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Hospital's children's A&E services suspended as 'not clinically safe'

Published 25/08/2016

The temporary changes are not impacting the adult A&E, which remains unaffected and open
The temporary changes are not impacting the adult A&E, which remains unaffected and open

A&E services at a scandal-hit hospital have been suspended for under-18s because senior clinicians have advised that they are not safe.

University Hospitals of North Midlands NHS Trust said it acted on Thursday because of a lack of "professionally trained and experienced staff" at Stafford's County Hospital, which used to be called Stafford Hospital.

The trust said c hildren should not be taken to County Hospital as walk-in patients, adding that those with minor illnesses and injuries should use primary care services such as their GP or community pharmacists.

It added: "Families who believe their children need emergency (A&E) attention should dial 999 for an ambulance. Ambulances will always take children to the most appropriate hospital to treat their condition."

Dr John Oxtoby, trust acting medical director, said after an external review and discussion with staff, the conclusion was formed that they "cannot mount an entirely safe and adequate service for children's emergency care in the context of the standards that are required in 2016".

Asked why the trust had taken the temporary decision, Dr Oxtoby said: "The reason is we've been judged against a series of standards that are designed to offer the best possible care for the very sickest of children that might appear in the emergency department, and actually the staffing.

"The particular staff, the skills (they) have in the organisation don't now match up to the standards which would be expected of a children's emergency centre today."

He said the trust was examining options to attract more paediatric medical specialists to enable the resumption of the department, and that relying on locums and temporary staff is not what they are seeking to do.

The announcement came on the day an NHS Improvement report highlighted how NHS trusts in England have halved the total deficit over the course of a year - with £500 million saved through a reduction in agency staff spending, due to controls introduced in October last year.

Liz Rix, chief nurse and acting deputy chief executive, said: "I fully appreciate the impact these temporary changes will have on families in Stafford and the surrounding area, and understand that people will be very concerned about this news.

"However, we cannot and will not continue to deliver services without the confidence that those services are safe."

Dr Ann Marie Morris, clinical director and emergency medicine consultant, said the decision was taken "in the best interests of children".

"People view the Children's Emergency Centre as a safety net, but this is only the case when the right number of professionally trained, experienced staff are in place at all times," she said.

"This is not currently the case and, as we cannot resolve this in the short term, the only responsible course of action we can take is to suspend the service."

The Stafford Hospital scandal involved poor care and high mortality rates among patients in the late 2000s.

It was renamed County Hospital after a £6 million public inquiry into the scandal, which concluded that hundreds of patients died after receiving poor care.

The hospital is not the only one to be hit by A&E staff shortfalls in recent months.

Earlier this month, Grantham and District Hospital announced it was to temporarily close its doors at night because of a shortage of emergency doctors.

In April, Lancashire Teaching Hospitals NHS Foundation Trust was forced to temporarily downgrade Chorley and South Ribble Hospital to an urgent care unit because it did not have enough doctors.

At the time the hospital said that continuing to provide a service without enough doctors would be "negligent" and put patients at "unacceptable risk".

In June, North Middlesex University Hospital NHS Trust also conceded that it was "facing a number of issues" in the A&E department, "particularly around medical staffing".

Last month the Royal College of Emergency Medicine warned that a gap between supply and demand for emergency doctors was leading to a "real crisis".

Stafford Conservative MP Jeremy Lefroy said he is "deeply disappointed" by the suspension and is pushing for the matter to be "resolved urgently".

"It is a vital part of our local NHS, serving some 30 of my younger constituents every day," he added.

"The safety of patients is paramount and so I understand the trust's decision to suspend the service.

"But the trust also has a clear responsibility to restore this essential service as soon as is safely possible."

Dr Anthea Mowat, chairwoman of the British Medical Association representative body, said the closure is another example of patients being failed because the Government does not appear to have a solution to the NHS workforce crisis.

"Emergency medicine in particular is experiencing a recruitment and retention crisis. This is crippling at a time when we need more of these doctors to keep up with rising demand on services," she said.

"More broadly, in light of further possible closures, we urgently need a long-term strategy for the NHS that addresses the fundamental workload and funding challenges that are overwhelming our health service."

Dr Clifford Mann, president of the Royal College of Emergency Medicine said the decision is "regrettable but sensible".

"All of the stories we have seen over recent weeks have one common theme - a lack of staff. There simply aren't enough doctors at a national level to cope with demand," he added.

"Urgent action is now essential and responsibility must be collective. There is a national crisis in the provision of emergency care and resource and staffing issues must be urgently addressed."

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