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Half of PICUs were ‘dangerously full’ in run-up to Christmas

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At least half of children’s intensive care units in England were dangerously overcrowded over a four-day period before Christmas, the Labour Party has warned.

It said the worst day was on 19 December when 55% of trusts with a paediatric intensive care unit (PICU) recorded a bed occupancy rate on the unit of 85% or more.

“Our findings reveal a distressing picture of the unprecedented pressures on paediatric intensive care units”

Jonathan Ashworth

On the same day, 47% of units were running at more than 100% capacity, according to the party’s analysis, which was based on the latest weekly figures collated by the NHS.

Barts Health NHS Trust, Mid Yorkshire Hospitals NHS Trust, and Nottingham University Hospitals NHS Trust all recorded six days at 100% or more capacity, making them among the worst performers.

The figures used by Labour were taken from NHS England’s Daily Hospital Situation Report on paediatric intensive care for the period 18-24 December 2017. For the week in question, 38 trusts in England were defined as having operational paediatric intensive care units.

Overall, during 18-21 December, the percentage of units recording 85% occupancy averaged 51%. However, in the next three days, the number of units running at dangerous occupancy levels decreased, averaging 37% for the period of 22-24 December.

Labour noted that experts deemed a bed occupancy rate of 85% dangerous, because of its impact on delays and the increased risk of serious infections.

“We’re faced with a chronic shortage of doctors and nurses across all paediatric services”

Peter-Marc Fortune

Jonathan Ashworth, the party’s health spokesman, said: “Despite the very best efforts of our brilliant NHS staff, our findings today reveal a distressing picture of the unprecedented pressures on paediatric intensive care units across the country.”

“To run a children’s care unit above 85% occupancy places patient safety at significant risk and is an entirely intolerable situation,” he stated.

In response, a Department of Health spokesman said: “We do not set standards or targets for bed occupancy, as we recognise that all hospitals operate differently and we expect them to manage their beds in way that works best for local patients’ needs.”

He highlighted that the week ending 24 December was actually an improvement on the previous week with average occupancy at 79.8%, down from 83.6% the previous week.

Meanwhile, Dr Peter-Marc Fortune, president of the Paediatric Intensive Care Society, noted that there ongoing pressure on PICUs, but like challenges faced by other parts of the service it became “most extreme” during winter.

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Jonathan Ashworth

“We’re faced with a chronic shortage of doctors and nurses across all paediatric services,” he said. “This is keenly felt within our children’s critical care units and fuels these pressures.”

Without a long-term solution, the pressure was set to increase, warned Dr Fortune, a consultant in paediatric intensive care.

“There is no proposal to resolve this shortage at the current time,” he said. “It’s down to the hard work of dedicated staff, across all of the NHS, that all children who need urgent care receive it. However, with demand on critical care services continuing to grow, a long term solution to this problem is needed.”

He noted that NHS England had commissioned a review of paediatric critical care services, which is looking at a new care model. But any new plan would require adequate resources, both to support the change and also underwrite the new service structure, Dr Fortune said.

DateNumber of Trusts with paediatric intensive care units over 85% fullPercentage of all Trusts with paediatric intensive care units operationalNumber of Trusts with paediatric intensive care units over 100% fullPercentage of all Trusts with Paediatric intensive care units operational

18th December

19

50%

17

45%

19th December

21

55%

18

47%

20th December

19

50%

16

42%

21st December

19

50%

13

34%

22nd December

14

37%

11

29%

23rd December

16

42%

12

32%

24th December

12

32%

10

26%

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