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Paediatricians say 50% increase in consultants and many more children's nurses and GPs with paediatric experience needed
Children's lives are being put at risk by failings in hospital care where the service is being run by crisis management because there are not enough well-qualified doctors and nurses, paediatricians have warned.
A radical blueprint for improving children's care from the Royal College of Paediatrics and Child Health urges greater specialisation – with a 50% increase in consultants and many more children's nurses and GPs with paediatric experience.
It warns that acute children's units are functioning with "dangerously low levels of staff". Trainees are left in charge of wards because there are too few consultant paediatricians. Consultants are forced into unscheduled overnight stays because there is nobody else to take over. Yet the number of children arriving at accident and emergency has been soaring, possibly because too few GPs have training in children's medicine and they do not spot problems early.
Children's care has long been regarded as a Cinderella service within an NHS that is orientated towards adults, and there is growing evidence that in mainland Europe and elsewhere, children get a higher priority and better care – often seeing specialists from the outset instead of a GP.
Professor Terence Stephenson, president of the college which is launching an ambitious report aimed at reshaping children's hospital services, says the solution is not only more consultants but also fewer children's acute hospitals, in order to concentrate services.
While he recognises the political sensitivity of closing or amalgamating hospitals, he says there are 220 children's hospital units in the UK, of which a third are not compliant with the European working time directive that no doctor should work more than 48 hours a week.
"The public are probably not aware that that's being solved by crisis management, particularly during mid-winter with things like flu, with consultants stepping in overnight or employing locums at the last moment. I'm sure the public is not aware of this.
"Because it's difficult to find individual cases where you can say this child died or that was harmed, people can ignore all that and say we want our local hospitals."
A year ago, an inquiry into the unexpected deaths of three children at two Birmingham hospitals said more consultants and specialist nurses were needed at the Good Hope and Heartlands hospitals.
"I always say to people if you were to fly easyJet tomorrow would you prefer to fly with a fully-trained pilot or a trainee? They don't have to think about that too long," said Stephenson. "We're suggesting children in the UK need to have a service that is predominantly staffed by fully-trained consultants."
