Agenda item

Presentation by Julie Bloomfield, Network Manager, North East & North Cumbria Paediatric Critical Care & Surgery in Children ODN.

The OSC was given an update on paediatric critical care beds. An overview was given on operational delivery networks and what paediatric critical care is, including levels, commissioning and healthcare worker ratios.

There are only two units in the country that provide paediatric cardiac transplants and the Freeman Hospital is one of them, making it internationally sought after.

The picture now as opposed to ten years ago is drastically different. Key differences are:

·        There is a cohort of children with very complex needs to are very susceptible to illness.

·        Children’s ability to fight acute infectious diseases has improved.

·        54 patient beds have been lost.

·        There are two short stay assessment units.

Great North Children’s Hospital (GNCH) is being overwhelmed with pressure at the moment. Mental health issues are having an impact on physical health as well. Children and young people with mental health problems can be admitted for significant time for mental health issues, which can also impact the availability of beds for other patients across the region. The Committee asked about provision for parents. GNCH has beds in cubicles for parents to sleep in, however car parking can be expensive. A charity called James Cook makes sure that families have meals but GNCH are unable to do this.

Durham and Darlington have one of the largest populations of children and young people across the region. Workforce issues are significant and have been out to advert 3 times.

There were some concerns about measles being prevalent which is being addressed. There is new RSV immunisation which will be available next winter and will have a positive impact on cases.

Before considering a transfer out of region, young people over the age of 16 may go into an adult service using the adult mutual aid pathway. However, if this team is under a lot of pressure, there is an attempt to treat in adult critical care and/or ask adult critical care staff to come and help in CYP.

The following have been developed:

·        Mechanisms for how to move sick children when necessary to different hospitals and/or provision.

·        A quick MS form that captures data on these cases.

·        Significant training and support for staff.

The NECTAR Bed Report shows that GNHC has the highest number of beds (130 in-patient beds), which is significantly higher than other locations (James Cook has second highest of 42 in-patient beds).

An update was given on the managing of winter demand including communication methods, the managing of demand, and tools and resources.

Surgery and Childrens Network is also included in this service. The service consists of 9 colleagues. This service is not a provider, it acts as a facilitator and aims to understand what young people in the region need when it comes to hospital care. Young people’s cases are only 20% of the population, so while numbers look more severe for adults the reality of children’s numbers is more extreme than it appears in data.

The Committee asked about dentistry waiting times. There are 1371 children waiting in the region, which is the highest waiting list. The next highest is Ears, Nose and Throat (861).

RESOLVED

       i.          The Committee noted the report.