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St John's Hospital children's ward to partially close over summer St John's Hospital children's ward to partially close over summer
(about 7 hours later)
A children's ward at a West Lothian hospital is to close to in-patients over the summer because of staff shortages. A children's ward at St John's Hospital in Livingston is to close to in-patients over the summer because of staff shortages.
NHS Lothian's decision to shut the ward to patients needing overnight care follows a warning that if it stayed open, it would pose a risk to patients. NHS Lothian's decision to shut the ward to patients needing overnight care followed a warning that it would pose a risk to children if it remained open.
The ward at St John's Hospital in Livingston treats more than 3,000 children a year. The ward treats more than 3,000 children a year.
The Scottish government said the closure, from Friday, was temporary. NHS Lothian said it had not managed to fill key medical and nursing posts in the ward despite recruitment campaigns.
The need to avoid an "unplanned service collapse" and suggesting closure initially for six weeks came in an internal document sent to the health board's chief executive. This had led to the service being heavily reliant on locum doctors, as well as staff from the hospital and the Royal Hospital for Sick Children in Edinburgh working extra hours.
The initial suggestion to close the ward overnight for six weeks in order to prevent an "unplanned service collapse" was made in an internal document sent to the health board's chief executive.
Day surgery
NHS Lothian said the children's ward would continue to operate as an assessment and programmed investigation unit from Monday to Friday between the hours of 08:00 and 20:00.NHS Lothian said the children's ward would continue to operate as an assessment and programmed investigation unit from Monday to Friday between the hours of 08:00 and 20:00.
'Unacceptable risk' Non-residual care, such as day surgery, will continue. There will be no change to maternity and neonatal services at the hospital.
It said the decision to implement changes was taken due to staffing and recruitment issues. The Scottish government said the closure, from Friday, was temporary.
The health board said that, despite national and international recruitment campaigns, it had not been possible to fill the key medical and specialist nursing posts and the service was heavily reliant on locum doctors, as well as staff from the Royal Hospital for Sick Children and St John's Hospital working extra hours. Children who have been assessed and need to be admitted to hospital, or those who become ill between 20:00 and 08:00, will be transferred to the Royal Hospital for Sick Children in Edinburgh.
Jim Crombie, chief officer of acute services, NHS Lothian, said: "We have not taken this decision lightly. The safety of children must be our top priority and all our services must be appropriately staffed. There was a similar closure three years ago due to staffing problems, and in June 2013 an expert team suggested replacing the ward with a short-stay unit to assess patients and refer them on.
"We are fully committed to maintaining and indeed expanding the role of St John's Hospital as one of Lothian's three major acute hospital sites, but if we don't make changes now to the operating hours of the children's ward, we run the risk of having to make an unplanned closure at a few hours notice, which would lead to the sudden diversion of patients. About 700 of the 3,000 children admitted to the ward last year required an inpatient stay of 24 hours or more.
Jim Crombie, chief officer of acute services at NHS Lothian, said it had not been possible to secure enough staff over the summer and, following a detailed risk assessment, the reduction in opening hours had been considered the safest option for children in West Lothian.
The decision had not been taken lightly and the safety of children "must be our top priority and all our services must be appropriately staffed", he said.
Mr Crombie added: "We are fully committed to maintaining and indeed expanding the role of St John's Hospital as one of Lothian's three major acute hospital sites, but if we don't make changes now to the operating hours of the children's ward, we run the risk of having to make an unplanned closure at a few hours notice, which would lead to the sudden diversion of patients.
"We have relied on our dedicated staff from St John's and across Lothian to work additional hours to provide these important services, but we cannot continue to rely indefinitely on a small number of staff working excessive hours."We have relied on our dedicated staff from St John's and across Lothian to work additional hours to provide these important services, but we cannot continue to rely indefinitely on a small number of staff working excessive hours.
"We must have a reliable and safe way of treating patients without that unacceptable risk of last-minute closure.""We must have a reliable and safe way of treating patients without that unacceptable risk of last-minute closure."
He added: "It has not been possible to confidently secure enough staff over the summer and, following a detailed risk assessment, this reduction in opening hours is considered the safest option for children in West Lothian." 'Same problems'
'Cannot go on' Local Labour MSP Neil Findlay said the long-term future of the ward was now in doubt, and called on the health secretary to "sort out this mess".
Non-residual care, such as day surgery, will continue.
Children who have been assessed and need to be admitted to hospital, or those who become ill between 20:00 and 08:00 will be transferred to the Royal Hospital for Sick Children, Edinburgh.
There was a similar closure three years ago due to staffing problems.
And in June 2013 an expert team suggested replacing the ward with a short-stay unit to assess patients and refer them on.
Local Labour MSP Neil Findlay said the long-term future of the ward was now in doubt.
"This is a complete and utter failure from the SNP government in Edinburgh and NHS Lothian to address staffing problems at St John's," he said."This is a complete and utter failure from the SNP government in Edinburgh and NHS Lothian to address staffing problems at St John's," he said.
"Back in the summer of 2012 the children's ward closed for three weeks because staff shortages meant that holidays could not be properly covered."Back in the summer of 2012 the children's ward closed for three weeks because staff shortages meant that holidays could not be properly covered.
"Despite having three years to learn the lessons of that summer the same problems have reared their heads again, with the long-term future of the ward in doubt.""Despite having three years to learn the lessons of that summer the same problems have reared their heads again, with the long-term future of the ward in doubt."
Patient safety
He added: "This cannot seriously go on. A ward shouldn't have to shut down so that hard-working staff can get the annual leave they are legally entitled to.
"The health secretary should do what her predecessors either couldn't or wouldn't do and sort out this mess."
A Scottish government spokesman said: "Patient safety is a top priority for the Scottish government and we have been assured by NHS Lothian that the action it is considering will provide safe, effective and person-centred healthcare for children across Lothian.A Scottish government spokesman said: "Patient safety is a top priority for the Scottish government and we have been assured by NHS Lothian that the action it is considering will provide safe, effective and person-centred healthcare for children across Lothian.
"This is a temporary arrangement and NHS Lothian is working towards a return to full service in the second half of August."This is a temporary arrangement and NHS Lothian is working towards a return to full service in the second half of August.
"It is for the board to determine staffing requirements to respond to clinical needs and NHS Lothian has informed us that it has considered a number of steps to address this issue - including consultants covering shifts directly, recruitment of locums and clinical development fellows."It is for the board to determine staffing requirements to respond to clinical needs and NHS Lothian has informed us that it has considered a number of steps to address this issue - including consultants covering shifts directly, recruitment of locums and clinical development fellows.
"We will continue to support them in finding a solution in the short term and also longer-term sustainability for the service.""We will continue to support them in finding a solution in the short term and also longer-term sustainability for the service."