- Understood concerns over advice given by 111 “escalated” to national leaders
- Sources say problem is a national issue
- Harm described as “collateral damage” of covid-19 crisis
Children may have died from non-coronavirus illnesses because they are not coming to hospital quickly enough, amid concerns NHS 111 may be giving flawed advice to stay away, according to senior paediatricians.
HSJ understands the concern about 111 giving the wrong advice to parents who should travel to hospital had been “escalated” to national leaders.
Several senior paediatric leaders in London raised serious concerns to HSJ. They said several children in the past week had been admitted to intensive care in London, and had been harmed — and, in some cases, died — because of the issue, though they did not want to identify particular hospitals or cases. The sources said it was a national problem.
One senior source at a children’s hospital said: “Some children without covid-19 have come to harm as a result of [the] current situation… changes ought to be made to 111 for children.” The source described it as “collateral damage” from the covid-19 situation.
NHS Digital, which runs NHS Pathways — the triaging software used by 111 to give advice — said there had been no changes to the Pathways algorithm which would result in people being advised not to go to hospital if their symptoms suggested it was the most appropriate option.
NHS England, which oversees the commissioning of NHS 111, said on Saturday that the ”clear message to parents and to patients is that they should continue to come forward for essential and urgent care”.
Royal College of Paediatrics and Child Health president Russell Viner told HSJ: “We’ve recently heard reports of a small but worrying number of cases where children may have become very unwell or even died because they weren’t seen early enough.
“There could be a number of reasons for this and we’re trying to find out more but our message for parents is clear: if your child is very unwell, we want to see them — we don’t want parents to wait or to worry.
“If parents are concerned and can’t get through on the phone, we want them to contact their GP or, if very worried, to go to a local urgent care centre or to [accident and emergency]. Hospitals have measures in place to help protect people from covid-19.”
A message distributed on social media and Mumsnet yesterday, which is said to be from someone who works in a London paediatric intensive care unit, read: “I work on a PICU in London. In the last 48 hours we have lost four children and we have two critically ill whose lives are in the balance.
“NONE of these cases is attributable to C-19 and in all six cases, these children probably would not have needed intensive care and certainly wouldn’t have died, had they been brought to hospital in good time.
“The reason they weren’t, in all six cases, is because they were advised by 111 that hospitals are now dangerous places and they should stay at home. Our consultants are seeking an urgent meeting with [Public Health England] to get the advice changed.
“PLEASE, if you are a parent and worried about your child, ESPECIALLY if s/he has an existing, managed condition, DO NOT accept this advice — trust your parental instinct and get your child to A&E if you are worried.
“Hospitals are NOT more dangerous than your child’s condition and the A&E departments are quieter than normal as only the genuinely in need are presenting, for the obvious reason. Please remember to follow guidance on social distancing and hand washing.”
Several paediatric sources in London, having seen the message, said they shared the concerns expressed.
NHSE said: ”The NHS is pulling out all the stops to respond to the biggest global health threat in a century, while also ensuring that people of all ages can still access the services they need in as safe a way as possible.
“There is capacity across the country to treat all those needing it at this time, and the clear message to parents and to patients is that they should continue to come forward for essential and urgent care.”
Updated 3 April 4.40pm with NHS Digital comment, and on 4 April at 1.15pm with NHS England’s comment.
Information provided to HSJ