A shortage of children’s intensive care beds is dangerous and cruel – the Government must act now to end this suffering
4 min read
Why are we tolerating the immense strain which doctors and nurses in Paediatric Intensive Care Units and A&E departments are under, asks Baroness Donaghy
Children lying on the floor in A&E Departments, being bused to different parts of the country because of the shortage of Paediatric Intensive Care beds (PICU) a shortage of specialist doctors and nurses – what an indictment of the Government’s neglect of the National Health Service!
The President of the Paediatric Intensive Care Society, Dr Peter-Marc Fortune, has said: “Everyone feels very buried and that they are working to their limit.” A doctor running a PICU unit described the system as being at breaking point and that it is “dangerous and rotten for the families”.
The Faculty of Intensive Care Medicine (FICM) has challenged the accuracy of official NHS “sitreps” data even though NHS England said the figures were submitted by the hospitals themselves. The “sitrep” data is published weekly by NHS England during winter months to show bed occupancy rates in intensive care units for adults, neonatal intensive care units and paediatric intensive care units – the average official figure was 83% occupancy but the FICM indicates that the figures were nearer 100% in December 2019 and that one in four hospitals “did not recognise their units’ sitrep data”.
One of the main pressures on PICU units is for beds for children with respiratory disease or respiratory vulnerability. A PICU doctor in London said: “We have no beds to accept patients with invasive pneumonia who need surgical resource, and we are stepping children down from intensive care to the main wards earlier than we would like to make way for the relentless influx of newer, sicker patients. The system is at breaking point.”
There is also a national shortage of mental health beds and some vulnerable children are transported hundreds of miles to find appropriate care or do not receive proper care. There was a pitiful example in the weekend papers of a young girl who was suicidal at the age of six years and who was not properly diagnosed for four years. Her parents were carers for 24 hours a day to try to stop her from self-harming.
The system was not geared up to give her proper care at the point of need nor were there sufficient specialist skills available. Once the diagnosis was eventually made, the little girl received appropriate treatment.
Since 1987-88 the number of general mental health beds in England has fallen by 73% from 67,100 to 18,400 according to the Royal College of Psychiatrists. Despite Government promises that mental health would be resourced on a more equal basis with physical health, there seems to be no coherent system for the treatment of children with mental health issues.
A 12-year-old girl who was mentally ill was kept in an A&E Department at Mid-Essex Hospitals for a total of 44 hours and 20 minutes. A source from the hospital cited lack of planning for bed availability and the ongoing lack of engagement from NHS England and the mental health Trust in finding a solution.
The Government must identify the real shortages in children’ emergency beds and set out a strategy for adequate funding and an overhaul of systems where necessary, as well as a plan to train sufficient specialist doctors and nurses.
If doctors do not believe the official figures, this needs investigation. We hear the constant message from doctors that the system is at breaking point. They know they are giving sub-optimal care to children on too many occasions.
Why are we tolerating the immense strain which doctors and nurses in PICU and A&E departments are under? For parents whose child is sick, and are already suffering the strain of that experience, to then witness the system failing their child must be intolerable. The government cannot put this problem in their pocket forever.
Baroness Donaghy is a Labour peer. Her Oral Question on the availability of children's emergency beds is scheduled for Monday 27 January
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