"I was shocked that paediatric ..."

About: Queen Elizabeth I I Hospital (Welwyn Garden City)

(as the patient),

What could be improved

I was shocked that paediatric A&E shuts at 9pm. My child's treatment had to be halted until another hospital had been found for an overnight stay. The Lister was full so was offered Cambridge which, in my opinion, is too far for a sick child to travel to, let alone family members.

Anything else?

By shutting paediatric a&e at night means that nurses end up spending their time organising transfers to other hospitals rather than providing care. It was quite obvious that they are also not happy with the night time closure and seemed to feel undermined in their role.

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Response from Queen Elizabeth I I Hospital

We’re very sorry that your experience of our children’s emergency service at the QEII was not as good as we would have liked. In responding to your comments, we hope that you don’t mind us going in to a little detail – something other readers of these comments may find helpful.

The decision to transfer overnight children’s emergency services from the QEII to the Lister hospital was made on the grounds of clinical safety, following an independent review called Better care for sick children that in turn led to a lengthy and detailed public consultation in 2005.

The change to overnight facilities was made on 1 August 2008, once an expanded new 24-hour children’s A&E and assessment unit was completed at the Lister. The children’s emergency service at the QEII continues to operate between the hours of 7.30am and 9.00pm every day of the week.

In the run-up to this change, we used a wide variety of ways to make sure that as many parents and carers as possible in east Hertfordshire and surrounding areas were aware of what they needed to do in an emergency at night. This included coverage in local newspapers, mailing of leaflets to GP practices and other primary health care staff, as well as to people’s homes across east Hertfordshire as loose inserts in local papers.

Since 1 August 2008, our communication efforts have continued. For example in September last year we asked all primary schools in the area to distribute the same leaflets to those caring for children. Following weekly audits of children attending our out-of-hours services at the QEII, we looked to identify those groups of people who may not have heard about the changes, working with our local primary care trust and specific GP practices. We have also worked in partnership with the local ambulance services, to ensure safe and timely transfer of children.

On a few occasions every year, our children’s ward can become full. Since children must be admitted to a children’s ward, we have no option other than to seek a bed in a nearby hospital with the right facilities for the child in question. Clearly we try our best to make sure that the family is inconvenienced as little as possible, but this must be balanced against the child’s clinical needs.

The Trust’s medical and nursing teams responsible for providing services to children across east and north Hertfordshire, as well as parts of Bedfordshire, are dedicated and committed completely to the provision of safe, effective and high quality care. The changes to the Trust’s children’s services over the last few years have resulted in real and sustained improvements in the care that children receive overall. It is worth noting that in the run up to the changes that took place in August 2008, the QEII unit was facing increasing incidences of being closed at short notice due to staffing difficulties.

If you remain unhappy with this explanation, we would welcome receiving a formal complaint so that we can investigate your particular case in detail and give you the written response that may well help you understand what happened and why. Your complaint can be sent to: patcomplaints.enh-tr@nhs.net

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