This review was triggered by a severe shortage of doctors and nurses.
The Board also agreed to develop a full contingency plan to temporarily move paediatric and obstetrics services by 1 September to Lincoln if needed in case the safety of current services cannot be sustained.
ULHT has had a long-standing shortage of children’s doctors and nurses and have carried out extensive worldwide recruitment. For all of Pilgrim’s children’s and maternity services to run 24/7, there should be eight middle grade paediatric doctors at the hospital. With effect from 1 August 2018, it is expected that there will be only one substantive middle grade doctor available.
The Trust has not been resting on its laurels and recruitment efforts continue. This involves working relentlessly with medical agencies, irrespective of financial cost, to find agency and locum medical staff to support the rota at Pilgrim in order to keep the children’s services running safely.
In mitigation, the Trust has recently recruited two agency paediatric consultants to provide more senior input into the rota and now has enough nurses to safely staff up to 12 children’s inpatient beds. The numbers of bed will flex up and down depending on the nurses available. This means that the Trust can now carry out planned surgery on children at Pilgrim.
Dr Neill Hepburn, Medical Director said, “I want to reassure people we are doing everything we can to recruit doctors and nurses to keep services running at Pilgrim.
“This is a difficult time for our staff and the public. We recognise that the potential loss of services causes worry and concerns to Lincolnshire people and we appreciate local services are important to the community and the hospital.
“The staffing situation is unpredictable and constantly changing and we are reliant on agency doctors and nurses with makes it difficult to plan rotas. Just last week we announced we had recruited four longer term locum middle grade doctors but already one has left to work in another country. This is the reality of the volatile paediatric labour market in the UK.
“The supply of junior doctors from August is also now fragile so the Board has charged the Trust Chair and Chief Executive to raise this at the highest levels as soon as possible to ensure sufficient junior doctors are made available.
“With this in mind, we will start to prepare for the worst case scenario to change services at Pilgrim – this will be in parallel of working to maintain services. This doesn’t mean that services will close, it means we will be prepared if the staffing shortage worsens and safety of services becomes precarious.
“If we don’t have the staff at Pilgrim, the safest option for the sick children of Lincolnshire will be to have one safely staffed children’s unit at Lincoln rather than having two poorly staffed services open.”
Board heard that the East Midlands Clinical Senate review on safety of four of the potential temporary options which was commissioned by NHS Improvement and NHS England will not now go ahead.
ULHT has asked the Royal College of Paediatrics and Child Health to review our services and offer their national expertise on best practice and safety in the longer term. This will start in June. Dr Mel Iles, Associate Medical Director for NHS Improvement and a leading paediatrician, is working with Pilgrim clinicians to see what else we can do to maintain services on the ground now.