Closure risk for children’s ward

NHS Lothian insists the move would be highly unlikely but has been forced to outline an emergency plan due to recruitment difficulties.

It also said its maternity unit might only be able to handle straightforward births.

In a paper presented to the NHS Lothian board yesterday, a section titled “Key Risks” said there was a potential danger that the health board couldn’t staff every shift for the paediatric and neonatal services.

That meant plans would need to be put in place for “a number of anticipated and short-notice possibilities”.

The NHS insisted that it was committed to keeping children’s services at the hospital open and said it was simply an emergency plan it was obliged to put in place because of ongoing recruitment difficulties.

Meanwhile, a midwife-led maternity unit would only be able to deal with straightforward births.

The report said the paediatric inpatient and outpatient rota at St John’s was being covered by just ten members of staff, and as a result was “vulnerable to unplanned absences”.

The board heard yesterday that one paediatric consultant has been appointed and will start work in July.

But from April 11, the hospital will no longer receive paediatric trainees and nationwide shortages have meant recruitment attempts have failed.

In January, six paediatric consultants wrote to medical director Dr David Farquharson to warn that staff shortages meant they could not guarantee “safe and continuous care” round the clock after the withdrawal of trainees.

Councillor Gordon Beurskens, of the Action to Save St John’s Hospital party, said: “We’ve never said there was a threat of closure to the children’s ward, we’ve said there’s a threat to the 24/7 services.

“You can’t play down the fact that that is in the paper as a potential risk.”

Dr Farquharson told the board that recruitment efforts were beginning in Australia and New Zealand.

He also said he was identifying trainee doctors who were due to complete their course to be targeted for recruitment.

In the short-term, he said locums would fill vacancies.

Cllr John Cochrane, of Action to Save St John’s, gave his support to the board. He said: “I think there’s a scary myth circulating in West Lothian that the children’s ward and neonatal ward are about to close. That myth has to be dispelled.”

Dr Farquharson said: “We are committed to continuing the current provision of paediatric and neonatal services.

“I only referred to changing the hours as part of key risks and how we might mitigate them.”

NHS Lothian vice-chairman Eddie Egan said reducing maternity services at St John’s from its current level of 2800 births a year was impossible. “Short of changing family planning law like the Chinese, it’s not going to happen,” he said.

IN SICKNESS AND IN HEALTH

Services which have been removed from St John’s:

• Acute surgery, such as appendix and kidney stones

• Trauma orthopaedics, such as hip replacements

• Mortuary services

• Pathology service

• Major incident status

Services which the NHS says have been added or developed as part of its model of “creating centres of excellence with multi-disciplinary teams based on one site” include:

• Regional Eating Disorder Unit, opened in January.

• Short Stay Elective Surgery Centre, including orthopaedics, general surgery and gynaecology.

• Prostate biopsy service.

• Endoscopy and Decontamination Unit to support the bowel cancer screening programme.

• Ten-bed A&E observation ward.

• Ear Nose and Throat unit – the Lothians’ main centre.

• Orthodontic and Dental Unit with teaching facilities.