Recommendation R10: Observe 'Welfare of Children and Young People in Hospital'
From The Allitt Inquiry Report, published 11 February 1994.
Recommendation
We recommend that the Department of Health should take steps to ensure that its guide, "Welfare of Children and Young People in Hospital", is more closely observed. (para 5.8.8)
Government response
Recommendation 10. We recommend that the Department of Health should take steps to ensure that its guide "Welfare of Children and Young People in Hospital", is more closely followed. The guide referred to make clear that hospitals themselves should determine the number of staff they require to look after the children in their care. It also made a number of recommendations about staffing levels. We have surveyed the current staffing arrangements in paediatric nursing and identified a need for further improvement in some places. For daytime shifts nearly 50 per cent. of hospitals meet the recommendations and among those units not yet there some 40 per cent. have plans in place for increasing the numbers of trained childrens nurses. The results of the survey will be made available shortly and a copy will be made available in the Library. There has been a considerable growth in the number of nurses entering training for paediatric nursing in recent years: up from 183 in 1988 to 819 in 1992–93 for pre-registration training and from 628 to 811 for post registration training over the five year period. Training commissions for paediatric nurses rose by 36 per cent. between 1991–92 and 1994–95 (from 879 per year to 1198) reflecting increased employer demand.
Delivery
DHSC and NHS England state no delivery position (27 February 2026)
The guide “Welfare of Children and Young People in Hospital” has now been superseded by a range of measures aimed at ensuring safe and effective staffing in settings where services are provided for babies, children and young people.
The position as of the current date is as follows:
• Evidence-based decision-making on safe and effective staffing is a requirement for all NHS organisations.
• The National Quality Board sets out expectations for nursing and midwifery staffing to help NHS provider boards make local decisions that will deliver high-quality care for patients within the available staffing resource. This includes improvement resources for setting providing services for babies, children and young people.
• The NHS Standard Contract requires that providers ensure that there are sufficient appropriately registered, qualified and experienced medical, nursing and other clinical and non-clinical Staff to deliver services, and have regard to applicable staffing guidance (GC5).
• The NHS Long Term Workforce Plan (June 2023) sets out a series of interventions to train, retain and reform the workforce, and put the NHS on a sustainable footing into the future. This includes a specific focus on workforce planning, and training requirements for children’s nursing. NHS England has committed to review the plan at least every two years.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Superseded”. Table row: section 3.2 No. 10, PDF page 18.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
In November 1994, the Secretary of State for Health referred to efforts by the Government to survey the current staffing arrangements in paediatric nursing, as well as recent growth in the number of nurses entering training for paediatric nursing.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 3.2 No. 10, PDF page 19.
Responsible bodies
Themes and tags
Who has spoken
- Department of Health and Social Care
Response - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding