Children's health staff shortages
44 items
2 sources
Significant workforce shortages across multiple disciplines in children's health, impacting care delivery and patient safety.
Cross-Source Insight
Children's health staff shortages has been flagged across 2 independent accountability sources:
33 inquiry recs
11 PFD reports
This issue has been identified by multiple independent accountability bodies, suggesting it is a recurring systemic concern.
Inquiry Recommendations (33)
BRIS-139 — Include children's acute and paediatric cardiac services in discrete validation pilot
Recommendation: The pilot exercise for this form of validation should include children’s acute hospital services and paediatric cardiac surgery.
Unknown
BRIS-167 — Appoint National Director for Children's Healthcare Services to promote improvements
Recommendation: A National Director for Children’s Healthcare Services should be appointed to promote improvements in healthcare services provided for children.
Unknown
BRIS-168 — Consider creating a Children's Commissioner for England to promote children's rights
Recommendation: Consideration should be given to the creation of an office of Children’s Commissioner in England, with the role of promoting the rights of children in all areas of public policy and seeking improvements to the ways in which the needs …
Unknown
BRIS-169 — Expand Cabinet Committee remit to include healthcare for children and young people
Recommendation: The Cabinet Committee on Children and Young People’s Services should specifically include in its remit matters to do with healthcare and health services for children and young people.
Unknown
BRIS-170 — Designate senior staff in health authorities for local children's healthcare commissioning
Recommendation: Each health authority and each primary care group or primary care trust should designate a senior member of staff who should have responsibility for commissioning children’s healthcare services locally.
Unknown
BRIS-171 — Designate executive board member to protect children's interests in trusts
Recommendation: All trusts which provide services for children as well as adults, should have a designated executive member of the board whose responsibility it is to ensure that the interests of children are protected and that they are cared for in …
Unknown
BRIS-172 — Urgently agree and implement National Service Framework for children's healthcare
Recommendation: The proposed National Service Framework (NSF) for children’s healthcare services must be agreed and implemented as a matter of urgency.
Unknown
BRIS-173 — NSF must establish standards for all children's acute healthcare services
Recommendation: The NSF should include a programme for the establishment of standards in all areas of children’s acute hospital and healthcare services.
Unknown
BRIS-174 — NSF must set obligatory and aspirational standards for children's services
Recommendation: The NSF should set obligatory standards which must be observed, as well as standards to which children’s services should aspire over time.
Unknown
BRIS-175 — NSF must include incentives for improving children's healthcare services, aiding needy trusts
Recommendation: The NSF should include incentives for the improvement of children’s healthcare services, with particular help being given to those trusts most in need.
Unknown
BRIS-176 — NSF must plan regular publication of children's healthcare quality and performance data
Recommendation: The NSF must include plans for the regular publication of information about the quality and performance of children’s healthcare services at national level, at the level of individual trusts, and of individual consultant units.
Unknown
BRIS-177 — NSF must provide strategic guidance for integrating children's healthcare services
Recommendation: There must be much greater integration of primary, community, acute and specialist healthcare for children. The NSF should include strategic guidance to health authorities and trusts so that services in the future are better integrated and organised around the needs …
Unknown
BRIS-178 — Locate children's acute hospital services in children's hospitals near general hospitals
Recommendation: Children’s acute hospital services should ideally be located in a children’s hospital, which should be physically as close as possible to an acute general hospital. This should be the preferred model for the future.
Unknown
BRIS-179 — Ensure free-standing children's hospitals provide access to all necessary facilities and specialists
Recommendation: In the case of existing free-standing children’s hospitals, particular attention must be given to ensuring that, through good management and organisation of care, children have access when needed to (a) facilities which may not routinely be found in a children’s …
Unknown
BRIS-180 — Pilot children's hospitals running all acute and community services in a geographical area
Recommendation: Consideration should be given to piloting the introduction of a system whereby children’s hospitals take over the running of the children’s acute and community services throughout a geographical area, building on the example of the Philadelphia Children’s Hospital in the …
Unknown
BRIS-181 — Organise children's specialist services for best staff, facilities, and outcomes, prioritising quality
Recommendation: Specialist services for children should be organised so as to provide the best available staff and facilities, thus providing the best possible opportunity for good outcomes. Advice should be sought from experts on the appropriate number of patients to be …
Unknown
BRIS-182 — Establish flexible Family Support Funds for travel costs at concentrated specialist children's trusts
Recommendation: Where specialist services for children are concentrated in a small number of trusts spread throughout England, these trusts should establish Family Support Funds to help families to meet the costs arising from travelling and staying away from home. The Funds …
Unknown
BRIS-183 — Validate trusts providing children's acute services for child-centred policies, staff, and facilities
Recommendation: After completion of a pilot exercise, all trusts which provide acute hospital services for children should be subject to a process of validation to ensure that they have appropriate child- and family-centred policies, staff, and facilities to provide a good …
Unknown
BRIS-184 — Ensure children are cared for in paediatric environments by qualified professionals
Recommendation: Children should always (save in exceptional circumstances, such as emergencies) be cared for in a paediatric environment, and always by healthcare professionals who hold a recognised qualification in caring for children. This is especially so in relation to paediatric intensive …
Unknown
BRIS-185 — Review and apply 1991 paediatric nurse staffing standards as minimum
Recommendation: The 1991 standards for the numbers of paediatrically qualified nurses required at any given time should serve as the minimum standard and should apply where children are treated (save in emergencies). The standards should be reviewed as a matter of …
Unknown
BRIS-186 — Require all surgeons operating on children to obtain paediatric qualification and revalidation
Recommendation: All surgeons who operate on children, including those who also operate on adults, must undergo training in the care of children and obtain a recognised professional qualification in the care of children. As matter of priority, the GMC, the body …
Unknown
BRIS-192 — Develop national standards for all aspects of congenital heart disease care and treatment
Recommendation: National standards should be developed, as a matter of priority, for all aspects of the care and treatment of children with congenital heart disease (CHD). The standards should address diagnosis, surgical and other treatments, and continuing care. They should include …
Unknown
BRIS-193 — Stipulate minimum paediatric cardiac surgery procedure volumes for hospitals to ensure outcomes
Recommendation: With regard to paediatric cardiac surgery, the standards should stipulate the minimum number of procedures which must be performed in a hospital over a given period of time in order to have the best opportunity of achieving good outcomes for …
Unknown
BRIS-194 — Establish minimum weekly operating sessions for paediatric cardiac surgeons to maintain competence
Recommendation: With regard to those surgeons who undertake paediatric cardiac surgery, although not stipulating the number of operating sessions sufficient to maintain competence, it may be that four sessions a week should be the minimum number required. Agreement on this should …
Unknown
BRIS-195 — Require two paediatric surgeons performing 40-50 open-heart operations annually for infants
Recommendation: With regard to the very particular circumstances of open-heart surgery on very young children (including neo-nates and infants), we stipulate that the following standard should apply unless, within six months of the publication of this Report, this standard is varied …
Unknown
BRIS-196 — Mandate paediatric environment, trained staff, and PICU access for children's interventional procedures
Recommendation: The national standards should stipulate that children with CHD who undergo any form of interventional procedure must be cared for in a paediatric environment. This means that all healthcare professionals who care for these children must be trained and qualified …
Unknown
BRIS-197 — Centralise rare paediatric heart condition surgery to maximum two expert-validated units
Recommendation: Surgical services for children with very rare congenital heart conditions, such as Truncus Arteriosus, or involving procedures undertaken very rarely, should only be performed in a maximum of two units, validated as such on the advice of experts. Such arrangements …
Unknown
BRIS-198 — Urgently investigate paediatric cardiac surgery units for unsafe low patient volumes
Recommendation: An investigation should be conducted as a matter of urgency to ensure that PCS is not currently being carried out where the low volume of patients or other factors make it unsafe to perform such surgery.
Unknown
IHRD-58 — Paediatric Fluid Management Training
Recommendation: HSC Trusts should ensure that all nurses caring for children have facilitated access to e-learning on paediatric fluid management and hyponatraemia.
Gov response: E-learning on paediatric fluid management and hyponatraemia made available to nursing staff.
Accepted
Delivered
IHRD-61 — Paediatric Communication Training
Recommendation: Clinicians caring for children should be trained in effective communication with both parents and children.
Gov response: Communication skills training provided for clinicians caring for children.
Accepted
Delivered
IHRD-69 — Executive Director Responsibilities
Recommendation: Trusts should appoint and train Executive Directors with specific responsibility for: (i) Issues of Candour. (ii) Child Healthcare. (iii) Learning from SAI related patient deaths.
Gov response: Executive Director responsibilities assigned for candour, child healthcare and SAI learning.
Accepted
Delivered
IHRD-71 — Children's Healthcare Governance
Recommendation: All Trust Boards should ensure that appropriate governance mechanisms are in place to assure the quality and safety of the healthcare services provided for children and young people.
Gov response: Governance mechanisms for children's healthcare services established across Trusts.
Accepted
Delivered
IHRD-85 — Deputy CMO for Children's Healthcare
Recommendation: The Department should appoint a Deputy Chief Medical Officer with specific responsibility for children's healthcare.
Gov response: Role considerations ongoing within Department of Health NI restructuring.
Accepted
No update 2+ yrs
PFD Reports (11)
Ellame Ford-Dunn Prevention of future deaths report
Concerns: Insufficient Tier 4 Paediatric Mental Health beds lead to long waits, resulting in children with mental health needs being inappropriately held on acute paediatric wards unsuitable for their care.
Response: NHS England has funded the recruitment of additional mental health nurses for paediatric wards and emergency departments at University Hospitals Sussex NHS Foundation Trust. They are also engaged in multidisciplinary …
Responded
Imogen Nunn Prevention of future deaths report
Concerns: A national shortage and lack of regulation for British Sign Language interpreters, alongside procurement issues and few BSL-proficient clinicians, create significant risks for deaf mental health patients.
Response: The Department for Education acknowledges concerns regarding BSL interpreter shortages and procurement, but maintains the government's preference for industry self-regulation. The Minister will raise these issues with the BSL Advisory …
Responded
Benjamin Arnold
Concerns: Maternity services are unequally split with limited support and no on-site paediatric cover at one site. Concerns also include ambiguous unit classification and non-standardised guidelines for the LISA procedure and newborn cardiac arrest causes.
Responded
Aarav Chopra
Concerns: Lack of guidance for immunocompromised patient antibiotics, unclear trainee competence, and poor consent processes were evident. Inadequate learning from deaths and fragmented electronic records also led to missed patient risk factors.
Responded
Sailor Court
Concerns: Unacceptably long and increasing waiting times for CAMHS assessment and treatment, due to a severe lack of resources, pose a significant risk to young people's mental health.
Responded
Madeleine Savory
Concerns: There is a national shortage of Tier 4 beds in paediatric mental health facilities, delaying timely access to crucial care for children in need.
Responded
Alex Dews
Concerns: School avoided NHS mental health referrals due to excessive waiting lists, instead procuring private support with unclear allocation processes and poor communication between the school and external providers.
Responded
Robyn Skilton
Concerns: Significant underfunding and under-resourcing of CAMHS caused extensive waiting times for child psychiatrist assessments, preventing timely diagnosis and treatment. Exploding referral rates without proportionate resource increases have made the service unsustainable, endangering young people.
Responded
Emma Carpenter
Concerns: Critical specialist eating disorder services for children lacked long-term funding and inpatient bed provision. Insufficient funding for school nurses caused poor communication between mental health and education systems.
Responded
Helena Farrell
Concerns: Critical failures included an inadequate CAMHS referral system with insufficient staffing and training, a failure to recognise escalating risks, and a school counsellor lacking verified qualifications and professional oversight.
Responded
Jackson Chadd
Concerns: Concerns include inadequate supervision for junior paediatric staff, insufficient consultant oversight for out-of-hours admissions, failure to apply national guidelines for fever in children, and disregarding parental concerns.
Overdue