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Changes To Paediatric Services Announced

July 15, 2013

BEDFORD Hospital NHS Trust has today (Monday, 15 July) announced changes to the way its paediatric services will be delivered.

The changes, which are an interim measure, follow a decision by Health Education East of England and the General Medical Council, to withdraw junior medical trainees from the hospital’s paediatric department.

To ensure paediatric services can continue to be delivered safely from 1 August (after junior doctors in paediatrics leave on 31 July) the Trust must change the way children’s care is delivered in the interim.

The decision over which services should change and how they should change was taken following a series of ‘risk summits’, led by NHS England, and involving the NHS Trust Development Authority, Bedfordshire Clinical Commissioning Group, Bedford Hospital NHS Trust, the East of England Ambulance Trust and other local hospitals.

From 1 August 2013, the Trust will, in the short term, no longer provide:

• Planned overnight inpatient care (on Riverbank Ward) for children having planned (elective) surgery, or planned medical procedures or care. Children will be cared for by their Bedford consultant at Milton Keynes Hospital (or another neighbouring hospital)

• Emergency overnight inpatient care (on Riverbank Ward) as there will be no emergency admissions from 31 July

• Children’s Accident and Emergency (children brought to hospital by ambulance will go straight to the next nearest hospital. Children (those aged up to 19) should not be brought to A&E as walk in patients from 1 August.

• Children’s Assessment Unit, for children requiring short-stay observation following attendance at A&E (as there will be no emergency admissions from 31 July)

The Trust will continue to provide:

• Children’s outpatients services (all children’s outpatients clinics will continue to run as normal)

• Nurse-led ambulatory care for children with chronic or long term conditions whose care can be managed by specialist paediatric nurses

• Day Unit (on Riverbank Ward) with day case care following planned surgery, or for planned medical procedures or care

• Maternity services and neonatal services are unaffected and continue to run as normal

• All other services, including adult A&E remain as normal.

Children are defined as being aged up to 19.

Acting Chief Executive, Stephen Conroy, said: “I know the strength of local feeling for our children’s services, for Riverbank Ward and our fantastic children’s nurses, and I fully appreciate the impact these changes will have on families in Bedfordshire.

“I am deeply sorry for the anxiety and distress the announcement of these changes will cause.

“It is important to remember that we must take these steps to ensure children’s care and treatment can continue to be delivered safely at all times. We cannot and will not continue to deliver services without the right number of doctors to safely do so.

“These changes do not mean that Riverbank Ward is closing, as we will still be treating and caring for children here. We will not be putting nursing jobs at risk.

“These changes are significant, but we are working to secure a safe and sustainable future for children’s services for local people, here at their local hospital.

“What is of most concern for me now, is making sure families in Bedfordshire know where they need to go and what they need to do if their child becomes unwell.

“Staff will be talking to all families with children who have planned operations or medical care, as well as those with chronic or long-term conditions. We will also be launching a public information campaign to help families understand the changes and what they mean.

“Critically, we are advising families who need emergency (A&E) attention for their child to dial 999 for an ambulance.

“This is a difficult time for families and the local community. Our focus is on making sure care is safe in the short term, and on ensuring long term sustainability for families to access the majority of emergency and planned children’s care at Bedford Hospital.”

Families or young people with concerns about how the changes may affect them should contact Riverbank Ward on 01234 730500.


Emergency Access

If families have a sick child who requires urgent medical attention they should dial 999 for an ambulance.

From 21 July no child will be brought to Bedford Hospital by ambulance.

From 1 August children should not be brought to Bedford Hospital A&E as walk-in patients.

The Trust has a statutory duty to provide medical care to all patients who come to A&E. As such if a sick child is brought to A&E, paediatric staff in Bedford’s A&E department will see them, stabilise them and arrange their transfer to another hospital (or treat and discharge them if their illness or injury is very minor). Sick children and families will not be turned away from A&E without help.

Key Figures

• The A&E department sees around 17,000 children each year (between 40 and 50 each day); with between four and six children admitted each day

• Riverbank Ward provides overnight planned care (surgical and medical) for around three patients each week

• Around 260 children have ‘open access’ to Riverbank Ward. These children will each have a care plan and staff will contact families about their individual needs/ how their care may be affected by these changes

• 526 children are seen for the first time by a consultant paediatrician as outpatients each year, and 1,300 children have follow-up appointments. This does not include children seen by other specialists (e.g. dermatology or orthopaedics)

• 750 children a year (between two and four a day) are treated as day cases


The Trust was notified on 5 July of Health Education East of England/ The General Medical Council’s decision to withdraw the most junior medical trainees from the paediatric department. Junior doctors were going to be withdrawn on 12 July, but HEEoE/ GMC agreed to extend that date to 31 July to allow a safe change to services. Services will change from 1 August (00.01 on 1 August).