Staff shortages and Brexit concerns 'jeopardising' children's health services

A serious shortage of paediatricians and concerns over Brexit are putting children's health services at risk, a Royal College has warned.

Hospital inpatient units for children and neonatal units across the UK are still having to close their doors to new admissions due to a shortage of staff, a new report from the Royal College of Paediatrics and Child Health (RCPCH) said.

In the year to September 2015, a shortage of nurses and/or doctors led to closures for a period of time at 31% of paediatric inpatient units and 41% of neonatal units across the UK.

General paediatric and neonatal rotas were also coping with an average vacancy rate of 14%.

This was despite a rising demand for care, with hospital admissions among children increasing by a quarter between 2013/14 and 2015/16, the report said.

There were an estimated 241 full-time equivalent vacancies for paediatricians, with 133 of those for consultants.

Furthermore, at least 752 more consultants were needed to meet workforce planning recommendations set down by the RCPCH.

The College has previously warned that NHS services for children were struggling to cope partly due to female doctors going on maternity leave and working part-time.

It said many doctors were choosing to start their own families sooner within postgraduate paediatric training programmes, and there was a high proportion of doctors on maternity leave.

Women represent 52% of the consultant and 74% of the trainee paediatric workforce, while 22% of consultants (33% of women and 9% of men) work less than full-time.

The report also warned of the impact of Brexit, saying there was "great uncertainly around immigration status and terms and conditions of employment for non-UK nationals" working in the UK.

The College said 40% of career-grade paediatricians gained their first qualification outside the UK, and called for paediatrics to be put on the shortage occupation list.

It said there must be assurance that "immigration rules allow entry to the UK of healthcare professionals whose clinical skills will benefit the NHS".

Professor Neena Modi, president of the RCPCH, said: "There is great uncertainty following the Brexit vote around the immigration status and terms and conditions of employment for non-UK nationals working in the NHS.

"These colleagues are a valued and crucial component of the UK child health workforce and a simple assurance that their right to work in the UK will be protected, and their conditions secured, would be immeasurably helpful."

She said the overall situation in paediatrics was "serious", adding: "There simply aren't enough doctors to meet the needs of infants, children and young people, and advance their healthcare through clinical research.

"It's a credit to the existing workforce that that they are, just, managing to continue to deliver the care children need.

"This is a dangerously under-resourced service, yet the means to redress the situation exist.

"It is legitimate for us, and the UK public, to ask why, when solutions exist, the health and wellbeing of children are being placed in jeopardy?"

Among recommendations put forward by the RCPCH are funding for an increase in trainee places, funding secondary care child health training for GPs and paediatric trainees, and promotion of an expansion in the academic paediatric workforce.