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Shortage of children’s hospice nurses hitting care for UK’s sickest youngsters

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A nursing shortfall means that children’s hospices are being increasingly forced to cut back on the vital palliative care they can offer to families, according to a charity.

Its survey of children’s hospices shows the nurse vacancy rate in such settings is higher than NHS and has been growing since 2015, said the charity Together for Short Lives.

“I am deeply concerned by nursing shortages we have found”

Barbara Gelb

In contrast, it noted that the number of children and young people who used children’s hospice services was increasing.

However, it also highlighted that health workforce planners did not assess the demand for nurses among children’s hospice organisations or include them in their wider nursing vacancy rates.

The charity is calling for an “urgent UK-wide summit” to discuss the children’s palliative care nursing workforce with the governments of the four UK countries, the Nursing and Midwifery Council, the Council of Deans of Health and Health Education England.

The survey carried out by Together for Short Lives indicates that the UK’s children’s hospices have a growing shortage of nurses.

As a result, children with life-limiting and life-threatening conditions were missing out on “lifeline” palliative care, including short breaks that can help keep their families together, said the charity.

The snapshot survey of 24 UK children’s hospices found the average nurse vacancy rate was 11% in mid-December 2016, representing an increase of 1% on the rate in 2015.

This rate is higher than the overall NHS nurse vacancy rate, which is thought to stand at around 9% in England, Northern Ireland and Wales, and represents over 130 full-time hospice posts unfilled.

Many hospices reported that it was getting harder to fill nursing posts, with 65% of the unfilled posts vacant for more than three months and 25% remaining vacant for over a year.

In addition, the survey suggested there was an increasing shortage of experienced nurses to care for children with rare and complex health conditions.

The number of vacancies was highest at salaries equivalent to Agenda for Change band 6, whereas in 2015 it was band 5, said the charity in a report on the survey findings, published today.

The majority of hospices of responded to the survey said vacancies were having an impact on care, with 17% stating that they were being forced to close beds.

For the first time, respondents reported that vacancies had affected their ability to provide 24/7 care, noted the charity in its report – titled The state of the UK children’s hospice nursing workforce.

Together for Short Lives

Hospice nursing shortage hitting care for sickest children

Barbara Gelb

Barbara Gelb, chief executive of Together for Short Lives, said she was “deeply concerned” by the nursing shortages indicated by the survey and that it was a “growing problem”.

“It’s shocking that children’s hospice services are having to reduce vital services as a result – they provide lifeline palliative care to Britain’s sickest children, helping to manage their pain and symptoms and maximising their quality of life and end of life care,” she said.

She highlighted that 36% of families caring for seriously ill children broke down and that children’s hospice services “play a crucial role in giving them desperately needed breaks from caring”.

“That’s why I’m calling on the UK’s governments, health workforce planners and universities to urgently work with us to find a way of boosting the supply of nurses to children’s hospices services now – so they don’t reach crisis point,” she added.

Paediatric palliative care nurse education

For the first time, Together for Short Lives also surveyed university child nursing undergraduate degree courses to find how they were teaching children’s palliative care.

A small sample of 15 course leads responded, said the charity.

The charity found that 33% of the universities that responded were planning to increase their children’s undergraduate nursing course intake in the future.

“Children’s palliative care nursing is an amazing profession”

Barbara Gelb

But, though there were many positive signs that courses included elements of best practice in their curricula, 27% of leads had not devised children’s palliative care competencies for their students.

Barbara Gelb said: “It is vital that universities help meet the children’s hospice nursing shortfall by educating enough children’s nurses and including children’s palliative care on their curricula.”

She said the charity was making an “open offer” to work with the Council of Deans and course leads to ensure education programmes for children’s nurses equipped them to care for “our sickest children”.

“Children’s palliative care nursing is an amazing profession and we want more people to have the opportunity to experience this incredibly rewarding career,” she said.

Together for Short Lives launched a campaign in the autumn to encourage school leavers, student nurses and existing registered nurses to consider a career in the sector.

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