ULHT's on Paediatric Services
Welcome to the latest briefing on ULHT’s efforts to maintain safe children’s and maternity services at Pilgrim Hospital, Boston.
Paediatric staffing latest
Due to the successful recruitment of four short-term locum doctors, Pilgrim’s multi-disciplinary team have said they can now keep the services going, despite difficult circumstances, until the end of July. Many thanks to them, the nurses and all staff involved for making this happen.
With effect from 1 August 2018, it is expected that there will be only one substantive middle grade doctor on the rota at Pilgrim out of rota of 8, with the others being covered by agency staff.
The staffing situation is volatile and constantly changing as the service is very dependent on agency doctors and nurses. While we are working hard to recruit doctors to work longer contracts and permanent staff, the reality is there is a shortage of paediatricians in the UK so agency staff have the pick of places to work and often leave a placement at short notice. This makes it difficult to plan rotas.
Although it’s our preferred option to maintain existing services at Pilgrim, this means it’s looking difficult for children and maternity services at Pilgrim Hospital to be sustained in their current form beyond August unless additional middle grade doctors can be found to fill significant gaps in the rota or other innovative and safe staffing models to be found.
We are 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.
To help support consultants and middle grades, we have committed to fund two extra locum paediatric consultants at Pilgrim.
Inpatient beds at Pilgrim
ULHT now has enough nurses to safely staff up to 12 children’s inpatient beds from a nursing perspective. The numbers of bed will flex up and down depending on the nurses available. This means that we can now carry out planned surgery on children at Pilgrim.
ULHT Trust Board review
I want to stress that no decision on the future of services has been made, and we are working hard to keep children’s and obstetric services at Pilgrim
The review to be carried out by East Midlands Clinical Senate on four of the potential temporary options has now been delayed. NHS Improvement and NHS England have asked them to offer their expert recommendations for which option(s) they consider safest on a temporary basis until a longer term solution can be agreed and delivered. As this won’t be finalised in time for our Board meeting on Friday 25 May but need to make a decision as soon as possible, our Board will still debate and discuss the four options. Board will receive a very detailed paper from the task and finish group set up with detailed equality and quality impact assessments to help us make an informed decision and build in time to make changes if needed ahead of 1 August.
If the Senate report is available in time, our June board will then consider the findings of the Senate’s report and amend decisions or plans accordingly.
We are listening
Over the last week, we have talked to lots of staff and the public.
A theme of people’s views is worry about where will parents and children go in an emergency if paediatric services were closed at Pilgrim. We want to assure people that A&E services will remain as they are now. That is if a child is taken ill with an asthmatic attack for example then paediatric staff in A&E will be there to support the emergency medicine staff.
Along with Dr Neill Hepburn and Sue Bennion, head of midwifery/nursing for women and children’s services, I attended a public meeting at Boston Grammar School on Thursday night. The campaign group SOS Pilgrim chaired the meeting and on the panel answering questions with us were local MP Matt Warman, the mayor of Boston and John Turner the lead for the STP.
As you’d expect the atmosphere was very passionate and many people present were anxious about the potential changes. I hope to have reassured some people that we are very much committed to keeping paediatric and maternity services running at Pilgrim, but due to the services being on a staffing knife-edge we have a duty to prepare for the worst and have thoroughly worked up plans in place in case we need to change services.
Thanks to Philip Bosworth for organising and chairing the meeting.
Whilst there, we also took the names of a few nurses and a retired doctor who may come to help out on the bank, if they are adequately trained.
Dr Mel Iles, Associate Medical Director for NHS Improvement, and leading paediatrician, spent several hours with all our acute paediatricians to talk through the situation, offer her suggestions based on her experience elsewhere and provide support. Matt Warman, MP joined to offer his personal support and listen to the issues too.
ULHT also held its quarterly members locality forum in Sleaford Rugby Club on Tuesday 14 May where I took the opportunity to update members on children’s services. A few members challenged me on not accepting nurses who said they offered to work shifts for us. We seriously consider all registered, qualified staff and have offered bank shifts which often provide the flexibility requested. But the reality is many of the staff coming forward are no longer adequately qualified to do the work required.
Registered nurses across Lincolnshire are constantly being invited to join our nurse bank- to pick up flexible nursing work along with favourable NHS terms and conditions.
Our nurse bank is a really valuable resource for us, helping us to fill nursing shifts on our wards and departments safely. We would like to encourage more people to consider joining the bank.
There are huge benefits for those who join our bank, both in terms of career development and experience and job flexibility.
If you know any registered nurses, particularly registered children’s nurses, ask them to apply to join the ULHT nurse bank today by calling 01522 573049 for shifts at Lincoln and Louth or 01205 446760 for Pilgrim and Grantham.
On Wednesday 16 May, along with Dr Neill Hepburn, Michelle Rhodes, Director of Nursing, Sue Bennion and Dr Rao Kollipara, consultant paediatrician, I presented to Lincolnshire’s health scrutiny committee on children’s services. We were questioned for nearly two hours on a range of issues from transport, to recruitment and midwifery led unit. All questions and statements were pertinent and intelligent and hope we reassured them that we are working hard to keep services going at Pilgrim, and in parallel working on plans for alternatives in case the staffing doesn’t improve. We agreed to go back to the meeting in June on the latest position.
We want you to help us in developing options for the future that best meet the needs of our population, please take few minutes to complete the survey below and please share with your networks. https://www.surveymonkey.co.uk/r/YBGC9LT
Staff from ULHT will also be attending a parish council meeting.
Once again, thanks to all staff working hard to help us continue to provide these services at such a critical time.
This closes on 1 July 2018.