• Royal college review backs closure of children’s emergency centre
  • Earlier review highlighted “potentially life threatening” management of cases
  • Concerns follow a review in 2006 highlighting similar fears for safety

Children’s lives were put at risk because of unsafe emergency services at Stafford Hospital, a review by the Royal College of Paediatrics and Child Health has warned.

The RCPCH recommended the children’s emergency centre, which closed due to safety concerns last year, should not reopen and should be replaced by an emergency care centre.

The centre was part of the service model introduced after the trust special administration process, which led to the dissolution of the Mid Staffordshire Foundation Trust.

The royal college was invited to review emergency services at Stafford Hospital – since renamed County Hospital – after a report raised serious concerns about the standard of care available to children.

A report by the West Midlands Quality Review Service in August said the children’s emergency centre, which opened in April 2015, presented immediate risks to children. It said there were not enough staff and those there lacked sufficient paediatric and anaesthetic training, including resuscitation and life support competencies.

Out of five cases it reviewed the service said three “were not managed appropriately with potentially life threatening consequences”.

An invited review by the college has agreed with the earlier report and said the emergency centre, which saw 30 children a day, should remain closed. The trust has published a summary of the RCPCH report and said it will release the full report at a later date.

The issues have come to light more than 10 years after a similar peer review made almost identical criticisms of children’s care the hospital. That report also highlighted “immediate risks” because of low levels of medical and nursing staff trained in paediatric life support. It said staff were absent from the A&E for “much of the day” and no one was on duty in the paediatric ward with relevant training at night.

The latest report, by two consultant paediatricians, a consultant anaesthetist, an expert children’s nurse and a lay reviewer, said an urgent care centre providing GP led services for minor injury and illness in children and young people could be provided by specialist nurses and meet the majority of local demand. Children with serious illnesses should be transferred to University Hospitals of North Midlands Trust’s site in Stoke.

The RCPCH said the new service could take time to develop so a children’s emergency centre should remain in Stoke, but added:

  • Nursing cover must be strengthened with emergency nurse practitioners and advanced paediatric nurse practitioners.
  • All clinical staff must have up to date paediatric resuscitation training including at least one member of staff should have advanced training and always be available.
  • Minor illness managed with “front door” primary care.

The RCPCH reviewers said: “The review team agrees with the findings of the WMQRS that the children’s emergency centre at County Hospital was not working safely and supports the trust’s decision to close the service.

“County Hospital has an enthusiastic and committed team, particularly the children’s nurses, and a local population who are passionate and dedicated to maintaining local services. However, the current arrangements cannot continue.”

The RCPCH said almost half of patients were still attending the hospital with minor illnesses rather than seeing their GP with the review saying the service was not set up to manage this safely with a risk serious conditions could be missed.

Andrew Donald, chief executive of Stafford and Surrounds CCG, said: “The CCG accepts the findings of the report and agrees that patient safety must remain our priority.

“We also have to find a way to make sure that patients are seen by the most appropriate service and will be working with the trust on the recommendation to implement a GP front of house service in the accident and emergency department at County Hospital, which we believe will help to support this.”

Staffordshire still unsustainable after 'failed' Mid Staffs dissolution