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A winter shake-up of children’s emergency care services in north-central London has left nurses “distressed” and concerned about patient safety, with some even quitting their jobs, Nursing Times has been told.
In the wake of Covid-19, paediatric accident and emergency departments at University College Hospital and Royal Free Hospital have been closed “temporarily” and patients are being diverted to the Whittington Hospital.
Nurses and staff from the closed departments have been given the option of moving to Whittington, which is set to be expanded to meet demand.
“It just worries me how they will be cared for at Whittington because there’s a serious lack of space and staff”
The changes would ensure children and young people’s services could continue uninterrupted if there was an increase in demand due to the pandemic over the winter period, according to North London Partners, the group overseeing the reorganisation.
The new model had been approved by the North Central London Clinical Advisory Group as the “safest way to deliver services for children and young people over the coming months”, it added.
However, one children’s nurse from the Royal Free Hospital in Hampstead who has spoken anonymously to Nursing Times said the changes had not been welcomed by all frontline staff.
They said “at least half” of the team that was expected to move over from University College Hospital had resigned and that the “majority” of them were nurses.
The resignations meant Whittington Hospital was struggling to meet the nurse workforce requirements for the expanded service, according to the nurse.
They said the original plan at Whittington Hospital was to have 56 inpatient beds for children and young people but due to staff shortages, less than 20 were open.
This was a “major issue” going into this winter because of the anticipated acuity of patients, added the nurse.
The nurse said they were concerned about the safety of patients, particularly those with long-term or complex conditions, who would now be treated at the Whittington where there was a “serious lack of space and staff”.
They added: “We have a lot of complex children – there are some children that are our regulars that are complex, either disabled, or they have long term conditions…or they’re known to have respiratory conditions every winter.
“Some of them, they always end up intubated every winter, and it just worries me how they will be cared for at Whittington because there’s a serious lack of space and staff.”
Significantly, they said they feared that a child might die at the Royal Free because of the removal of children’s nursing staff and services there.
“I’m really concerned and distressed that it is inevitable that a child will die at the Royal Free because there’s just been sort of this pattern of children dying when an A&E is closed,” the nurse said.
The nurse said they wanted to see changes reversed but was worried that children’s services at the Royal Free Hospital would remain permanently shut.
“Nurses are angry that their patients and their services are being put at risk without any real consultation or transparency”
Anthony Johnson, registered nurse and lead organiser at Nurses United, said the group had been supporting several members within London trusts on this issue.
“Nurses are angry that their patients and their services are being put at risk without any real consultation or transparency with the public or staff,” he told Nursing Times.
Lisa Elliott, director of the Royal College of Nursing London, said it was “aware of the proposed changes and will support any members that need it”.
“Any permanent changes would need to be consulted on,” she added.
Whilst Unison London head of health Jamie Brown said: “Any Covid-related staff moves must only be temporary.
“No one should be forced to move their workplace to a different trust.”
North London Partners works with partners across north-central London, including the clinical commissioning group and NHS providers to support a system-wide response to the coronavirus pandemic.
In response to the claims made by the nurse, a spokesperson on behalf of North London Partners said: “The Whittington Hospital’s children’s emergency department has expanded to accommodate the temporary diversion of UCLH’s and the Royal Free Hospital’s children and young people’s emergency departments.”
They assured that the emergency department at the Whittington Hospital had “sufficient paediatric healthcare professionals and beds to care for children requiring urgent and emergency care this winter”.
They added: “Nursing teams have done an incredible job responding to the Covid-19 crisis, many being redeployed to other services and sites, and a small number of emergency department paediatric nurses working at the Whittington have stepped down in the last six months for different reasons, including to relocate and pursue other career opportunities.”