last two weeks, at least 17 children with acute illnesses requiring intensive care have had to be transported out of their regions because of a lack of beds. Some paediatric intensive care units, treating the most seriously ill children, are working at 115% of their capacity, such is the level of demand and lack of resources, according to the Paediatric Intensive Care Society. As of Friday night, there were just four beds available in England and one in Belfast.
The revelations illustrate the stress being faced by the NHS this winter. New figures provided by the Labour party additionally show that, in October, only 67.3% of ambulances for the most seriously ill adults and children, who are not breathing or do not have a pulse, arrived on the scene within eight minutes of being called, against a target of 75%.The revelations illustrate the stress being faced by the NHS this winter. New figures provided by the Labour party additionally show that, in October, only 67.3% of ambulances for the most seriously ill adults and children, who are not breathing or do not have a pulse, arrived on the scene within eight minutes of being called, against a target of 75%.
Dr Peter-Marc Fortune, a consultant paediatrician and president of the Paediatric Intensive Care Society, said the network of intensive care units had been officially designated “critcon 2” at a national level, meaning that the system was running at “full stretch”. Dr Peter-Marc Fortune, a consultant paediatric intensive care specialist and president of the Paediatric Intensive Care Society, said the network of intensive care units had been officially designated “critcon 2” at a national level, meaning that the system was running at “full stretch”.
Last week the Observer revealed that units in London and Leicester were at full capacity.Last week the Observer revealed that units in London and Leicester were at full capacity.
Fortune said the situation was now “hottest” in the north of England and added that he feared paediatric intensive care units nationally could in the coming days be designated as “critcon 3”, defined as an unprecedented situation under which three of the four regions declare themselves as working at maximum capacity. Fortune said the situation was now “hottest” in the north of England and added that he feared that the status of the availability of paediatric intensive care beds could in the coming days be designated as “critcon 3”, defined as an unprecedented situation under which three of the four regions declare themselves as working at maximum capacity.
He said: “I have heard back from about a third of the units in the country. None of them were running at less than capacity. And there were reports of anything up to 150% of what would be the commissioned full level. He said: “I have heard back from about a third of the units in the country. None of them were running at less than capacity. And there were reports of anything up to 115% of what would be the commissioned full level.
“I would not suggest that anyone has come to any harm, and it is important to say that. However, we are concerned that the system is stretched to capacity and that any further stress on the system will risk a reduction in safety standards. “There is no suggestion anyone has come to any harm because of this. However, we are concerned that the system is stretched to capacity and that any further stress on the system may risk a reduction in safety standards.
“We are in this position because we commission a certain number of beds in the country and during the year that capacity copes. “We find ourself in this position because a number of beds are commissioned across the country and during the year this capacity copes.
“But we believe, anecdotally, it runs above the international safety standard of 85% of capacity. Most units are reporting that over the year. When we come to the pinch points, which is traditionally the second and third weeks of December, you are obviously going to stress the system at that time. It is being pushed to its absolute limits.” “Anecdotally, bed occupancy on most units runs above 85% for much of the year. And 85% is widely regarded as the maximum figure of activity in order to deliver both efficient and safe care. When we come to the busiest period, which is traditionally the second and third weeks of December, the system is obviously going to be stressed. It is being pushed to its absolute limits.”
Fortune said he was aware in the last two weeks of a child having to be transported 120 miles to an intensive care bed, and a second case in which an acutely ill child had to wait nine hours before a free bed could be identified.Fortune said he was aware in the last two weeks of a child having to be transported 120 miles to an intensive care bed, and a second case in which an acutely ill child had to wait nine hours before a free bed could be identified.
He said: “Fortunately with that particular child we were able to deliver all the therapies via our mobile team. There are therapies that require a child to be physically in an intensive care unit. We are being forced into a triage situation because we don’t have the ability to move children immediately into beds full time. He said: “Fortunately with that particular child it was possible to deliver all the therapies via our mobile team. If there were an occasion when such therapies were required, with no beds immediately available, we could be forced into a triage situation where other children may have to wait or be moved between beds.”
“While our mobile teams – of which there are only one or sometimes two for a brief period of time in each of the regions – are tied up they cannot respond to another case, perhaps in a different general hospital. People there will be very able to do the initial care but as things step up they cease to be in a comfort zone. It’s certainly not ideal.” Details of the current situation have emerged as a report from the Paediatric Intensive Care Audit Network (Picanet) lays bare the strains on the system. In 2015, only about a third (29%) of the country’s paediatric intensive care units (PICUs) met the nursing establishment levels currently recommended by the Paediatric Intensive Care Society.
Fortune, who called for a review of paediatric critical care services being undertaken by the NHS to address the lack of resources, added: “In itself the time on the road is not a problem as long as the child doesn’t become unstable in that time. And our teams are very good at getting them stable. But you clearly want them to be able to get from a place of security to the ultimate place of security, which is intensive care, as fast as possible. And that ideally does not mean travelling 120 miles.”
Details of the current situation have emerged as a report from the Paediatric Intensive Care Audit Network (Picanet) lays bare the strains on the system. In 2015, only a third (29%) of the country’s paediatric intensive care units (PICUs) met the nursing establishment levels currently recommended by the Paediatric Intensive Care Society.
One in five referrals for admission to a PICU are refused, with nearly two thirds of these refusals due to no staffed bed being available. The report notes: “While most children who require a PICU bed will eventually be admitted, the process of approaching many PICUs to find a bed is time-consuming and stressful for parents and carers and hospital staff.”One in five referrals for admission to a PICU are refused, with nearly two thirds of these refusals due to no staffed bed being available. The report notes: “While most children who require a PICU bed will eventually be admitted, the process of approaching many PICUs to find a bed is time-consuming and stressful for parents and carers and hospital staff.”
Referring to the data for last weekend, a spokesman for NHS England said: “Figures published on Friday show PICU occupancy across England was 85%, proving that beds are indeed available when needed.” NHS England said data for a week ago showed units running at 85% of capacity.