Agenda item

5.1       The Committee considered a report updating on the outcomes of the changes to the paediatric service model at EDGH, and East Sussex Healthcare NHS Foundation Trust’s (ESHT) response to the recommendations of the Committee’s review report. Dr Matthew Clark, Chief of Women and Children Division ESHT, introduced the report and highlighted that there had been a slight decrease in the number of children being transferred to Conquest Hospital in Hastings, and that no patient safety incidents had been raised since the implementation of the new model.

5.2 The Committee asked for an update how the Scott Unit would be used in the future.

5.3 Dr Clark confirmed that the Scott Unit, which had previously housed the short-stay paediatric unit, was reserved for paediatric services. The area was currently being used as a paediatric outpatient area as the usual area on Friston Ward had needed to be temporarily closed for fire safety work. There was ongoing work on how the space could be used in the future to create a child-friendly environment for both acute and community paediatric services.

5.4 The Committee asked why the Committee’s recommendation of having the paediatric consultant responsible for GP telephone triage on-site at Eastbourne was not being progressed.

5.5 Dr Clark noted that presently there was a split between where the paediatric consultant doing telephone triage was located depending on where they were based. Roughly a third to half of the time the consultant was based at EDGH, and half to two thirds of the time they were based in Conquest. Having run the new model for six months there had been no noticeable advantage of having the consultant permanently based on-site at Eastbourne. Extensive discussions had taken place with the consultant body where there was an almost unanimous view that they did not need to be based at Eastbourne and the independent review had agreed. Dr Clark also confirmed that staffing of all services were under constant review, and where staff were based could and would be moved to match need and demand.

5.6 The Committee asked if ESHT had data on whether any families were travelling independently to Conquest Hospital in Hastings as a result of the changes.

5.7 Dr Clark noted that there was not a robust way for capturing this information, recognising that the ability of patients to choose where to be treated was a feature of how people accessed NHS healthcare. Dr Clarke added that if a child is unwell enough to be taken to hospital by ambulance, the ambulance would take them to the Conquest hospital and this has not changed.

5.8 The Committee asked for confirmation of whether there were any trainee paediatric consultants working at EDGH.

5.9 Dr Clark confirmed that there were currently no resident doctors (previously known as junior doctors) training to be paediatric consultants.

5.10     The Committee asked if there had been any changes in the number of complaints from staff, patients or families.

5.11     Dr Clark noted that the number of complaints had remained stable, and there had not been a noticeable increase or decrease in the number. There had also been no formal staff grievances made and despite some initial disruption people had successfully moved into their new roles. The additional Advanced Paediatric Nurse Practitioners in the Emergency Department were working well with the team. Richard Milner, ESHT Chief of Staff, added that if a formal complaint came into the Trust, it would be reviewed by either himself of Joe Chadwick-Bell (Chief Executive), and he confirmed that there had not been a single formal complaint from a member of the public about the new model.

5.12     The Committee asked if ESHT were confident it had sufficient capacity to deal with the level of demand in Hastings.

5.13     Dr Clark confirmed that the new model had not resulted in increased demand for paediatric care in Hastings. It was unusual for Hastings to not have enough capacity on the ward to meet demand, although it did occasionally happen. There was consultant ward rounds seven days a week and a consultant always on call. In addition, there were now two consultants on site during winter to support the level of demand and had made recent changes to resident doctors rotas to make them more available. He added that ESHT was also pleased to be supporting local GPs to deliver paediatric services closer to communities, especially in areas with greater deprivation.

5.14     The Committee whether high ambulance wait times impacted on children when they needed to be transferred from Eastbourne to Hastings.

5.15     Dr Clark answered that if a child was sufficiently unwell that they needed to be transferred between hospital sites they would be prioritised by the ambulance service. The Trust had an existing transport policy to support vulnerable families to travel between sites that are unable to do so via their own means.

5.16     The Committee asked for an update on the implementation of recommendations 5 and 6 of HOSC’s review, relating to finalisation of care pathways and communications to families.

5.17     Dr Clark confirmed that all care pathways had been finalised and were to be signed off at an internal meeting soon, although children were already being cared for along those pathways. ESHT agreed to share the details once they had been formally ratified. Dr Clark also confirmed that there had been communication with families of those with very complex needs who are regular attendees at the hospital to develop their individual care pathways. There was still work to develop some chemotherapy pathways, which was highly specialised and needed careful consideration to ensure it was done correctly.

5.18     The Committee asked if there had been any significant safety issues or service incidents since the Committee last received an update in March.

5.19     Dr Clark confirmed that there had been no serious patient safety incidents reported since the new model had been implemented.

5.20     The Committee asked if Healthwatch’s feedback related to the new model and paediatric space could be shared with the Committee.

5.21     Dr Clark answered that the Trust was happy to share the feedback Healthwatch had provided.

5.22     The Committee asked how patients and families would be consulted on the future use of the Scott Unit.

5.23     Dr Clark explained that there was an ongoing programme of work on how the Trust could best utilise its estate for paediatric services, which would involve consultation with staff and service users. ESHT would hopefully be in a position to provide a more detailed update at the December HOSC meeting.

5.24     The Committee RESOLVED to note ESHT’s response to HOSC’s review recommendations, ESHT’s update report, and the independent report on the new service model in Appendix 2.