A CHILDREN'S ward which has been closed to overnight admissions since July should not rush to resume a 24/7 service, an expert report has warned.
The review by the Royal College of Paediatrics and Child Health (RCPCH) said that a return to full inpatient care with out-of-hours cover remained its "preferred model" for the 14-bed children's ward at St John's Hospital in Livingston, but stressed that ongoing staff shortages mean that "24/7 working is currently neither safe nor sustainable".
Read more: Children's ward to close for summer
The report added: "There is a risk that moving back to a 24/7 model too early will put too much pressure on staff, further damaging morale and risking regular closures which is unsettling for the population and for staff."
Despite a string of national and international recruitment campaigns, NHS Lothian has been unable to recruit the number of paediatric consultants needed to safely provide round-the-clock care.
As a result, the health board decided to close the ward temporarily to inpatient admissions from July 7 - the third such closure in five years. The paediatric day surgery, outpatient clinics and GP assessments have continued to operate normally.
Although NHS Lothian said it was committed to reinstating the service "as soon as possible after the summer", it remains closed to admissions and patients from the West Lothian region are travelling 20 miles to the Royal Hospital for Sick Children in Edinburgh instead.
Read more: Row over 'secret' report into children's ward
The report noted that during the first six weeks after the service change, 19 of the 22 children requiring an emergency transfer from A&E at St John's to the RHSC were picked up by an ambulance within the 19 minute target time and a further eight "very urgent" cases were collected within an hour. However, it added: "This was during the relatively quiet summer period and even then four 'less urgent' cases had to wait over four hours, with one waiting over seven hours for transfer. This is an area that must be urgently addressed by the health board, particularly with the winter pressures likely to exacerbate the problem."
Labour MSP for Lothian, Neil Findlay, said: “This report underlines what local people have been saying for months – the children’s ward at St John’s should stay open 24/7.
“The workforce crisis in our health service has meant the ward has now been closed to out of hours admissions since July. That is simply a disgrace with parents facing a twenty mile trip to Edinburgh with a sick child.”
Read more: Row over psychiatrist 'gagged' over Livingston maternity unit
The RCPCH report is a follow-up to its 2016 report on the unit. It said that St John's had "been running on fragile staffing rotas since at least 2008".
It added: "It has a longstanding reputation as a unit that is under threat of closure and the large number of reviews and assessments that have been conducted have all concluded similarly with little tangible change to the situation. This is a significant blight on recruitment."
However, the report stressed that "at no point" had the review team being told that "cost-cutting" was behind the decision to close inpatient beds.
Jacquie Campbell, Chief Officer of Acute Services, NHS Lothian, said: “We are working extremely hard to recruit additional senior staff so that we can reinstate 24/7 services at the site and we remain committed to the service.
“But so far we have been unable to provide sufficient staffing cover to ensure patients receive a safe service overnight.
“We know this is frustrating for patients and families, but the RCPCH has been explicit in their clinical and expert opinion that this decision was the right thing to do."
She added: "We will be looking at these recommendations very carefully in the context of how we can provide patient services safely."
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