St John's Hospital children's ward to partially close over summer

The ward at St John's Hospital will be closed to in-patients over the summer

A children's ward at St John's Hospital in Livingston is to close to in-patients over the summer because of staff shortages.

NHS Lothian's decision to shut the ward to patients needing overnight care followed a warning that it would pose a risk to children if it remained open.

The ward treats more than 3,000 children a year.

NHS Lothian said it had not managed to fill key medical and nursing posts in the ward despite recruitment campaigns.

This had led to the service being heavily reliant on locum doctors, as well as staff from the hospital and the Royal Hospital for Sick Children in Edinburgh working extra hours.

But the health board has stressed that the staff shortages were not due to financial reasons.

The initial suggestion to close the ward overnight for six weeks in order to prevent an "unplanned service collapse" was made in an internal document sent to the health board's chief executive.

Day surgery

NHS Lothian said the children's ward would continue to operate as an assessment and programmed investigation unit from Monday to Friday between the hours of 08:00 and 20:00.

Non-residual care, such as day surgery, will continue. There will be no change to maternity and neonatal services at the hospital.

The Scottish government said the closure, from Friday, was temporary.

Children who have been assessed and need to be admitted to hospital, or those who become ill between 20:00 and 08:00, will be transferred to the Royal Hospital for Sick Children in Edinburgh.

There was a similar closure three years ago due to staffing problems, and in June 2013 an expert team suggested replacing the ward with a short-stay unit to assess patients and refer them on.

About 700 of the 3,000 children admitted to the ward last year required an inpatient stay of 24 hours or more.

Dr Edward Doyle, associate divisional medical director for women's and children's services at NHS Lothian, told BBC Scotland there had been "longstanding difficulties with medical staffing at St John's paediatrics."

Speaking on the Good Morning Scotland programme, he said: "That's worsened for a number of reasons over the last three months and looking ahead over the rest of the summer given shortages, maternity leave and difficulty recruiting locums, I felt I couldn't give the board an assurance that we could run a safe service for the next six weeks.

"So I made a recommendation that we close to inpatients for that period."

Dr Doyle said that financing additional staff for the ward had not been the issue, and added: "Effectively I have unlimited money to hire locums. NHS Lothian has not made that an issue at all.

"The issue is availability of highly skilled people in a very competitive situation. And these people want holidays with their family as well and its an opt-in arrangement so we cannot require people to do extra work."

'Same problems'

Local Labour MSP Neil Findlay said the long-term future of the ward was now in doubt, and called on the health secretary to "sort out this mess".

"This is a complete and utter failure from the SNP government in Edinburgh and NHS Lothian to address staffing problems at St John's," he said.

"Back in the summer of 2012 the children's ward closed for three weeks because staff shortages meant that holidays could not be properly covered.

"Despite having three years to learn the lessons of that summer the same problems have reared their heads again, with the long-term future of the ward in doubt."

A Scottish government spokesman said: "Patient safety is a top priority for the Scottish government and we have been assured by NHS Lothian that the action it is considering will provide safe, effective and person-centred healthcare for children across Lothian.

"This is a temporary arrangement and NHS Lothian is working towards a return to full service in the second half of August.

"It is for the board to determine staffing requirements to respond to clinical needs and NHS Lothian has informed us that it has considered a number of steps to address this issue - including consultants covering shifts directly, recruitment of locums and clinical development fellows.

"We will continue to support them in finding a solution in the short term and also longer-term sustainability for the service."