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Whittington A&E changes: a cause for ‘deep unease’

Junior doctors said they contacted the British Medical Association about the staffing issues

16 October, 2020 — By Tom Foot

Whittington Hospital

Junior doctors at the Whittington have written to its management expressing “deep unease” at a major overhaul of children’s A&E services.

A letter sent this week warned there was a “critical shortage” of nursing staff and beds led by an “overworked and under-experienced team” will put paediatric patients’ safety at risk.

All north London child patients are now being taken to the Whittington after the paediatric emergency units at the Royal Free and University College Hospital were shut down.

NHS chiefs say the changes are a temporary response to the Covid-19 pandemic and have the backing of clinical directors at the three hospitals.

But the Tribune has been contacted by several senior clinicians in the past fortnight and now a junior doctors’ letter on Whittington-headed paper warning of a “risk to patient safety” has been leaked.

The letter said: “As front-line workers, it has already been a gruelling year responding to Covid-19: many of us have faced redeployments, cancelled time off, illness and a multitude of other personal challenges. These latest changes will further erode our morale and bring a significant risk of burnout.”

The letter said that nationally reorganisations of hospital services had already led to “excess morbidity and mortality amongst children”, adding: “An overworked, under-experienced team, working in limited physical space, is not a recipe for safe or effective care. We feel these changes are being rapidly forced through without adequate planning, oversight or consultation.”

Any children arriving at the Royal Free and UCH are now being redirected to the Whittington in Highgate.

Shirley Franklin, from Defend Whittington Hospital Coalition, said: “We understand there is a requirement for flexibility from staff, but equally there is a need for management to be open about the issues.

“Management is telling us one thing and people in the hospital are saying another. “These people need to take it to their unions. The central problem is the lack of funding coming from central government.”

The junior doctors said they had contacted the British Medical Association about the staffing issues and rota management.

The Tribune reported last month how consultants at UCLH and the Royal Free have raised similar safety warnings with commissioners in three separate letters.

This week, the senior paediatric consultant at UCLH signed a public petition so far backed by more than 2,000 people. North London Partners – a health authority for five north London boroughs including Islington – was set up to find efficiencies of up to £1billion in five years.

Managers have been looking at reducing the number of paediatric emergency units for years and there are concerns among insiders that the Covid pandemic has been used to realise a long-held cost-cutting ambition.

Its managers stressed this week that the changes are technically temporary until the spring when a consultation would be held if it was decided to make the new set-up permanent.

They could not guarantee that this would happen, hinting “we will need to continue to respond to the ongoing challenge of the pandemic for a long time to come”.

A North London Partners spokesman said: “Our staff are our most valuable asset. We met with junior doctors last week to discuss their concerns in detail and we were able to address many of these concerns. We welcome people asking questions and raising concerns, and we take them very seriously.”

A statement signed by medical directors of the three hospitals said: “We absolutely recognise how unsettling these changes may be for patients and their families, especially when they have been treated by a particular hospital for a long time.

“But we would like to reassure everybody that the changes are temporary and have been carefully thought through over the last four months.

“They have also been risk assessed by experienced doctors and nurses who have worked in our hospitals for many years.”


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