Hospital trusts should ensure adequate children’s community services are in place before closing in-patient units, a senior leader in paediatrics has warned.

This call comes from the Judith Ellis, the new chief executive of the Royal College of Paediatrics and Child Health, who predicts a wave of further consolidations in services as trusts struggle to recruit consultants.

Group of school children

Professor Ellis said there was a risk children’s health services had suffered from the focus on care of older people

The former children’s nurse, who joined the college last month, told HSJ: “If you are trying to get 24/7 consultant cover you have to be realistic – you can’t have them spread out across a wide area.

“We will get consolidation into fewer areas and the college supports that because there is no choice if you want safe quality care for children. The only way to do that is to consolidate.

“We get worried that decisions are taken that aren’t thought through fully. The NHS is under pressure and things are happening, but for us every time someone should be saying ‘is this right for children?’

The college saw danger in NHS trusts pressing ahead with closures without enhancing community paediatric services.

If inpatient services are to be centralised “the services out in the community have to be capable, so you have professionals trained to recognise if a child starts to deteriorate they may need to come in [to hospital] quickly”, Professor Ellis said.

“This is the plan that should be looked for, you do need that alternative plan.”

She continued: “You can’t just close a unit and not have a plan for how you keep children safe and that is where commissioners need to be on the ball.

“NHS England should be keeping an eye on this.”

Professor Ellis added that the college supported a future of enhanced paediatric community services, rapid access clinics and support for GPs and other services from paediatricians and children’s nurses “co-located” in the community.

The college is revising its education standards to ensure doctors had the skills for this new way of working.

“We mustn’t lose the specialty element but it is a real juggle of changing for the benefit for children and not losing what you have that is good,” Professor Ellis said.

“It will be difficult for some people but for the college we have to look at what an effective and quality model of care for children is going to be and therefore training has to change.”

Professor Ellis said there was a risk that children’s health services had suffered from the focus on the care of older people, following the Francis inquiry.