Unclear healthcare delegation

The role of the personal officer should be clearly defined in each establishment’s personal officer scheme. The Prison Service should publish a model scheme, which should be regarded as having been adopted by every establishment which does not produce one of its own.

The role of the duty manager or duty governor in the review process should be clarified.

Children's ward rounds should be led by a consultant and occur every morning and evening.

A consultant fixed with responsibility for a child patient upon an unscheduled admission should be informed promptly of that responsibility and kept informed of the patient's condition, to ensure senior clinical involvement and leadership.

Senior paediatric medical staff should hold overall patient responsibility in children's wards accommodating both medical and surgical patients.

The accountable nurse should, insofar as is possible, attend at every interaction between a doctor and child patient.

To ensure continuity, all children's wards should have an identifiable senior lead nurse with authority to whom all other nurses report. The lead nurse should understand the care plan relating to each patient, be visible to both patients and staff and be available to discuss concerns with parents. Such leadership is necessary to reinforce nursing standards and to...