Final Report > Chapter 29: The Care of Children > A framework for the future of children's healthcare services > The need for sufficient, paediatrically trained staff

The need for sufficient, paediatrically trained staff

30 Until the proposed NSF appears, the future direction of children's healthcare services will remain unclear. Thus, identifying the number of paediatrically trained nurses and doctors which will be required in the future is currently problematic. It is imperative, therefore, that the professionals who care for children should be fully involved in the development of the NSF, and engaged in analysing the implications for levels of staffing. Equally, it is imperative that the NSF be agreed and implemented as a matter of urgency. We deal with staffing issues in more detail later on.

31 We believe that the proposed NSF must also:

• set standards which must be observed, as well as those to which services should aspire, while leaving appropriate room for innovation and adaptation to local needs. Too often in the past, the failure to stipulate standards which are mandatory has undermined efforts to ensure that proper standards of care are delivered;
• establish incentives (including but not limited to financial incentives) for the improvement of children's healthcare services, with particular help for those trusts which most need it; and
• set out plans for the publication of information about the quality and performance of children's healthcare services at national level, at the level of the individual trust, of the specialty, and of individual consultant units.

32 We have said earlier in our Report that we believe the inspection of trusts by the Commission for Health Improvement (CHI) should be developed so that it becomes a system whereby hospitals are validated to provide services. Once the system is established, we believe that, in the case of children's healthcare services, there should be a specific process of validation, such that trusts would only be permitted to provide healthcare services for children if they meet the appropriate standards in a range of relevant areas, including numbers of paediatrically trained staff, a proper level of paediatric facilities and an environment imbued with the values of paediatric care. In this regard, we note the proposal of the Royal College of Surgeons in a recent report from its Paediatric Forum. [14] It recommends that inpatient surgery on children should only be undertaken in those hospitals which provide comprehensive paediatric facilities. It then lists proposed minimum requirements which any district acute hospital must meet if it includes surgery on children amongst its services. This is precisely the type of requirement we have in mind. By contrast, it is currently still the case that there is no mechanism to ensure that hospitals which do not meet such standards refrain from undertaking surgery on children.

Footnotes

[14] The Royal College of Surgeons of England. `Children's Surgery - A First Class Service'. London, May 2000