Paediatric emergency services
Following the 2011 review of emergency pathways for acute medicine and emergency general surgery patients, and the development of London quality standards to improve these services, a review of paediatric emergency services in all London hospitals was carried out to ensure that children can also access high quality and safe care.
Whilst some improvements in the provision of paediatric emergency services have been made in the capital since the publication of Healthcare for London’s Meeting the health needs of children and young people – a guide for commissioners in 2009, there remains more to do.
London has a higher mortality rate for paediatric emergency admissions when compared to the rest of the country and this is increasing when compared to mortality rates for other age groups in the capital. There are many factors that could explain the higher mortality rates for paediatric emergency admissions in London, but child death reviews have highlighted that regardless of where the child dies – primary, secondary or tertiary care – there are often avoidable factors in secondary care. These avoidable factors need to be addressed.
Many hospitals are failing to meet national guidance, implement best practice or comply with recommendations and standards set by the Royal Colleges to improve the quality and safety of care and improve patient outcomes. Often children are admitted unnecessarily when alternative management plans might be appropriate and there is variable access to senior personnel who might influence this process. Furthermore, staffing levels are variable out-of-hours and there are too few paediatric doctors to staff rotas to safe and sustainable levels.
The review was clinically-led and two multi-disciplinary clinical expert panels were established to support the development of the case for change and quality standards. The paediatric emergency medicine panel was chaired by Dr Gulamabbas Khakoo, Consultant Paediatrician at the Hillingdon Hospital NHS Foundation Trust. The paediatric emergency general surgery panel was chaired by Mr Simon Eccles, Clinical Director for Paediatrics at Chelsea and Westminster NHS Foundation Trust.
The review examined current services and developed a case for change and quality standards to support the improvement of paediatric emergency services across the capital. Our aim is to promote the implementation of change that will secure improved quality and safety in paediatric emergency care across the capital, providing a service that benefits patients.