Paediatric doctor shortfall fears

EFFORTS are under way to minimise any potential impact on children’s healthcare services in the Borders due to a continuing national shortage of specialist paediatric doctors.

The paediatric workforce is managed on a regional basis as part of a three health authority set-up.

As well as NHS Borders, this includes health boards in Fife and Lothian, and together the three make up the South East and Tayside Planning Group (SEAT).

One looming issue is that a total of 47 senior trainee paediatric doctors are needed to help provide out-of-hours cover in some of the hospitals in the regions, but by February there is likely to only be 34.

In a joint statement on paediatric staffing across South-East Scotland, SEAT told us: “The paediatric workforce is managed on a regional basis to ensure safe and sustainable services across the region.

“NHS Lothian, NHS Fife, NHS Borders and NHS Education for Scotland’s south-east region [also part of SEAT], are working together and in partnership with stakeholders, to decide how best to deploy the workforce to provide safe and sustainable care for children and babies across south-east Scotland, now and in the future.

“A paper detailing options for the future provision of children’s and maternity services across the region will be presented to the NHS Lothian Board at its November 28 meeting, to the NHS Borders Board on December 6 and to the NHS Fife Board on December 18.

“The public should be reassured that any decision will be taken in the best interests of patient safety and that there will be full engagement with all stakeholders.”

Paediatric and maternity services are currently provided at the Royal Hospital for Sick Children, including the national paediatric intensive care unit, and the Simpson Centre for Reproductive Health in Edinburgh; St John’s Hospital, Livingston; the Victoria Hospital, Kirkcaldy and Borders General Hospital.

The Royal College of Paediatrics and Child Health undertook a review of paediatric training in south-east Scotland earlier this year.

The review recognised training was of a very high standard, but recommended that trainees should not work out-of-hours at St John’s Hospital and possibly the BGH, as it felt the small number of cases and limited case mix does not provide sufficient training experience.

Since 2008, there have been growing challenges in medical paediatric staffing across Scotland and the UK as a result of various factors, including a reduction in the number of hours trainee doctors can work under EU rules and the lack of experienced locum doctors, due to changes in immigration rules.

In order to address the situation, Borders, Lothian and Fife health boards have been working together to try to address the situation.

It was two years ago that NHS Borders introduced changes which saw out-of-hours cover for children’s and maternity services provided by advanced nurse practitioners, with the support of a paediatric consultant.

Health chiefs have made a significant investment in training and development for these nursing roles and a spokesperson told TheSouthern this week: “Within the NHS in the UK, it has been recognised that there is a national shortage of experienced paediatric registrars for staffing in the acute specialties.

“NHS Borders is working with the other boards in South East and Tayside (SEAT) and NHS Education for Scotland to look at all options to minimise any potential impact this could have on the provision of existing services within the regions.

“Locally, we continue to invest in our children’s and maternity services to ensure we can provide safe, effective and high-quality care.

“We have developed an innovative model to support the continuation of overnight paediatric services.

“This involves developing the skills of paediatric and neonatal nurse practitioners to create a service that will be sustainable in the long term.”