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Found 158 results
  1. News Article
    London’s fragmented children’s cancer services will finally be reformed following a decade of delays and allegations of cover-up by senior officials. NHS England has said it will adopt recommendations that will see the capital’s services brought up to standards already common across the rest of the country, with children’s cancer centres needing to be based in hospitals with full paediatric intensive care units. The changes will be imposed “with no exceptions or special arrangements permitted,” it said in a letter yesterday. This means the Royal Marsden’s children’s service at its base in Sutton, south London, will have to move to a new hospital. Currently sick children who deteriorate at the Marsden’s site have to be rushed by ambulance to St George’s Hospital 40 minutes away. More than 330 children were transferred from the Marsden to other hospitals between 2000 and 2015 and in one year 22 children were transferred for intensive care a total of 31 times, with some experiencing at least three transfers individually. The changes will also affect cancer care at University College London Hospital which links with Great Ormond Street Children’s Hospital. The world-renowned Royal Marsden trust, whose chief executive Dame Cally Palmer is also NHS England’s national cancer director, was at the centre of a cover-up scandal before the COVID-19 pandemic. In 2019, the Health Service Journal revealed a major report, commissioned by NHS bosses in London following the deaths of several children, had been “buried” by NHS England. Read full story Source: The Independent, 12 November 2021
  2. News Article
    A senior doctor has warned that paediatric intensive care units (PICUs) are ‘as pressured as I can ever recall’ – despite the absence of cold weather, which typically leads to higher demand levels. James Fraser, president of the Paediatric Critical Care Society, said national bed occupancy in PICUs has “often been greater than 95 per cent” over recent weeks, while several units have reported 100 per cent occupancy. He said some children have had to be transferred between regions in order to admit them to a bed. PICUs are often under more pressure during winter, due to seasonal RSV and other viral infections. But high demand levels have started earlier this year, which has meant severely ill children have occasionally waited longer in local hospitals before being admitted to PICUs, and have sometimes had to be transferred to another site. Mr Fraser told HSJ: “[PICUs] are really busy, as pressured as I can ever recall them. “Every winter PICUs are under huge pressure due to seasonal RSV bronchiolitis. This usually happens between November and February. This year we always anticipated it would be a much longer season. It’s putting a lot of pressure on our national bed base. “What is different is we have been under this pressure earlier in the year with RSV and other viral chest infections. We have been under this pressure for a month. The pressure is both the number of patients and there are a lot of staff off having to self-isolate." Read full story (paywalled) Source: HSJ, 29 October 2021
  3. News Article
    Five serious incidents, including the deaths of two children, spark “urgent” investigations at specialist trust Great Ormond Street Hospital FT has linked the incidents partly to what it described as a “faulty” batch of a type of glue used to close wounds during surgery Supplier says it followed the correct recall processes for the product Five serious incidents, including the deaths of two children, have sparked ‘urgent’ investigations into the processes through which clinicians are alerted to potential safety concerns over medical products used on patients. Great Ormond Street Hospital Foundation Trust has been investigating the incidents which happened between December 2020 and April 2021. The trust has linked the incidents partly to what it described as a “faulty” batch of a type of glue used to close wounds during surgery. The glue, called Histoacryl, is produced by B. Braun Medical Ltd, and the company issued three separate “field safety notices”, relating to different batches of the product, in March and April this year. The company has stressed that it followed the correct recall processes throughout. According to a report to GOSH’s public board meeting on 29 September, Histoacryl has been used for the endovascular treatment of brain arteriovenous malformations for more than 30 years, but earlier this year batches of the product were identified as hardening less rapidly than expected. The trust told HSJ in a statement: “A comprehensive serious incident investigation has been carried out to determine the impact of the faulty glue on all patients treated with it. “The investigation found that whilst the passage of glue through the intended vessel may have been contributory in some instances of harm, it was unlikely to be the sole or main factor. “Both patients who died had serious and complex medical conditions and the procedure to correct these always carries a high degree of risk which is discussed extensively with the families before any treatment takes place.” Read full article here (paywalled) Original source: Health Service Journal
  4. News Article
    Three acute trusts have teamed up to carry out surgical procedures on hundreds of children over several weekends as part of plans to tackle waiting lists in the region. Trusts across the Bath and North East Somerset, Swindon and Wiltshire Integrated Care System are pooling resources to tackle long waits in paediatric oral and ear, nose and throat services. The initiative began on the April bank holiday weekend. Thirty-eight of the longest waiters from Royal United Hospitals Bath Foundation Trust, who had been waiting up to 74 weeks for oral surgery, were treated by Salisbury FT. The other trust involved in the plans is Great Western Hospitals FT. More than 400 children are expected to be treated over a series of joint surgery weekends. The next, which will also focus on both oral and ENT surgery, will take place over the early May bank holiday. RUH’s chief executive Cara Charles-Barks told HSJ the joint surgery plans will have a “huge impact” on the region’s elective waiting lists. Read full story (paywalled) Source: HSJ, 21 April 2021
  5. News Article
    NHS England are set to launch a new service for children suffering from long COVID. Although data has suggested that children are less likely to suffer from severe disease, there have been an increasing number of reports of continued symptoms. The new service will consist of 15 new paediatric hubs with experts to treat young people and advise their families and carers or refer them to specialist services. The NHS has invested £100m in specialist services to help meet the needs of the possible hundreds of thousands who are expected to experience long COVID with symptoms ranging from breathing difficulties to fatigue. Read full story. Source: Sky News, 15 June 2021
  6. Event
    until
    Infection is a leading cause of childhood deaths, but many of these deaths are avoidable with timely treatment. The national Before Arrival at Hospital Project (BeArH), funded by the National Institute for Health Research (NIHR), explored what happens to children under five years of age with serious infections before they are admitted to hospital. The aim of this research was to explore what helps children get help quickly and what might slow this process down, so that lessons could be learned for the care of this group of children in the future. This forum will be led by Professor Sarah Neill, Dr Damian Roland and Natasha Bayes. To join the research forum and hear the findings of this important research project from the study team, email lpt.research@nhs.net for the Microsoft Teams link.
  7. Content Article
    The delivery of safe and effective healthcare to paediatric and neonatal patients presents unique challenges to the medication-use system. The diversity of patients within this population and the consequences of ontogeny on pharmacokinetics and pharmacodynamics directly impact the safe use of medications in children and increase the risk of adverse drug events. This review from Elkeshawi et al. will explore the medication-use system for hospitalised children and neonates, discuss vulnerabilities within this system, and provide examples of advancements made to improve the paediatric medication-use system.
  8. Content Article
    Family Integrated Care (FICare) is an approach to neonatal care which aims to involve parents as equal partners in the care of their babies while in the Neonatal Intensive Care Unit (NICU). FICare aims to minimise separation, support parent-child bonding and promote parental decision-making. In this blog, Katie Cullum, Lead Nurse for Innovation and Quality Improvement at East of England Neonatal Operational Delivery Network, talks about the proven benefits of Family Integrated Care and why all NICUs should be implementing the model to improve outcomes.
  9. Content Article
    iSupport are an international group of health professionals, academics, young people, parents, child rights specialists, psychologists and youth workers who are all passionate about the health and wellbeing of children, especially when they interact with healthcare services. The group is made up of over 50 members from around the world. iSupport have been working together throughout 2021 to develop standards for children and young people (aged 0-18 years) undergoing clinical procedures, based on internationally agreed children’s rights set out by the UNCRC (1989). The standards aim to ensure that the short and long-term physical, emotional and psychological well-being of children and young people are of central importance in any decision-making for procedures or procedural practice. The standards have been developed through ongoing and extensive consultation within the collaborative group and with established youth and parent forums. iSupport have also sought wider feedback, input and consensus through an international online survey.
  10. Content Article
    To tackle the serious harms, up to and including death, associated with eating disorders it is crucial that more is done to identify them at the earliest stage possible so that the appropriate care and treatment can be provided. The aim of this guidance from the Royal College of Psychiatrists is to make preventable deaths due to eating disorders a thing of the past.
  11. Content Article
    Health systems currently present a great degree of complexity, which provides risks to patients related to healthcare, and the possibility of incidents with or without harm. Patient safety culture highlights the need to investigate, analyse, and mitigate incidents to reduce risks to the patient. Medication errors have a high potential to do harm in paediatric hospital routines and most of them are preventable. The objective of this study was to describe a severe drug-related adverse event and present the root cause analysis and implemented improvements.
  12. Content Article
    This article describes perceptions of the culture of safety in paediatric primary care in the US, and evaluates whether organisational factors and staff roles are associated with these perceptions. The authors found that perceptions of the culture of safety and quality in paediatric primary care practices were generally positive, but differences in perceptions did exist based on staff role.
  13. Content Article
    This National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report highlights the results of a study into quality of care received by people aged 0-24 receiving long-term ventilation (LTV). It aimed to identify remediable factors in the care provided to children and young people who were receiving, or had received, LTV.
  14. Content Article
    On 3 September 2021 assistant coroner Jonathan Stevens commenced an investigation into the death of Martha Mills, aged 13 years. Martha sustained a handlebar injury whilst cycling on a family holiday in Wales. She was transferred to King’s College Hospital London and died approximately one month later. Her medical cause of death was: 1a refractory shock 1b sepsis 1c pancreatic transection (operated) 1d abdominal trauma.
  15. Content Article
    The purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) was to consider the management and care of preterm labour and birth of twins. Preterm birth—defined as babies born alive before the completion of 37 weeks of pregnancy—is one of the main causes of death, long-term conditions and disability in under-fives worldwide, and 60% of twin pregnancies result in premature birth. The reference event for this investigation was the case of Sarah, who was pregnant with twins and was overseen by an obstetrician during her pregnancy. Sarah was assessed as having a higher-risk pregnancy as she had had previous medical intervention on her cervix and was pregnant with twins. Shortly after having been discharged from a hospital with a specialist neonatal unit following suspected early labour, she went to her local maternity unit at 29+2 weeks with further episodes of abdominal tightening. Her labour did not progress as expected and a caesarean section was required to deliver the babies at 29+6 weeks. The twin girls were born well, but 23 days after their birth a scan revealed brain injury in both babies. The investigation identified several findings to explain the experience of the mother in the reference event, including the lack of scientific evidence or specific guidelines and the uncertainty associated with the clinical decision making in this scenario. This highlighted the need for further research into preterm labour as a recognised risk factor for twin pregnancies. As part of the investigation, HSIB identified that since 2019 a large volume of national work and research in the area of twin pregnancy and preterm birth has been undertaken. The investigation report sets out the work currently in progress and seeks to understand if it will address gaps in knowledge.
  16. Content Article
    This leaflet produced by Group B Strep Support and the Royal College of Obstetrics and Gynaecology provides information about group B Strep (GBS) aimed particularly at pregnant women. It includes; an explanation of what group B Strep is. what GBS could mean for a baby. how to reduce the risk of GBS infection to a baby. a list of the signs of GBS infection in newborn babies.
  17. Content Article
    Foreign body ingestions are common events among paediatric patients. Button battery ingestions are particularly dangerous. Although the incidence of button battery ingestions has not changed over the last 30 years, the rates of emergency department visits, major morbidity, and mortality have risen dramatically since the introduction of the 3-volt–20 mm lithium batteries in 2006. These batteries are larger and more powerful than their predecessors, which has increased the incidence of esophageal impaction and significant tissue injury.  The overall incidence of major morbidity or mortality after button battery ingestion is 0.42%. However, in children under six years old who ingest batteries >20 mm, the rates of major complications are as high as 12.6%. All reported fatalities have occurred in children under five years old. This article in the Anesthesia Patient Safety Foundation newsletter looks at the perioperative management of children who have ingested a button battery.
  18. Content Article
    Our home is a place where we spend so much more time. However, this is one place where there may be fewer safeguards and less protection from the risks of serious injury, especially to young children. Preventable accidental injury remains a leading cause of death and acquired disability for children in the UK. Moreover, it affects deprived children more. Hospital admission rates from unintentional injuries among the under-fives are significantly higher for children from the most deprived areas compared with those from the least deprived. This short article from Ian Evans highlights what healthcare professionals working with children and families need to know about accidents and accident prevention in a higher income setting.
  19. Content Article
    This report draws on data from the National Child Mortality Database (NCMD) to investigate how illness around the time of birth affects the health of children up to the age of 10, and to draw out learning and recommendations for service providers and policymakers. This report aims to understand patterns and trends in child deaths where an event before, or around, the time of birth had a significant impact on life, and the risk of dying in childhood.
  20. Content Article
    This study in BMJ Open Quality examines aspects of workplace culture, employee motivation and leadership behaviours that support continuous learning and improvement, in an effort to measure the transition to high reliability. It reports on the development of two scales (trust in team members and trust in leadership) in a US children’s hospital which was seeking to assess progressive movement towards a ‘culture of safety'. The scales were designed to measure two cultural conditions fostered by the five high reliability principles and a composite measure on local learning activities.
  21. Content Article
    This article tells the story of two-year-old Chloe, who died after hospital staff failed to recognise that she had meningitis, sending her home after her parents first took her to A&E. The NHS Trust carried out an internal investigation which identified many areas where care should have been better and set out a range of recommendations for improving care of children in A&E in the future. The Trust only apologised to the family after an out-of-court settlement was made.
  22. Content Article
    The Australian Institute of Health Innovation conducts world-class research to catalyse health service and systems improvements in Australia and internationally. Its research generates highly practical evidence-based recommendations and information that health services can implement or use now. The Health Innovation Series supports clinicians, hospitals, policy makers and developers to apply this evidence to enhance the health system and services. The Health Innovation Series communicates research evidence in an easy-to-read, short format with clear recommendations, covering a wide range of topics. 
  23. Content Article
    Insufficient milk intake in breastfed neonates is common, frequently missed, and causes preventable hospitalisations for jaundice/hyperbilirubinaemia, hypernatraemia/dehydration, and hypoglycaemia - accounting for most U.S. neonatal readmissions. These and other consequences of neonatal starvation and deprivation may substantially contribute to fully preventable morbidity and mortality in previously healthy neonates worldwide.This article argues that modern misconception of exclusive breastfeeding as natural and thus safe causes common and preventable harm to neonates. This review shows that the evidence regarding common and preventable harm to neonates associated with breastfeeding insufficiencies is sufficient to warrant fundamental changes to early infant feeding policies and practices.
  24. Content Article
    Andrew Stroud's daughter Bia has type 1 diabetes, and in this blog, Andrew talks about his family's experiences supporting Bia to manage her diabetes. He describes the huge value of technology in improving diabetes management and reducing the mental burden of the condition on people with diabetes and their parents and carers. However, like all technology, medical devices for diabetes can fail, and Andrew highlights the need to be prepared for this situation to ensure the person with diabetes is safe while they cannot use the devices they rely on every day.
  25. Content Article
    The Royal College of Paediatrics and Child Health (RCPCH) is issuing the UK’s paediatricians with detailed advice on how they can help households in poverty. It has drawn up a series of resources, including advice for doctors treating children to use appointments to talk sensitively to their parents about issues that can have a big impact on their offspring’s health. These include diet, local pollution levels, socio-economic circumstances and difficulties at home or school, which are closely linked to children’s risk of being overweight, asthmatic or stressed.
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