Emergency services for children at County Hospital in Staffordshire have been suspended because of safety concerns amid a shortage of accident and emergency nursing and medical staff with specialist paediatric skills.
The University Hospitals of North Midlands NHS Trust, which currently runs the hospital, said on Thursday that the service, which sees 30 children a day, was not clinically safe for anyone under 18.
“This allows us the space to examine future options for safe children’s services”
It said in a statement that the accident and emergency department has a lack of sufficient numbers of staff with very specific levels of paediatric and anaesthetic training, including resuscitation and life-support competencies.
The suspension comes 10 years after the similar concerns were raised over emergency services for children at the hospital, which was then known as Stafford Hospital and run by the former Mid Staffordshire NHS Foundation Trust. It was renamed in the wake of the Francis inquiry.
University Hospitals of North Midlands NHS Trust said the interim closure, which started at 10am on 25 August, will not affect adult services which remain open 14 hours a day between 8am and 10pm.
The trust said the model of service, introduced by the former trust special administrators in 2015, was no longer viable and there were not sufficient staff at its other main site, Royal Stoke University Hospital, to rotate between the two sites.
The trust said children should not be taken to the A&E and any arrivals would be looked after until staff could arrange for a transfer to another hospital.
The decision was taken after safety concerns highlighted in a draft report by the West Midlands Quality Review Service. The trust said these could not be addressed in the short term.
“We have taken this decision in the best interests of children”
Ann Marie Morris
In 2006, a peer review of Stafford Hospital’s services for critically ill children said there were “immediate risks” because of low levels of medical and nursing staff trained in paediatric life support.
It said these staff were absent from the A&E for “much of the day” with no one on duty in the paediatric ward with relevant training at night.
It also said there was insufficient medical and nursing staff generally within A&E, with no nurses available for triage and patients waiting for up to two hours having only been seen by a receptionist.
Concerns about children’s services at the hospital were also raised by an earlier peer review report in 2003. The 2013 public inquiry by Sir Robert Francis QC found both were not acted on.
Earlier this month, the Royal College of Paediatrics and Child Health warned that the NHS had failed to act on its recommendations over a number of years to radically redesign paediatric services, which was exacerbating workforce shortages.
Safe staffing fears lead A&E to stop seeing children
Liz Rix, chief nurse and acting deputy chief executive at the trust, said on Thursday: “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,” she said. “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.”
Ann Marie Morris, the trust’s clinical director and emergency medicine consultant, added: “We have taken this decision in the best interests of children.
“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,” she said. “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.”