Agenda item

(To receive a report from United Lincolnshire Hospitals NHS Trust, (ULHT) which provides the Committee with an update on the current model of the paediatric service at Pilgrim Hospital, Boston and the performance of this model.  Mark Brassington, Deputy Chief Executive and Director of Improvement and Integration and Simon Hallion, Divisional Manager, Family Health Division from ULHT will be in attendance for this item)

The Chairman invited Mark Brassington, Deputy Chief Executive and Director of Improvement and Integration, Simon Hallion, Divisional Manager Family Health and Dr Suganthi Joachim, Divisional Clinical Director for Family Health to remotely present the report to Committee, which provided an update on the Paediatric Service, at Pilgrim Hospital, Boston. 

Detailed at Appendix A to the report was a copy entitled "Proposal for the Next Stage Development of the Paediatric Assessment Unit (PAU) Model at Pilgrim Hospital Boston."

The Committee was reminded of the background to the original model agreed in August 2018, which sought to assess and discharge all children presenting at Boston within a twelve-hour time frame, with children requiring longer inpatient periods being transferred to Rainforest Ward at Lincoln County Hospital, by private ambulance.

It was noted that by the spring of 2019, however, the PAU was not always strictly following the twelve-hour model.  It was noted further that the absence of an immediate High Dependency Unit-level ambulance transfer service meant that sicker children (non-intensive care) needed to receive the early phase of their care at Pilgrim Hospital, Boston.  Over the intervening two-year period, a more sustainable longer-term model of care had been actively developed alongside the successful recruitment into both the medical and nursing teams.

It was reported that the ULHT Trust Board had supported a revised interim model for paediatric care at Pilgrim Hospital, Boston, moving the service towards a Short Stay Paediatric Assessment Unit, with an average length of stay below 24 hours.  The remit of the unit would be to deliver both an assessment and short term observation function, with the option of some children with defined care plans remaining on in the unit beyond 48 hours.

In conclusion, the Committee was advised that the clinical teams believed that the described model delivered a short stay PAU that reflected national best practice and enabled children and young people to receive their full care needs at Pilgrim Hospital, Boston.

It was also highlighted that general public and patient engagement had been ongoing around the Pilgrim Hospital paediatric service over the last three years, including extensive patient involvement in adjustments to the service offer to reflect local need.

The Committee were invited to provide guidance on the level of public engagement required to make the current service model into a more permanent arrangement.

During discussion, the Committee raised the following points:

·       Congratulations and support was extended to the improved service.  The Committee was advised that there had been a high level of consultation with the local population and patients, which had been gratefully received as had the support of staff at Pilgrim Hospital, Boston.  Particular thanks were extended to the SOS Pilgrim Group for the articulate way the needs of the local population had been presented;

·       Whether the model to be adopted at Pilgrim Hospital, Boston would be replicated in other hospitals and by neighbouring hospital trusts.  The Committee was advised that the model had been seen as good practice, and innovative in its approach.  It was noted that the Trust was taking forward the learning from the service to the Lincoln County Hospital.  It was agreed that further information would be obtained via the Clinical Commissioning Group regarding what paediatric services were in place for Lincolnshire patients requiring paediatric services from neighbouring hospital trusts; and

·       The Support provided to children to help them with their stay in hospital.  The Committee noted that the improved services at Pilgrim Hospital, Boston had enabled staff to support families in a more wrapped around way. 

The Chairman on behalf of the Committee extended his thanks to the representatives for their presentation.

RESOLVED

1.     That the report on the development of the paediatric service at Pilgrim Hospital, Boston over the last three years be noted; and that thanks be extended to staff for their effort in maintaining and restoring paediatric services over the last year.

2.    That the Chairman be authorised to respond to United Lincolnshire Hospitals Trust, outlining the views of the Committee on:

(a)  The substance of the proposal for a short stay paediatric assessment; and

(b)  To support the proposal by the Trust for a twelve-week engagement period.