Final Report > Chapter 9: The Paediatric Cardiac Surgical Service in Bristol > The paediatric cardiac surgical service in Bristol > Intensive care at the BRI

Intensive care at the BRI

18 Both children and adult cardiac patients were cared for in the ICU at the BRI. Children were separated from the adults to the best of the staff's ability by using the two beds that were between a side wall and the nurses' station. This was not always possible, however, due to the pressure on beds.

19 Nationally, until the early 1990s, it was not unusual for children and adults to be cared for in the same ICU. Dr Susan Jones, President of the Association of Paediatric Anaesthetists (APA),1997-1999, told the Inquiry that it was fairly common as late as 1993 for children to be admitted to a part of an adult ICU ward. She went on: `I think that it has been changing gradually, anyway, as big paediatric tertiary referral centres, mainly at children's hospitals, have actually expanded their intensive care unit and, indeed, provided retrieval teams so that they can actually go to a DGH, or wherever, to actually pick up these children and transfer them back.' [13]

20 Professor David Baum, then President of the Royal College of Paediatrics and Child Health and Professor of Child Health, University of Bristol, told us about the approach of healthcare professionals in 1984 to caring for children on such mixed wards: `At that time, if one were looking at or were preparing a policy document, I have no doubt that the conclusion would have been very firmly, these should be separate entities. That would apply if one was talking about the mix from adolescence and adult, let alone younger children and babies, let alone if they were profoundly ill. In the ten to fifteen years since the time that you are addressing, we have regressed somewhat, but it has only been in the last two or three years that under the heading of paediatric intensive care services, as you know, the Government has come down on the side of not only having a policy, but actually implementing a policy, so that in all parts of the land we are still at the implementation phase, there should be a separate fully equipped fully staffed paediatric intensive care unit. That has still not been totally achieved for the nation in May 1999.' [14]

21 The UBHT acknowledged that since the publication of the report `Welfare of Children and Young People in Hospitals' [15] in 1991, it had been the policy in the NHS that wherever possible, children should be nursed separately from adults, in dedicated children's units by Registered Sick Children Nurses (RSCN). The UBHT stated that: `The policy of UBHT in the 1980s to move children's cardiac surgery to the Bristol Royal Hospital for Sick Children was in accordance with this policy, but in practice it was thwarted by lack of capital funding.' [16]

Footnotes

[13] T8 p.28 Dr Jones

[14] T18 p.40-1 Professor Baum

[15] DoH. `Welfare of Children and Young People in Hospitals', London: HMSO, 1991

[16] WIT 0030 0013 Phillip Wagstaff