A good start
The new paediatric assessment centre opened on what was ward 4A on Monday 6 August. We have seen over 600 children since then and around 520 have been discharged home and family with no need for further inpatient care. The remainder went on to other hospitals that could deliver the ongoing care the children required.
The model has been working well. During the first few months there have been a number of occasions when children have stayed longer than the agreed 12 hours maximum stay. Every occasion when a child stays over 12 hours on the assessment unit is recorded on our incident reporting system (DATIX) and investigated. Analysis shows that no harm to the patient has resulted from any of these delays.
The team are working hard developing new pathways and ways of working to minimise any delays. An example of the pathways being reviewed is one currently underway for the transfer of patients requiring high flow oxygen.
We have found that we did not need the expected number of private ambulances to cover peak times, and so now we have one ambulance available 24 hours per day, with a second available during peak periods only. We have made sure, however, that if the number of children requiring to be transferred should increase over the winter we can increase ambulance provision.
Detailed plans are currently being finalised to make certain that the service will be sensitive to possible increased demand over the winter period and we can sustain the progress that has been made.
Recruitment and staffing
As in previous months, the recruitment activity continues at pace. An additional middle grade doctor to support the rota was agreed last month. There is now one substantive middle grade doctor working with six agency locum middle grade doctors within the current rota. Three new doctors have started with us in the past few months and an additional six doctors are going through the recruitment process.
Our recruitment efforts include:
- A rolling NHS jobs advert for medical staff.
- Recruitment to medical agency staff.
- International recruitment.
- Use of specialist recruitment support.
- Training junior doctors at the Pilgrim Hospital.
- Exploring other models of recruitment to fill vacancies.
We have also been successful in our negotiations with the organisation that manages medical trainees; HEEM, to allow trainees to work some locum hours at Pilgrim to fill rota gaps.
Royal College of Paediatrics and Child Health independent review
We have very recently received the report carried out by the Royal College of Paediatrics and Child Health into the service, which is broadly supportive of our current approach. We are now going through the report and its recommendations in detail and developing an action plan which we will share with you before it is finalised to ensure we have all aspects covered.
Visit by Matt Hancock MP, Secretary of State for Health and Social Care
Matt Hancock visited the new assessment unit, among other areas in the hospital, to see for himself what progress we are making to sustain the services in spite of the staffing challenges we face. He left reassured with our progress and the initiatives we are taking to recruit and retain key staff.
Due to the ongoing staffing issues we have to establish a children’s service that is fit for the future in a rural community. We intend to work with you, our staff, partners and families to ensure that Lincolnshire is used as a role model for others facing similar challenges.
We will continue our engagement with staff, patients, individual members of the public and interest groups around our service, including visiting groups, gathering opinions in public areas and holding our own engagement events.
The next engagement session will take place from 7pm to 8.30pm on Tuesday 6 November in the committee room in the Postgraduate Medical Education Centre at Pilgrim Hospital, Boston and we would welcome as many contributions as possible.
If you intend to come along, please RSVP to firstname.lastname@example.org or ring 01522 572301.
In addition, we are planning further engagement sessions in Boston market place, supermarkets and play areas, as well as with groups representing parents of children with long term conditions and those from the migrant community.
We have also worked with campaign groups to identify patients they have been in contact with who have raised issues about the service and interim model, to help understand the issues and address them. All information we receive through our engagement activity is highly valued and shared with the service for consideration as part of future planning for the service.