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Paediatric units in the NHS are understaffed and under pressure, audit reveals

Additional resourcing of children’s health services in the NHS is urgently needed, a report says.

The Facing the Future Audit 2017, published by the Royal College of Paediatrics and Child Health (RCPCH), calls on government to expand the consultant workforce to help units increase consultant presence at peak times – usually between 8am to 10pm – and improve the standard of hospital care.

To do this, the report recommends that in the UK, 465 full time equivalent (FTE) paediatric trainees are recruited at ST1 (trainees in their first year of training) level every year for the next five years which will help achieve the consultant expansion required.

The College recommends an increase in total of 752 FTE paediatric consultants to meet standards: 520-540 in England, 84-110 in Scotland, 84-91 in Wales and 30-31 in Northern Ireland.

The audit analyses data submitted by paediatric clinical directors on two sets of standards produced by the RCPCH. It finds:

  • On weekdays, a paediatric consultant is present in the hospital during times of self-identified peak activity in 38.7% of units
  • At weekends, a paediatric consultant is present in the hospital during periods of self-identified peak activity in 28.6% of units
  • Across all training rotas, 30.1% of paediatric units have the recommended number of staff to manage care (10 or more WTE)

Dr Carol Ewing, Vice President for Health Policy, the Royal College of Paediatrics and Child Health, said: “To improve the care delivered by units, it is vitally important they meet each and every one of the standards set out in this audit. However, as we have seen from our hospital visits, units are only going to be able to do this is they have the resources in place to support them.

“In order to meet three key standards – children seen by a consultant within 14 hours of admission; two consultant-led hand overs; and presence at peak times – paediatric departments need increased consultant presence from around 8am to 10pm.

“The growth in the paediatric workforce is crucial if this is to happen.”

To help units drive up the standard of care, the RCPCH recommends the government prioritise adequate resource to fund the workforce development needed to implement standards in children’s health services.

It calls for a centrally funded increase to the number of paediatric trainee places to ensure at least 465 full time equivalent trainees enter each year of training across the UK to achieve an expansion in the consultant-level workforce by the desired 752 full time positions.

The college also wants the government to commit to developing a cross-departmental child health strategy for England by 2019

Read the full report.

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