Doncaster and Bassetlaw NHS Trust STP — House of Commons, 2017-01-30
Topic: Health
Philip Martin Dunne (Conservative, Centre-right): I start by paying tribute to the passion with which the hon. Member for Bassetlaw (John Mann) laid his case before us this evening, and I share his welcome to my hon. Friend the Member for Newark (Robert Jenrick), who joins him here The hon. Gentleman’s remarks are clearly timely, and he started his contribution by laying out his vision for innovative technology to be brought to bear for the people of South Yorkshire and Bassetlaw through the emerging sustainability and transformation plan. He drew on his experience from across the world in his previous life to try to bring innovation to bear, and I will touch on the STP towards the end of my remarks The hon. Gentleman spent most of his contribution talking about the more immediate issue of the challenge of maintaining a 24-hour children’s ward in Bassetlaw hospital. He has given us many examples of the impact of the current closure—or the fear of the impact of the closure—on families in his constituency and their children who have had experience in the ward. He did so with considerable empathy and conviction, and I am sure his constituents will be grateful for that I wish to start my remarks by setting out the facts as they have been presented to me in preparing for this debate. It is the case that Bassetlaw hospital stopped providing an overnight children’s service today. Children who would have been treated at Bassetlaw overnight will now be treated at the Doncaster royal infirmary or Sheffield children’s hospital. The closure is being undertaken by the trust on safety grounds, as there are workforce shortages for both paediatric medical and nursing staff, despite attempts to fill the gaps with locum staff. This is a patient safety issue; the current situation does not offer a safe and sustainable service, which the hon. Gentleman would expect for his constituents. That is the fundamental premise on which this decision has been taken. The replacement service will be monitored to ensure it is safe and effective prior to any decision in October about the long-term future of the service In December 2016, the trust identified an emerging issue with safely staffing children’s nursing, as there were gaps of six whole-time-equivalent registered children’s nurses. The trust has attempted to source children’s nurses through locum agencies but has been unsuccessful. Additionally, there is currently a three-person gap on the junior doctor rotation at the trust. I am advised that the trust has undertaken an overseas recruitment drive for medical staffing through an agency, but this has also, unfortunately, not been successful The situation with the workforce and the unpredictability of the locum doctor cover has resulted in the ward being temporarily closed at night to new admissions on many occasions in recent months, but children admitted earlier in the day who are stable have remained on the ward overnight. To put this into context, between 1 November and last Friday the trust had transferred 23 children out of the ward, averaging two per week. The total number of children remaining in the ward overnight from 1 September was 452, an average of three per night. I want to assure the hon. Gentleman that the trust appreciates that some children are admitted to the ward regularly—he gave us such examples from constituents’ emails—but due to the nature of their illness it is impossible to predict when this will be. The trust is contacting regular users of the children’s ward individually to discuss their particular care needs and how these can be best delivered under the new system. The trust will continue to provide a seven-day "hot clinic" service for ill children who need to be seen quickly for clinical diagnosis but are unlikely to need an admission for assessment. I understand that this clinic will also invite children discharged from the assessment unit on the previous day for a consultant review, if clinically necessary. This will offer parents confidence about their child’s progress if they have been in the assessment unit the day before The service that has become operational as of today is a consultant-led paediatric assessment unit, providing services seven days a week. The intention is that this will run from 8 am to 10 pm, with a cut-off time for the last admitted child for assessment of 8 pm each day. At the moment, the cut-off time for assessment is 7 pm, and that will move to 8 pm following a review after the new model has been operational for two months. As ever, the paramount consideration is the safety of the children Children admitted during the day who have been assessed by a consultant as "acutely unwell" will be rapidly transferred to a centre such as the Doncaster royal infirmary or Sheffield’s children’s hospital. I understand that the new model of care for the trust is consistent with Royal College of Paediatric and Child Health guidance, and represents the latest and safest national guidance The hon. Gentleman referred to long waits for non-urgent patient transport, and I can provide some reassurance on that. The trust and the CCG have, from today, jointly commissioned a dedicated urgent transport facility to be available from 4 o’clock in the afternoon to 2 o’clock in the morning, seven days a week, specifically to cater for any necessary children’s transfers. The trust is committed to providing the highest-quality care for children, as recently demonstrated when it invested around £250,000 to build the assessment unit and new children’s out-patient area We should remember that the decisions on how to provide safe care for children, which come into force today, are a matter for the local NHS. It is right for these issues to be addressed at a local level, where the local healthcare needs and demands are thoroughly understood and considered. The local NHS makes decisions to ensure the safety and welfare of patients. Although the decision may cause upset and disruption for patients and families, it is for the local NHS to ensure that the services provided are of the highest quality possible and are safe and sustainable. Above all, parents with sick children need to have confidence that their child will be treated at the safest level and by the most appropriately qualified staff. I am sure the hon. Gentleman will agree that that is paramount Nottinghamshire County Council’s scrutiny committee has been informed of the service changes, and I understand that no decision was made to refer the changes to the Secretary of State.