Agenda item

(To receive a report from United Lincolnshire Hospitals NHS Trust, which provides an update in relation to Children and Young Persons' Services. Dr Neill Hepburn, Medical Director and Dr Suganthi Joachim, Divisional Clinical Director, Family Health, ULHT, will be in attendance for this item)    

The Committee considered a report submitted on behalf of United Lincolnshire Hospitals NHS Trust (ULHT), which updated the Committee on its services for children and young people.  The item was presented by ULHT's Medical Director, Dr Neill Hepburn, and Dr Suganthi Joachim, ULHT's Divisional Clinical Director for Family Health.

The report to the Committee set out the progress with the interim model for children and young people services, which had been put in place as a result of the suspension of inpatient paediatric services at Pilgrim Hospital, Boston, in August 2018 and the introduction of a paediatric assessment unit (PAU).  The cause of the suspension of inpatient services had been a shortage of middle grade doctors, as well as Health Education East Midlands relocating trainees from Pilgrim Hospital to Lincoln County Hospital.

The report provided data on the effectiveness of the interim model; progress with the recommendations from the Royal College of Paediatrics and Child Health; workforce issues; and actions taken by ULHT in response to the Care Quality Commission's Section 29A warning notice, which has been issued on 29 July 2019. 

The following points were clarified by questions from members of the Committee:

·         Pilgrim Hospital continued to provide special care for babies born from 34 weeks onwards, as part of the interim service model (with Lincoln County providing special care for babies from 27 weeks onwards).

·         The increase in the number of IR1 (incident reporting) forms reflected a desire to capture everything under the interim service model, including all instances where children stayed at Pilgrim longer than twelve hours in the PAU.

·         In relation to the time taken to resolve three serious incidents, there was an acknowledgement that investigating and reporting on serious incidents can take a long time, as they often involved several agencies.

·         The twelve hour length of stay guideline for children in the PAU was being reviewed, particularly for instances where a child was likely to be discharged.

·         For the students studying the new nursing degree at the University of Lincoln, ULHT's practice would be to 'treat them well and train them well' to encourage the nurses to stay with ULHT on completion of their studies.

·         The 'behavioural conditions pathway' referred to children with autism and attention deficit hyperactivity disorder, and was delivered by several agencies.

·         The number of births had reduced at Pilgrim Hospital.  Proposals to reduce the number of cots at the Hospital would not be implemented, until there had been consideration of all the options, including the potential to provide special care to babies with gestation over 32 weeks.

·         The Care Quality Commission inspection had taken place when the interim service model was in operation was running with staff shortages, with out-of-date clinical guidelines, which was currently being addressed.

·         The interim service model had formed the basis for work on the development of longer term solutions for children and young people services, with formal public consultation due on the plans for any permanent service reconfiguration as part of the acute services review.  There was currently no intention to return to the previous length of stay model for inpatient children at Pilgrim, except for certain children who could exceed the twelve hour length of stay in certain circumstances.

·         People in Boston and the surrounding area were supportive of the services provided at Pilgrim Hospital and wanted these to retained for the benefit of the local community.  It was, however, important that services for the local community were safe.

·         ULHT was asked to consider how the information had been presented to the Committee, particularly as the statistics alone could be construed negatively, without supporting explanations.  There was a need for balance in the presentation of information.

·         Adverse publicity inevitably affected the morale of existing staff, and could also be a factor in the recruitment of staff to Pilgrim Hospital and ULHT as whole.

·         There had been no recent analysis on the impact of the interim service model on paediatric services in neighbouring hospitals, such as Peterborough City Hospital, and Diana, Princess of Wales, Hospital, Grimsby.

·         Owing to ULHT continuing to be in financial special measures, access to funds for capital investment remained challenging, so the timescales for securing capital funding and undertaking the required building work could be at least two and half years.

·         The Royal College of Paediatrics and Child Health had seen ULHT's action plan in response to their report and had indicated their support for it.  However, there would be no value at this stage for a further visit from the Royal College to ULHT.

·         Funding for additional nurse training had been received, and the details would be shared with the Committee, when available.

·         The most recent patient feedback on the interim service model would be provided to the Committee.           

RESOLVED

(1)          That United Lincolnshire Hospitals NHS Trust be requested to submit a further report to the Committee on children and young people services in six months.

(2)          That United Lincolnshire Hospitals NHS Trust be congratulated on the completion of all the recommendations from the report by the Royal College of Paediatrics and Child Health in October 2018.

(3)          That it be noted that United Lincolnshire Hospitals NHS Trust had completed six out of the eight actions, issued by the Care Quality Commission on 29 July 2019 as part of a Section 29A Warning Notice.