Agenda item

Children and Young Persons Services at United Lincolnshire Hospitals NHS Trust - Update

(To receive a report from United Lincolnshire Hospitals NHS Trust, which provides the Committee with an update on the current position regarding children and young persons services.  Senior Managers from United Lincolnshire Hospitals NHS Trust, will be in attendance for this item)

Minutes:

Consideration was given to a report from the United Lincolnshire Hospitals NHS Trust, which provided an update on Children and Young Peoples Services.  The report also provided the status of the Royal College of Paediatric and Child Medicine report and its relevance to the interim model.

 

Kevin Turner, Deputy Chief Executive and Dr Neill Hepburn, Medical Director were in attendance for this item.

 

The Committee was advised that the interim paediatric service model currently in place at Pilgrim Hospital, Boston had been introduced on 6 August 2018 was working well to address the significant challenges faced by the Children and Young People's Services.  The Committee was reminded that the interim service comprised of an enhanced paediatric presence in the Pilgrim Hospital Emergency Department and an acute paediatric assessment unit with a twelve-hour length of stay; and outpatient clinics and surgery continuing at Pilgrim Hospital, Boston.

 

The Committee was advised that since the introduction of the dedicated ambulance transfer service, there had not been any instances where an ambulance had not been available to meet the needs of the service.  Details of the transfers were shown on pages 30 and 31 of the report.

 

It was reported that since the introduction of the interim model at Pilgrim Hospital, there had been a significant improvement in throughput, as well as there being an improvement to the patient experience.  It was highlighted that during the first 26 weeks of operation of the interim model, 1,869 patients had been seen in the paediatric assessment unit.  A breakdown of the source of referrals was shown on page 32 of the report.

 

The Committee was advised that since the introduction of the interim model, no patient safety incidents had been experienced, or reported as a result of the change.

 

The Committee was advised further that staffing was still an on-going problem.  It was noted that there had been a successful outcome from discussions with Health Education East Midlands to allow junior doctors to undertake additional locum work to fill some of the gaps in the rota.  It was noted further that the recruitment of children's trained nurses continued to be a challenge.  It was reported that a staff survey was to be undertaken in March to obtain the views of staff on the interim arrangements. 

 

It was reported that risks were managed through the project risk register, a copy of which was attached at Appendix A to the report.   It was highlighted that no incidents of patient harm had been reported.

 

Details relating to what had been learnt from complaints specific to the new paediatric model of care were shown on pages 36 to 38 of the report.

 

In conclusion, the Committee was advised that the interim model was addressing the difficulties and challenges caused by a shortage of doctors and nurses in the young people's services at Pilgrim Hospital, Boston; and that an update on the progress made on the recommendations following the Royal College of Paediatrics & Child Health report would be made available in due course.

 

During discussion, the Committee raised the following issues:-

 

·         Some members were pleased that the international recruitment was seeing some results; and some improvements to the service;

·         Concern was expressed to the distance some parents had to travel to visit their children.  The Committee was advised that there had been a reduction in the number of children who had been admitted into hospital; and for those who were admitted, there was transport provision in place which was based on a set of criteria.  It was highlighted that the Trust did not directly provide general transport support.  The Committee noted that there was provision for families to stay with their children at the hospital.  Reassurance was given that the number of referrals had reduced and those that were admitted were cared for in a safe environment;

·         Clarification was sort with regard to the breakdown in the figures relating to the number of children who had been transferred; and whether more beds were needed to be made available at Lincoln County Hospital.  Clarification was given to the figures detailed on page 31 of the report.  The Committee was advised that if Lincoln did not have enough beds, on occasions patients had been transferred to Grimsby.   

·         Some concern was expressed relating to children being admitted on to an adult ward.  The report advised the Committee that no children had been put on adult wards, against the child or parent/carer's wishes.  Confirmation was also given that no children had been transferred to an adult ward from the assessment unit.  The Committee was advised that the question would only be asked in respect of children 14, 16 and above, and with parental permission;

·         One member enquired how the Trust was going to communicate to the people of Boston about the interim arrangements.  The Committee was advised that the best promotion of the service was when the service worked for them. Acknowledgement was given that there was still some way to go, but it was an improving picture; 

·         Some concern was also expressed to the lack of public engagement.  The Committee was advised that the Trust worked hard to engage with the local population.  The Trust was advised that the public perception locally was that engagement was not happening.  A suggestion was made that more publicity needed to done regarding engagement events;

·         One member expressed concern that the consultant paediatric medical staff remained concerned about maintaining the safety of the middle grade medical rota.  The Committee was advised that steps were being taken to mitigate the situation as the Health Education East Midlands had agreed to allow juniors to undertake additional locum work to help fill some of the gaps in the rota;

·         Healthy Conversation 2019 exercise – One member highlighted that a proposal had been included for an urgent treatment centre at Stamford Hospital.  A question was asked as to whether this would be from 8am to 8pm, or be 24 hours.  The Committee was advised that conversations were starting to happen to help shape provision and that  an acuity based model would be provided to support the engagement process;

·         One member enquired when the Committee would receive an update on the progress with the action plan arising from the report by the Royal College of Paediatrics and Child Health.  The Committee noted  that the report was being complied and would be available to view shortly; 

·         A question was asked with recruitment remaining a major issue; had anything been done to help prospective employees for example directing them to housing, community and ethnic support groups and information about the area; and had the Trust considered offering more flexible working.  Confirmation was given that HR had all the policies in place and that working flexibly was constantly being developed;  and

·         A further question asked was when an applicant declined a job offer, was feedback offered to identify the reasons why and was there any trends in those reasons.  The Committee was advised that this data was captured.  Normally, a declined application was because the applicant had received a better offer elsewhere.

 

The Chairman on behalf of the Committee extended thanks to the presenters for their attendance.

 

RESOLVED

 

1.    That a copy of the updated report from the Royal College of Paediatrics and Child Health be received by the Committee at a future meeting.

 

2.    That an update on Children and Young People's Services at United Lincolnshire Hospitals NHS Trust be received by the Committee in three months' time.

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