Boston's Pilgrim Hospital to maintain paediatric and maternity services for time being

ULHT has had a long-standing shortage of children’s doctors and nurses and has been working on a series of options to ensure paediatric services at Pilgrim Hospital, Boston can be delivered safely in spite of a shortage of middle grade doctors.

For all of Pilgrim’s children’s and maternity services to run 24/7, there should be eight middle grade paediatric doctors at the hospital. With effect from 1 August 2018, it was predicted that there would only be only one substantive middle grade doctor available and there was a risk that some services may need to temporarily close to maintain patient safety.

Whilst recruitment is underway, teams within the Trust have been working on developing an interim arrangement to enable services to be maintained at Pilgrim hospital. Today the Board agreed to move towards an interim model for the services, which sees women and children who present to Pilgrim continuing to be seen and assessed there.

There is still work to do on the model, which relies on continued support from staff and stakeholders. Therefore the Board has also agreed that contingency planning will also continue in case the model is not possible.

Medical Director for ULHT, Dr Neill Hepburn, said: “The staffing situation in the Pilgrim paediatric department remains difficult, as we remain reliant on short-term agency staff, many of whom only work occasional shifts.

“However, in recent months we have been able to recruit additional agency middle grade doctors, and funding has been approved for two additional locum consultants. This means that we have been able to explore new options for how we deliver care in the department, and the model agreed today is the result of that.

“This model is still a work in progress, with some of the detail yet to be worked up, but in principle it has been agreed that it will begin from August 1, running until the end of the year.”

The model will see:

• Outpatient clinics continuing at Pilgrim.

• Pilgrim managing only low-risk neonatal births (above 34 weeks gestation).

• A 24 hour children’s assessment and observation unit established on the children’s ward at Pilgrim, offering restricted periods of observation.

• Paediatric day surgery remaining at Pilgrim.

• Consultant-led maternity unit remaining at Pilgrim.

• 98% of current activity remaining at Pilgrim (the exceptions will be the transfer of small numbers of babies pre 34-weeks gestation or who require more intensive care and children needing more than 12 hours observation)

Dr Hepburn said: “We are continuing our efforts to recruit paediatricians, as we would like to see a full paediatric and neonatal service resumed at the hospital as soon as possible. We are working with our health care partners, such as Health Education England, who are committed to help us through this difficult time and are developing new ways of training for these doctors.

“But in the interim, our teams have made great progress in developing a model that allows us to continue to see and assess women and children who present to the hospital.

“There will be a small number of babies and children transferred to other sites for care under this model, notably babies born below 34 weeks gestation and any children who require extended observation. We understand that this will be of concern to our patients and public, but we have done our best to find a way to retain as many services at the site as possible and are hopeful that we will be able to return to a full service in future.”